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GAZETTE
Whiplash and its Effects on the Temporo
Mandibular Joint
Whiplash can often cause damage to
the jaw joints and muscles, which if
unrecognised and untreated, can
later become a dominant medical
problem, writes Dr. Meurig
Devonald*
"Whiplash" is the common term for
neck injury which often occurs when
riding in a car which is involved in a
road accident. Typically, the passen-
ger's head forcibly snaps backward as
the body is thrown forward. The head
may then snap forward in a recoil
motion. This severe backward and
forward motion damages the neck
muscles and especially the soft tissues
(muscles and ligaments) supporting the
neck, head, and jaw.
It is easy to see why this damage
! happens, when you consider that the
head itself weighs up to 15 pounds (the
weight of an average bowling ball).
When this "bowling ball" snaps
backward, it creates 500 to 600 lbs. of
! force on the neck! Women are even
more vulnerable to whiplash injuries
than men because their neck muscles
are smaller in relation to head weight.
| Persistent Symptoms of Whiplash
Since injuries to soft tissues do not
show up on x-rays, it is difficult to see
immediately whether or not these
injuries have occurred as symptoms
may not be felt until hours or days after
the accident. Once symptoms do
appear, however, they can be very
painful and quite persistent.
j
Whiplash symptoms include:
• neck pain, stiffness, and decreased
range of motion,
! • headaches,
[ • numbness of the head and face,
i • blurring of vision and pain behind the
i
eyes,
• problems with balance,
j • difficulty swallowing,
: • ringing in the ears,
•jaw pain.
Dr. Meurig Devonald.
One reason why symptoms may persist
is because in many cases of whiplash,
the jaw joint and the muscles which
support the jaw are damaged as well.
The accident may trigger a condition in
which these muscles go into spasm and
become very painful. Specific clues as
to whether this damage occurred
include:
• pain in or around the jaw joints,
• clicking or popping of the jaw joints,
• locking or limited opening the mouth,
• difficulty with bringing your teeth
together.
Because both patients and health care
providers often do not suspect that the
jaw joints and muscles may have been
damaged, this aspect often goes
unrecognised. When not recognised
and untreated it can become the
dominant medical problem.
Two recent studies using magnetic
resonance imaging have shown that
J
between 87% and 94 % of people who
j had suffered a whiplash injury without
j
direct trauma showed damage and
dislocation of jaw tissue associated
| with the headaches, spasms and
general pain experienced with having
! their heads whipped backwards and
then forwards suddenly.
The Preventive Dental Research Group
] studied 500 people injured in motor
vehicle accidents whose cases had been
settled, but were still suffering from
I injuries traced back to the accident
I itself.
These are all typical symptoms of a
' temporo mandibular joint (TMJ)
| injury but were undiagnosed at the
time.
In motor vehicle accidents, particularly
in rear end collisions, the suddenness
This study revealed that the residual
! symptoms were:
i
• headaches,
• neckaches,
• backaches,
• earaches,
• ringing in the ear,
• clicking noise when opening and
closing the mouth,
• difficulty when swallowing,
• hearing loss,
• pain in chewing,
• pain in the face and jaws,
• dizziness.
Figure 1 - Anterior Neck Muscles Anchor the Mandible Resulting in a Dislocation.