TMJ Injury and Motor Vehicle Accidents

The relationship between TMJ pain and whiplash injuries has gained much attention in the last few years, and two new studies provide some more information on this problem.

The first study¹ examined the relationship between accident mechanics and TMJ symptoms in 219 patients after motor vehicle accidents (MVAs). Not surprisingly, the researchers found that higher speed collisions were more likely to result in TMJ problems than were lower speed collisions. However, they also found patients were more likely to have TMJ pain if they had their head turned in either direction at the time of the collision, or if their car was hit from the rear. The study also noted that a large percentage of the TMJ patients were women—89%. Delayed onset was also a problem addressed: 15% of the patients reported that the symptoms appeared one month or longer after their accident.

The second study,² by the same team of researchers, was a follow-up evaluation of patients who had received treatment for TMJ pain after an MVA, but who were no longer receiving treatment. 30 patients were given phone interviews regarding their current symptoms (if any), current treatment, current insurance claims and litigation—an average of 52 months after their accidents.

The study found that 73% of the patients had their insurance claim or litigation settled at the time of the interview, an average of 21 months earlier. However, 23 patients (76.7%) reported that they still had symptoms from their injury, and 8 (26.7%) felt that their jaw symptoms interfered with their daily activities. Only 8 reported that they had no more jaw pain, but two of these had had some pain since the settlement or in the last 3 months. Twenty-three patients (76.7%) reported that they had headaches, and 25 (83.3%) stated that they currently had neck pain.

When the patients were divided into those with current litigation and those who had settled, the researchers found no virtually no difference between the two groups in terms of symptoms—in fact, the group of patients with settled claims reported slightly more neck pain than those with pending litigation.

1. Burgess JA, Kolbinson DA, Lee PT, Epstein JB. Motor vehicle accidents and TMDS: assessing the relationship. Journal of the American Dental Association (JADA) 1996;127:1767-1772.
2. Kolbinson DA, Epstein JB, Burgess JA, Senthilselvan A. Temporomandibular disorders, headaches, and neck pain after motor vehicle accidents: a pilot investigation of persistence and litigation effects. The Journal of Prosthetic Dentistry 1997;77(1):46-53.