Jaw symptoms and signs and the connection to cranial cervical symptoms and post-traumatic stress during the first year after a whiplash trauma

• Published in: Disability and rehabilitation 2010, Vol.32 (24), p.1987-1998
• Main Authors: Severinsson, Yvonne, Bunketorp, Olle, Wenneberg, Bengt
• Format: Article
• Language: English
• Subjects: Accidents; Accidents, Traffic - classification; Activities of Daily Living; Adult; Aged; Biomechanical Phenomena; Biomechanics; classification; complications; epidemiology; etiology; Female; First year; Headache; Headache - epidemiology; Headache - etiology; Headaches; Humans; jaw; Jaw Diseases; Jaw Diseases - epidemiology; Jaw Diseases - etiology; Kirurgi; Logistic Models; Male; Mastication; Middle Aged; Neck Pain; Neck Pain - epidemiology; Neck Pain - etiology; Nonparametric; Odontologi; Odontology; Post-Traumatic; post-traumatic stress; Posttraumatic stress disorder; Prospective Studies; rehabilitation; Road accidents; Statistics; Statistics, Nonparametric; Stress Disorders; Stress Disorders, Post-Traumatic - epidemiology; Stress Disorders, Post-Traumatic - etiology; Surgery; Sweden; Sweden - epidemiology; Traffic; Whiplash; Whiplash Injuries; Whiplash Injuries - complications; Whiplash Injuries - rehabilitation
• ISSN: 0963-8288; 1464-5165; 1464-5165
• DOI: 10.3109/09638281003797323

Purpose. To estimate the prevalence of jaw symptoms and signs during the first year after a neck sprain in a car collision. Further, to determine their relationships to the localisation and grade of the initial neck symptoms and signs, headache, post-traumatic stress and crash characteristics. Methods. One hundred and forty-six adult subjects and crash characteristics were prospectively investigated in an in-depth study during 1997-2001. Head, neck, and jaw symptoms and signs were recorded within 5 weeks and after 1 year. Acute post-traumatic stress was estimated with the Impact of Event Scale-Revised (IES-R). Results. Jaw symptoms were initially reported by three men (5%) and three women (4%), and subsequently developed in eight women (10%) during the following year. Jaw signs were noted initially in 53 subjects (37%) and in 28 subjects (24%) after 1 year, without difference between sexes, and more often after low-speed impacts. Headache in females, cranial cervical symptoms, pronounced neck problems, post-traumatic stress and whiplash-associated disorders (WAD) grade II-III after rear-end impacts were related to jaw signs during the acute phase. After 1 year, jaw signs were related to residual neck problems, headache and post-traumatic stress. Conclusions. Jaw symptoms are seldom reported during the acute phase after a whiplash trauma. Women more often than men develop jaw symptoms during the first year. Jaw symptoms and signs may develop also after low-speed impacts, especially after rear-end collisions. Jaw symptoms and signs should be observed after whiplash trauma, especially in those with headache, pronounced neck problems, cranial neck symptoms and post-traumatic stress.