Temporomandibular Disorder Pain After Whiplash Trauma: A Systematic Review

Keywords: Temporomandibular joint dysfunction, TMD, temporomandibular joint, TMJ, Orofacial pain, mouth, joint pain, TMD joint pain, whiplash, neck injury, rear-end collision, and chronic pain.

Whiplash is a neck injury usually caused by rear-end automobile collisions. Whiplash can be mild or severe and some people may develop chronic pain after a whiplash injury. A recent review aimed to assess the prevalence of temporomandibular disorder (TMD) pain after whiplash trauma and whether treatments commonly used for TMD are equally effective in patients with TMD pain and those with TMD/whiplash-associated disorders (WAD) pain. After an in depth search and review of 125 articles, the studies reported median prevalence of TMD pain after whiplash trauma was 23%. The article goes on to explain there is some evidence that prevalence and incidence of TMD pain is increased after whiplash trauma. Dr. Stan Farrell, whose office is located in Scottsdale, Arizona, uses the most effective methods of treatment and works diligently to erase the pain caused by TMD in the lives of his patients. If you or someone you know has experienced TMD pain after whiplash trauma, please schedule an appointment for a consultation with Dr. Farrell at 480-945-3629. www.headpaininstitute.com

Birgitta Häggman-Henrikson, DDS, PhD/ Thomas List, DDS, Odont Dr/Hans Westergren, MD, PhD/Susanna Axelsson, DDS, Odont Dr

Aims: To assess, by systematic review of the literature, (1) the prevalence and incidence of temporomandibular disorder (TMD) pain after whiplash trauma, and (2) whether treatment modalities commonly used for TMD are equally effective in patients with solely TMD pain and those with TMD/whiplash-associated disorders (WAD) pain. Methods: A systematic literature search of the PubMed, Cochrane Library, and Bandolier databases was conducted from January 1966 through October 2012. The systematic search identified 125 articles. After an initial screening of abstracts, 45 articles were reviewed in full text. Two investigators evaluated the methodological quality of each identified study. Results: Eight studies on prevalence/incidence of TMD pain in WAD and four studies on interventions in TMD pain and WAD met the inclusion criteria. The reported median prevalence of TMD pain after whiplash trauma was 23% (range 2.4% to 52%) and the incidence ranged from 4% to 34%. For healthy controls, the reported median prevalence was 3% (range 2.5% to 8%) and the incidence ranged from 4.7% to 7%. For patients with a combination of TMD pain and WAD, treatment modalities conventionally used for TMD, such as jaw exercises and occlusal splints, had less of an effect (median improvement rate of 48%, range 13% to 68%) compared to TMD patients without a whiplash injury (75%, range 51% to 91%). Conclusion: There is some evidence that prevalence and incidence of TMD pain is increased after whiplash trauma. The poorer treatment outcome suggests that TMD pain after whiplash trauma has a different pathophysiology compared to TMD pain localized to the facial region.