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Whiplash in the neck from a car accident is usually paired with temporomandibular joint injuries (TMJ).  It was found that 95% of people with neck whiplash (cervical hyperextension/hyperflexion injuries) from a car accident also had TMJ abnormalities.  MRI’s were taken of people that had been in a motor vehicle accident (MVA).  It was found that 95% of patients who had cervical whiplash but had not sustained direct trauma to the face, head, or lower jaw (mandible) and had no TMJ complaints before the MVA ended up with TMJ injuries.  The most common injury was disc displacement with reduction followed by effusion, inflammation or edema, and disc displacement without reduction.

Injury percentage:

• Disc displacement with reduction 72%
• Disc displacement without reduction 15%
• Effusion 69%
• Inflammation or edema 51%

Due to the jaw’s proximity to the neck, it is not surprising that one would affect the other.  Best practice for an examiner after a MVA is to check adjacent areas to any area of injury.  However, when I was taught this at school, they beat it into us that if the patient’s neck hurt, you should check the shoulder and the mid-back (for all patients not just motor vehicle patients).  If the shoulder is hurt check the neck, midback, and do a cursory look at the elbow.  If the midback hurts look at the neck, low back and a cursory exam for the shoulder and make sure you ask appropriate questions about organ function.  You get the point.  What is interesting to me about this study is that it changes how I address the jaw with regard to MVA’s.  Best practice before I read this study was a cursory look at the jaw if there was neck pain after an MVA, especially if there no history of the patient hitting their head on anything or of them having loss of consciousness (LOC).  If they have hit their head during the MVA, had LOC, or are complaining of jaw pain, then I would do a full exam on the jaw.  This seems obvious.  But after reading this study I will now be changing my practice to include a full exam of the jaw with all neck whiplash patients.

Reference

Garcia, Ralph, D.D.S, Arrington, John, M.D. (2016) The Relationship Between Cervical Whiplash and Temporomandibular Joint Injuries: An MRI Study. https://www.tandfonline.com/doi/abs/10.1080/08869634.1996.11745973