The Course of Orofacial Pain and Jaw Disability After Whiplash Trauma

Abstract

Study Design. Prospective cohort study. Objective. The aim of this study was to evaluate the course of orofacial pain and jaw disability in relation to neck pain, neck disability, and psychosocial factors at the acute stage and the chronic stage after whiplash trauma. Summary of Background Data. Many individuals report chronic pain in the orofacial region after whiplash trauma. The possible association between whiplash trauma and orofacial pain is debated. Prospective studies are therefore needed to evaluate the development of orofacial pain after whiplash trauma. Methods. Within 1 month following a whiplash trauma, 176 cases were examined and compared to 116 controls with questionnaires concerning neck and jaw pain and related disability, nonspecific physical symptoms and depression. At the 2-year follow-up, 119 cases (68%) and 104 controls (90%) were re-examined. Results. Compared to controls, cases reported more jaw and neck pain, both at baseline and follow-up. A majority (68%) of cases with pain in the jaw region in the acute stage also reported jaw pain at the follow-up. The intensity of jaw and neck pain was correlated both at baseline and follow-up. Both neck pain and jaw pain were correlated to nonspecific physical symptoms and to depression. Conclusion. Orofacial pain and jaw disability related to neck pain are often present already at the acute stage after whiplash trauma and persist into the chronic stage for most individuals. Assessment following whiplash trauma should therefore include both the neck and the orofacial regions. More studies are needed to further evaluate risk factors for development of orofacial pain after whiplash trauma. Level of Evidence: 3

Clinical signs in the jaw and neck region following whiplash trauma—A 2‐year follow‐up

“…The higher odds ratios among cases regardless of time, implies that pain on palpation is unchanged over a 2‐year period and that cases do not improve nor get worse. We previously reported more self‐reported jaw symptoms after whiplash trauma (Lampa et al, 2020), and the lack of time effect for clinical signs in the orofacial region in the present study commensurate with this.…”

“…The study was approved by the Regional Ethical Review Board in Umeå, Sweden (Dnr 2010-156-31 M) and was conducted in accordance with the World Medical Association Declaration of Helsinki. Parts of the questionnaire data for the baseline characteristics have been reported previously (Lampa et al, 2020).…”

“…Jaw and neck trauma (Lampa al., 2020), and the of time effect for clinical signs in the orofacial region in the present study commensurate with this.…”

“…Common symptoms are neck pain, neck disability and headache (Al‐Khazali et al, 2020; Sterner & Gerdle, 2004) with a higher risk for long‐term symptoms among women (Walton et al, 2013). Other common symptoms include posttraumatic stress and depression (Stålnacke, 2009), visual disturbances, fatigue and pain in other body parts (Styrke et al, 2014) including pain in the orofacial region (Carroll et al, 2007; Lampa et al, 2020).…”

Jaw‐neck motor function in the acute stage after whiplash trauma

“…In this context, it is worthwhile to also consider that high intensity of neck pain in the early stage after whiplash trauma is a negative prognostic factor for recovery 10 . Furthermore, individuals with jaw pain in the acute stage after whiplash trauma have a high risk of reporting jaw pain also in the chronic stage 51 . Therefore, examination of the jaw system should be considered by health and dental care providers in conjunction with a whiplash trauma for early identification and management of individuals at risk for long‐term jaw pain and dysfunction.…”