umu.sePublikationer
Ändra sökning
RefereraExporteraLänk till posten
Permanent länk

Direktlänk
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Annat format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annat språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf
Effects on jaw function shortly after whiplash trauma
Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.ORCID-id: 0000-0002-7431-9618
Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
Umeå universitet, Medicinska fakulteten, Institutionen för farmakologi och klinisk neurovetenskap, Klinisk neurovetenskap.
Umeå universitet, Medicinska fakulteten, Institutionen för odontologi. Department of Orofacial pain and Jaw function, Malmö University, Malmö, Sweden.ORCID-id: 0000-0001-6088-3739
2017 (Engelska)Ingår i: Journal of Oral Rehabilitation, ISSN 0305-182X, E-ISSN 1365-2842, Vol. 44, nr 12, s. 941-947Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Normal jaw function involves muscles and joints of both jaw and neck. A whiplash trauma may disturb the integrated jaw-neck sensory-motor function and thereby impair chewing ability; however, it is not known if such impairment is present shortly after a neck trauma or develops over time. The aim was to evaluate jaw function after a recent whiplash trauma. Eighty cases (47 women) were examined within 1 month after a whiplash trauma and compared to 80 controls (47 women) without neck trauma. Participants completed the Jaw disability checklist (JDC) and Neck Disability Index (NDI) questionnaires and performed a 5-minute chewing test. Elicited fatigue and pain during chewing were noted, and group differences were evaluated with Fisher's exact test and Mann-Whitney U-test. Compared to controls, cases had higher JDC (P<.0001) and NDI scores (15% vs 2%, P<.0001), and reported more fatigue (53% vs 31%, P=.006) and pain (30% vs 10%, P=.003) during the chewing test. Cases also had a shorter onset time for fatigue and pain (both P=.001) Furthermore, cases reporting symptoms during chewing had higher JDC and NDI scores compared to cases not reporting symptoms (both P=.01). Symptoms mainly occurred in the trigeminal area for both groups, but also in spinal areas more often for cases than for controls. Taken together, the results indicate that jaw-neck sensory-motor function is impaired already within 1month after a whiplash trauma. The association between neck disability and jaw impairment underlines the close functional relationship between the regions, and stresses the importance of multidisciplinary assessment.

Ort, förlag, år, upplaga, sidor
WILEY , 2017. Vol. 44, nr 12, s. 941-947
Nyckelord [en]
accidents, facial pain, mastication, neck pain, temporomandibular joint dysfunction syndrome, traffic, iplash injuries
Nationell ämneskategori
Odontologi
Identifikatorer
URN: urn:nbn:se:umu:diva-142232DOI: 10.1111/joor.12571ISI: 000414577300003PubMedID: 28891205OAI: oai:DiVA.org:umu-142232DiVA, id: diva2:1164661
Tillgänglig från: 2017-12-11 Skapad: 2017-12-11 Senast uppdaterad: 2020-01-29Bibliografiskt granskad
Ingår i avhandling
1. Pain and disability in the jaw and neck regions after whiplash trauma: a short- and long-term perspective
Öppna denna publikation i ny flik eller fönster >>Pain and disability in the jaw and neck regions after whiplash trauma: a short- and long-term perspective
2018 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
Alternativ titel[sv]
Smärta och dysfunktion i käk- och nackregionerna efter whiplashtrauma : ett kort- och långtidsperspektiv
Abstract [en]

Whiplash trauma, a hyperextension-flexion trauma to the neck that is often related to a car accident, affects tens of thousands in Sweden every year. A significant proportion will develop long-term symptoms including neck pain and dysfunction – this is embraced as Whiplash associated disorders (WAD). Some individuals also develop pain and dysfunction in the orofacial region that is denoted as Temporomandibular disorder (TMD). TMD is common in the population with a prevalence of about 10% but the relation to whiplash trauma is still unclear. The limited number of prospective studies on TMD after whiplash trauma show diverging results, but it has been suggested that TMD develops over time and not in close proximity to the trauma. Prospective studies are needed to determine the course of jaw pain and disability after whiplash trauma.

The general aim of this thesis was to evaluate the presence and course of pain and disability in the jaw and neck regions at the acute and chronic stages after whiplash trauma.

This prospective cohort study included at baseline 176 cases with a recent whiplash trauma, and 116 age and gender matched controls without a history of neck trauma that were recruited from the general population. The cases had visited the emergency department at Umeå university hospital, Sweden, with neck pain within 72 hours following a car accident and had been diagnosed with neck distortion by a physician. The cases were examined within one month after the trauma (December 2010 to January 2016) and at a 2-year followup (December 2012 to January 2018). All participants completed questionnaires regarding pain and disability in the jaw and neck regions, physical symptoms (pain and non-pain items), and depression. At baseline, 80 of the cases and 80 of the controls also completed a 5-minute chewing capacity test. At the 2- year follow-up, 119 cases (68%) and 104 controls (90%) were re-examined with the same questionnaires.

Compared to controls, within one month after a whiplash trauma cases reported significantly more pain in the jaw and neck regions with a positive correlation between the intensity of pain in these regions (Paper I). In the acute stage after trauma, cases, compared to controls, showed a reduced chewing capacity, and this was related to the severity of neck disability (Paper II). For cases, jaw and neck pain correlated positively to each other, to non-specific physical symptoms, and to depression at both the acute (Paper III) and chronic stages (Paper IV). About one third (34%) of the cases reported orofacial pain at baseline, and for a majority of these, the pain persisted at the 2-year follow-up (Paper IV).

The presence of orofacial pain early after a whiplash trauma indicates involvement of central sensitization and spread of pain between the jaw and neck regions. The positive correlations between pain in the jaw and neck regions, and to psychosocial factors, underline the integration of these regions and the importance of a biopsychosocial perspective. The impaired jaw function shortly after a neck trauma further underlines the close sensorimotor relationship between the trigeminal and cervical regions. The finding that orofacial pain is common shortly after whiplash trauma, and often persists into the chronic stage, indicates that assessment in the acute stage should include both the neck and jaw regions. From this, it follows that multidisciplinary teams that entail both medical professions and dentists specialised in orofacial pain can be beneficial in the early assessment after whiplash trauma.

Ort, förlag, år, upplaga, sidor
Umeå: Umeå Universitet, 2018. s. 68
Serie
Umeå University odontological dissertations, ISSN 0345-7532 ; 141
Nyckelord
Jaw pain, Neck Pain, Neck disability, Orofacial pain, Psychosocial factors, Temporomandibular disorders, TMD, Temporomandibular joint, TMJ, Whiplash injury
Nationell ämneskategori
Odontologi
Forskningsämne
odontologi
Identifikatorer
urn:nbn:se:umu:diva-153181 (URN)978-91-7601-953-5 (ISBN)
Disputation
2018-11-30, Sal B, 9 tr, byggnad 1D, Norrlands Universitetssjukhus, Umeå, 13:00 (Svenska)
Opponent
Handledare
Tillgänglig från: 2018-11-09 Skapad: 2018-11-08 Senast uppdaterad: 2018-11-09Bibliografiskt granskad

Open Access i DiVA

Fulltext saknas i DiVA

Övriga länkar

Förlagets fulltextPubMed

Personposter BETA

Lampa, EwaWänman, AndersNordh, ErikHäggman-Henrikson, Birgitta

Sök vidare i DiVA

Av författaren/redaktören
Lampa, EwaWänman, AndersNordh, ErikHäggman-Henrikson, Birgitta
Av organisationen
Institutionen för odontologiKlinisk neurovetenskap
I samma tidskrift
Journal of Oral Rehabilitation
Odontologi

Sök vidare utanför DiVA

GoogleGoogle Scholar

doi
pubmed
urn-nbn

Altmetricpoäng

doi
pubmed
urn-nbn
Totalt: 143 träffar
RefereraExporteraLänk till posten
Permanent länk

Direktlänk
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Annat format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annat språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf