Health Journal Healthy Life, Happy Family
Article List
The aftermath of a car accident and temporomandibular joint dysfunction

In today’s society, the car has become an indispensible commodity. In fact, in Korea, there is 1 car for every 4 people and growing! As vehicle use and ownership increase, so also does the prevalence of traffic accidents, as well as the problems surrounding them.

Most people don’t think of going to a dentist after a car accident unless they specifically have an injury to the face, jaw, or other areas of the mouth. However, over 60% of patients injured in traffic accidents do not receive appropriate care despite physiotherapy, orthopedic therapy, and even neurological treatment.

Whiplash, an injury where the head and neck are violently rocked back and forth, is a common traffic accident injury. This can cause damage in the ligaments and muscles around the cervical vertebrae, and also cause headaches, pain, and stiffness in the neck. The aftermath of an accident includes headaches, frozen shoulder pain, lower back pain, dizziness, and abnormalities in the eyes and ears. The fact that these symptoms are accompanied by a sudden change in the occlusion of the temporomandibular joint has raised the concern of dentists as a follow-up treatment to traffic accidents. In fact, these post-accident symptoms are now called temporomandibular joint syndrome, or TMJ syndrome.

Dr. Lader, Dr. Rogal, and Dr. Stewart reported in a 1982 study that 80% of traffic accidents cause damage to the TMJ (temporomandibular joint), and that appropriate TMJ therapy treatment would greatly relieve post-accident symptoms. Unfortunately, due to a lack of realistic diagnostic equipment, it was diffi cult to properly share this information with the general medical community.

However, in the late 1980s, the MRI (magnetic resonance imaging) emerged as an effective tool to observe the condition of the TMJ disc and soft tissue in the aftermath of a traffic accident. This helped inform the rest of the medical community about the relationship between TMJ and traffi c accident injuries.

Unfortunately, our country still does not seem to be enlightened with this information. Patients in Korea often seek orthopedic, neurological, and even acupuncture treatments, but with no success in finding the source of the problem. Eventually, the pain gets worse until they are forced to look in other places in search of a solution. In addition, even if the patient understands the issue of TMJ syndrome, when they seek treatment, their insurance companies often ask why a patient with pain on different parts of the body would seek dental care for treatment. Therefore, the education must extend not just to prospective patients, but also to the insurance companies that provide them health care.

The following demonstrates how traffic accidents can cause temporomandibular joint damage, Cohen and Toole measured and recorded the movement of the head during a rear impact collision, as a rapid 138 ° movement of the head and neck.

This excessive movement (hyperdistension) surpasses the limit of 80 ° which is the range of normal motion. An average head, which is about the weight of a bowling ball (4.5kg), rocking back and forth in a sudden, violent motion cannot not have problems. In particular, rear impact collisions results in greater damage because there is no support or protection.

When the head is suddenly and excessively bent backward, the mandible (jaw) will lift up from its fixed position in the mouth. In such conditions, the disc of the temporomandibular joint can be displaced and cause several issues.

Temporomandibular joints are much more complex than one might think, controlling a number of important human tissues (blood vessels, nerves, ligaments, muscles, etc.) and can even have an impact on the liver. Therefore, it is very important to check the condition of the TMJ after any accident.

When the head is bent backward, the recoil brings it back towards and into the chest so that the chin hits the chest bone (solar plexus). The impact can cause internal bleeding in the area as well as fractures in the lower jaw between the jaw joints and skull.

This is the reason why you lose your senses momentarily in a traffi c accident. It is the same principle of a boxer giving a KO uppercut that momentarily knocks his opponent senseless. This sudden shock causes damage to the tissue surrounding the teeth, as well as creating tiny invisible fractures in the teeth which eventually lead to sensitivity to cold beverages or air.

After an accident, therefore, it is important to seek chirodontic treatment (therapeutic dentistry) for jaw joint calibration and head-to-toe treatment of the entire body to ensure proper recovery.