Whiplash may lead to jaw pain, problems

By Anne Harding

NEW YORK (Reuters Health) - People who suffer whiplash injuries in car accidents are at increased risk of having temporomandibular joint (TMJ) problems months later, Swedish researchers report.

Such problems can include pain, locking, and clicking in the joint, which is located directly in front of the ears and hinges the jawbone into the skull.

After a whiplash injury, people should be aware of their increased risk of TMJ problems, and should see a doctor if they experience them, Dr. Annika Isberg of Umea University in Sweden, one of the study's authors, told Reuters Health.

"Doctors should be aware of it and health personnel should be aware of it. Insurance companies should be aware that patients can develop symptoms later," she added.

Isberg and her colleague Hanna Sale, a doctoral candidate at Umea University, sought to better understand whether TMJ pain could result after whiplash trauma; to date, studies on the topic have shown mixed results.

The researchers compared 60 consecutive people with neck symptoms of whiplash after rear-end car collisions to 53 matched individuals who had not experienced any trauma to the head or neck. One year later, 34 percent of the individuals with whiplash reported pain, dysfunction or both in their TMJ, compared to 7 percent of control individuals.

One in five of the people who had suffered whiplash said their TMJ symptoms were their chief complaint.

Women were more likely than men to have such symptoms, and to consider them to be their main complaint.

Reasons for the gender difference aren't clear, noted Isberg, but she pointed out that women tend to face a greater risk of joint problems overall; other researchers have theorized that women have weaker neck muscles than men.

Treatment of TMJ problems varies, said Isberg, and anyone with such problems must be carefully evaluated to make sure they receive the appropriate care. "An individual diagnosis is absolutely necessary to design the treatment for the specific patient," she said.

SOURCE: Journal of the American Dental Association, August 2007.