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Whiplash trauma did not predict jaw pain after 2 years: an explorative study
Umeå University, Faculty of Medicine, Department of Odontology.ORCID iD: 0000-0002-1932-9610
Umeå University, Faculty of Medicine, Department of Odontology.ORCID iD: 0000-0003-2920-6654
Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Rehabilitation Medicine.ORCID iD: 0000-0002-2916-0628
Umeå University, Faculty of Medicine, Department of Odontology.ORCID iD: 0000-0002-7431-9618
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2024 (English)In: Clinical Oral Investigations, ISSN 1432-6981, E-ISSN 1436-3771, Vol. 28, article id 165Article in journal (Refereed) Published
Abstract [en]

Objectives: To explore predictive factors for the development and maintenance of jaw pain over a 2-year period.

Methods: One hundred nineteen cases (73 women) and 104 controls (59 women), mean age 34.9 years (SD 13.9), attended baseline and 2-year follow-up examinations. The whiplash cases visited the emergency department at Umeå University Hospital, Sweden, with neck pain within 72 h following a car accident, and baseline questionnaires were answered within a month after trauma. Controls were recruited via advertising. Inclusion criteria were age 18–70 years, living in Umeå municipality and Swedish speaking. The exclusion criterion was neck fracture for cases and a previous neck trauma for controls. Validated questionnaires recommended in the standardized Research Diagnostic Criteria for temporomandibular disorders were used. Jaw pain was assessed by two validated screening questions answered with “yes” or “no.” A logistic regression analysis was used to predict the outcome variable jaw pain (yes/no) after 2 years.

Results: Whiplash trauma did not increase the odds of development of jaw pain over a 2-year period (OR 1.97, 95% CI 0.53–7.38). However, non-specific physical symptoms (OR 8.56, 95% CI 1.08–67.67) and female gender (OR 4.89, 95% CI 1.09–22.02) did increase the odds for jaw pain after 2 years.

Conclusion: The development and maintenance of jaw pain after whiplash trauma are primarily not related to the trauma itself, but more associated with physical symptoms.

Clinical relevance: The development of jaw pain in connection with a whiplash trauma needs to be seen in a biopsychosocial perspective, and early assessment is recommended.

Place, publisher, year, edition, pages
Springer Nature, 2024. Vol. 28, article id 165
Keywords [en]
Temporomandibular disorders, Whiplash injuries, Facial pain, Jaw pain, Neck pain
National Category
Dentistry
Identifiers
URN: urn:nbn:se:umu:diva-221419DOI: 10.1007/s00784-024-05555-zPubMedID: 38383824Scopus ID: 2-s2.0-85185695499OAI: oai:DiVA.org:umu-221419DiVA, id: diva2:1840040
Funder
Region Västerbotten, RV-909851Region Västerbotten, VLL-324631Available from: 2024-02-22 Created: 2024-02-22 Last updated: 2024-10-25Bibliographically approved
In thesis
1. Perspectives on concurrent jaw and neck pain: function, development and perceptions
Open this publication in new window or tab >>Perspectives on concurrent jaw and neck pain: function, development and perceptions
2024 (English)Doctoral thesis, comprehensive summary (Other academic)
Alternative title[sv]
Samtidig käk- och nacksmärta : funktion, utveckling och upplevelser
Abstract [en]

Background: Jaw and neck pain are prevalent and are often concurrent. Despite this, jaw and neck pain are often assessed and managed separately. Jaw pain is mainly treated within dentistry, whereas pain elsewhere in the body is treated within healthcare. Patients with jaw pain have expressed a struggle with finding the right care. Moreover, early identification and treatment are important factors in pain management in terms of the longterm prognosis for the affected individual. This results in suffering over a prolonged time and increased costs for the health care system. The prevalence of jaw pain is twice as high in connection with a whiplash trauma. However, previous studies on the relationship between orofacial pain and whiplash trauma have mainly been cross-sectional. The main purpose of this thesis was to evaluate and explore function, development and perceptions of concurrent jaw and neck pain.

Methods: The thesis is based on four studies, all with different study designs. The studies were conducted at the Department of Odontology, Umeå University, Sweden, in collaboration with Umeå University Hospital, Sweden. In Study I, with an experimental design, the effect of resistance load on jaw and head movements were evaluated among 26 pain-free individuals. Studies II and III were based on a cohort consisting of 292 individuals that entailed 176 whiplash cases and 116 controls at baseline. All individuals answered questionnaires, and 200 of the 292 had a clinical examination at baseline (one month after the trauma). After two years, 223 individuals repeated the questionnaires and 120 of 223 individuals had a second clinical examination. In study II, clinical signs were evaluated, whereas in study III, predictive factors for jaw pain after two years were explored. In study IV, patients' perspectives on the development of concurrent jaw and neck pain in relation to navigating the health care system were explored. Sixteen individuals with concurrent jaw and neck were interviewed using individual semi-structured interviews.

Results: In the experimental study, the ratio between jaw and head movements was increased when resistance load was applied to the lower jaw, which indicates that the neck involvement increased. In the study regarding clinical signs, cases and women presented more pain on palpation at baseline and at the two-year follow-up. In the explorative study, whiplash trauma did not increase the odds for jaw pain over a two-year period. The development and maintenance of further jaw pain after whiplash trauma was not related to the trauma itself but more associated with non-specific physical symptoms or female gender. In the qualitative study, participants expressed that navigating the health care system was perceived as difficult, and they had a holistic approach regarding their pain and mental status.

Conclusions: Within this thesis we have demonstrated that function and pain in the jaw and neck regions are connected. In addition, navigating the health care system was perceived as difficult, and sufferers wanted to receive confirmation from their health care providers. Therefore, dentistry and healthcare should be aware of the connection between jaw and neck pain. Moreover, an increased collaboration is needed between dentistry and healthcare in terms of multidisciplinary management using a biopsychosocial perspective.

Place, publisher, year, edition, pages
Umeå: Umeå University, 2024. p. 71
Series
Umeå University odontological dissertations, ISSN 0345-7532 ; 151
Keywords
cohort studies, facial pain, longitudinal studies, motor acitivity, movement, musculoskeletal pain, neck pain, temporomandibular disorders, qualitative research, whiplash injuries
National Category
Dentistry
Research subject
Medicine; Odontology; Odontology
Identifiers
urn:nbn:se:umu:diva-230935 (URN)978-91-8070-441-0 (ISBN)978-91-8070-442-7 (ISBN)
Public defence
2024-11-29, Sal B, Byggnad 1D, Norrlands Universitetssjukhus, Umeå, 09:00 (English)
Opponent
Supervisors
Funder
The Kempe FoundationsRegion Västerbotten, RV-909851; RV990480; VLL-324631Umeå UniversityPersonskadeförbundet RTP
Note

Forskningsfinansiärer: Svenska Tandläkare-Sällskapet, Folksam Forskningsstiftelse och SOL, Riksföreningen för Tandläkare inom Forskning, Utbildning och Specialisttandvård.

Available from: 2024-11-08 Created: 2024-10-25 Last updated: 2024-11-11Bibliographically approved

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Böthun, AliciaLövgren, AnnaStålnacke, Britt-MarieLampa, EwaÖsterlund, CatharinaHäggman-Henrikson, BirgittaHellström, Fredrik

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CiteExportLink to record
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Citation style
  • apa
  • apa-6th-edition.csl
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
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  • de-DE
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