umu.sePublications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Effects on jaw function shortly after whiplash trauma
Umeå University, Faculty of Medicine, Department of Odontology.ORCID iD: 0000-0002-7431-9618
Umeå University, Faculty of Medicine, Department of Odontology.
Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neuroscience.
Umeå University, Faculty of Medicine, Department of Odontology. Department of Orofacial pain and Jaw function, Malmö University, Malmö, Sweden.ORCID iD: 0000-0001-6088-3739
2017 (English)In: Journal of Oral Rehabilitation, ISSN 0305-182X, E-ISSN 1365-2842, Vol. 44, no 12, p. 941-947Article in journal (Refereed) 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.

Place, publisher, year, edition, pages
WILEY , 2017. Vol. 44, no 12, p. 941-947
Keywords [en]
accidents, facial pain, mastication, neck pain, temporomandibular joint dysfunction syndrome, traffic, iplash injuries
National Category
Dentistry
Identifiers
URN: urn:nbn:se:umu:diva-142232DOI: 10.1111/joor.12571ISI: 000414577300003PubMedID: 28891205OAI: oai:DiVA.org:umu-142232DiVA, id: diva2:1164661
Available from: 2017-12-11 Created: 2017-12-11 Last updated: 2018-11-08Bibliographically approved
In thesis
1. Pain and disability in the jaw and neck regions after whiplash trauma: a short- and long-term perspective
Open this publication in new window or tab >>Pain and disability in the jaw and neck regions after whiplash trauma: a short- and long-term perspective
2018 (English)Doctoral thesis, comprehensive summary (Other academic)
Alternative title[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.

Place, publisher, year, edition, pages
Umeå: Umeå Universitet, 2018. p. 68
Series
Umeå University odontological dissertations, ISSN 0345-7532 ; 141
Keywords
Jaw pain, Neck Pain, Neck disability, Orofacial pain, Psychosocial factors, Temporomandibular disorders, TMD, Temporomandibular joint, TMJ, Whiplash injury
National Category
Dentistry
Research subject
Odontology
Identifiers
urn:nbn:se:umu:diva-153181 (URN)978-91-7601-953-5 (ISBN)
Public defence
2018-11-30, Sal B, 9 tr, byggnad 1D, Norrlands Universitetssjukhus, Umeå, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2018-11-09 Created: 2018-11-08 Last updated: 2018-11-09Bibliographically approved

Open Access in DiVA

No full text in DiVA

Other links

Publisher's full textPubMed

Authority records BETA

Lampa, EwaWänman, AndersNordh, ErikHäggman-Henrikson, Birgitta

Search in DiVA

By author/editor
Lampa, EwaWänman, AndersNordh, ErikHäggman-Henrikson, Birgitta
By organisation
Department of OdontologyClinical Neuroscience
In the same journal
Journal of Oral Rehabilitation
Dentistry

Search outside of DiVA

GoogleGoogle Scholar

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 60 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf