Gerald S. Fine, D.D.S.

   Oral and Maxillofacial Surgery

Brookline Office
Tel: 617-731-6060

Our commitment is to provide you the highest standard of oral and maxillofacial surgery in a professional manner.

Whiplash and Temporomandibular Disorder

Two weeks ago I examined a patient involved in a motor vehicle accident. Six months earlier she was at a full stop at a traffic signal when her vehicle was struck from behind. The patient was transported to a local hospital, seen and released with no further follow up indicated. She subsequently slowly began to develop symptoms of temporomandibular disorder. My examination at that time did not confirm any findings of TMD and my report to her attorney stated my findings to be unremarkable.

The hypothesis that symptoms of temporomandibular disorder are related to whiplash in the absence of facial impact is often claimed.

Cultural Variations--If symptoms of TMD arise following acute injury to the T.M.J. ( Temporomandibular Joint) or support structures, the incidence of TMD symptoms in motor vehicle accident (M.V.A.) victims should be the similar in different cultures. However studies in Norway and Australia have documented the rarity of TMD among M.V.A. victims who claim to have suffered whiplash injuries. Within the United States, in some regions, TMD symptoms are rarely reported after M.V.A.s. Such data suggest that TMD symptoms reported are not physiologically based.

People who are in accidents are in pain and distress which can increase their susceptibility to information from doctors, lawyers and the media. They may pre consciously recognize that jaw pain is a culturally acceptable outlet for their distress, much as headaches are considered an acceptable response to stress. Although the patient's jaw pain may be real, it is not likely to have been caused by physical injury during the M.V.A. Several studies have examined the forces generated in rear-end collisions and their effects on the mandible and T. M. J.. There is no experimental evidence that the forces experienced in an M.V.A. cause T. M. J. injury.

The relationship between whiplash and motor vehicle accidents is complex and warrants further consideration. Pain may derive from psychological and cultural factors rather than physical injury.

‍Gerald S. Fine, D.D.S.
Practice limited to oral & maxillofacial surgery‍