Dental Problems


Whiplash is an injury to the neck which often happens to people in automobile accidents. Among those victims of whiplash, 60% never fully recover. This could be because of unrecognised damage to your jaw joints and muscles which support those joints. This page explains how that damage might occur from a whiplash and how your dentist might help.

'Whiplash' is the common term for a neck injury which often occurs when riding in a car which is hit from behind. Typically, the passenger's head forcibly snaps backward as the body is thrown forward. The head may then snap forward in a recoil motion. This severe backward and forward motion damages the neck muscles and especially the soft tissues (muscles and ligaments) supporting the neck, head, and jaw.

It is easy to see why this damage happens, when you consider that the head itself weighs up to 15 pounds (the weight of an average bowling ball). When this 'bowling ball' snaps backward, it creates 500-600 pounds of force on the neck! Women are even more vulnerable to whiplash injuries than men because their neck muscles are smaller in relation to head weight.

Persistent Symptoms of Whiplash
Since injuries to soft tissues do not show up on x-rays, it is difficult to immediately see whether or not these structures have been damaged. The symptoms may not be felt until hours or days after the accident. One symptoms do appear, however, they can be very painful and quite persistent.

Whiplash symptoms include:
- Neck pain, stiffness, and decreased range of motion
- Headaches
- Numbness of the head and face
- Blurring of vision and pain behind the eyes
- Problems with balance
- Difficulty swallowing
- Ringing in the ears
- Jaw pain

One reason why symptoms may persist is because in many cases of whiplash, the jaw joints and the muscles which support the jaw are damaged as well. The accident may trigger a condition in which these muscles go into spasm and become very painful.

Specific clues as to whether this damage occurred include:
- Pain in or around the jaw joints
- Clicking or popping of the jaw joints
- Locking or limited opening of your mouth
- Difficulty with bringing your teeth together

Because both patients and healthcare providers often do not suspect that the jaw joints and muscles may have been damaged, this aspect often goes unrecognised. When not recognised and treated it can become the dominant medical problem.

How can the jaw be affected by a neck injury? To understand this, it is necessary to have some understanding of how the head, neck, and jaw are related.

Balancing the Head on the Spine

In everyday life, carrying the head upright is no small task! The head is completely supported by the neck - which also serves as the head's lifeline to the rest of the body. The uppermost part of the spine provides the skeletal support for the neck. These seven small bones, or vertebrae, are called the cervical spine. Attached to and between the vertebrae are pads of cartilage called discs, which act as cushions or shock absorbers as the spinal bones move. The skull sits on top of the atlas - the uppermost bone of the cervical spine. The Atlas is appropriately named after the Greek god who supported the weight of the world on his shoulders.

How the Jaw Attaches
The mandible, or jaw, is the moving part of the head that is involved in speaking, chewing, and swallowing. It is attached to the skull by two joints on either side of your head, just in front of your ears. These joints are called the Temperomandibular Joints (TMJ for short). These joints also have a small disc of cartilage which sits on tope of each joint like a cap to allow for smooth movement of the jaw. Jaw movement is controlled by a complex balance of many muscles. Some of these muscles attach the jaw to the skull. These allow you to close your teeth together. Others attach the jaw to the front of the neck from below, and allow you to open your mouth very wide. Keeping the head properly balanced on top of your spine involves the many muscles of the jaw, neck, shoulders and back.

When the neck is forced to move beyond its normal range of motion, as with a whiplash, the muscles and ligaments stretch and tear. The discs which cushion and protect the neck vertebrae may also be damaged.

Jaw Joint Damage from Whiplash
The muscles which control your jaw are also affected. Those which attach the jaw to the front of the neck do not have time to relax. They end up anchoring the jaw by holding it still so that the mouth opens too wide while the head snaps back. This excessive opening of the mouth while the head snaps backward may cause the jaw joints to dislocate. They are often rammed up against the back of the delicate part of the skull bone which encases these joints. As with the spinal column, this may compress and damage the disc which cushions each jaw joint from these delicate areas. It is estimated that 38% of all impulses that go to your brain pass by the TMJ area. Consequently, when these joints are displaced, they impinge on sensitive nerve endings and cause a variety of symptoms. Many of these symptoms are quite similar to those which are typically associated with whiplash.

If you, a friend, or a relative are suffering from the persistent symptoms of whiplash and suspect that your jaw joints and surrounding muscles might have been damaged, contact your dentist. Your dentist will conduct a thorough evaluation of the joint area. If the jaw muscles or joints were damaged, treatment will involve fitting an orthotic device, or 'splint' between your upper and lower teeth. This will limit the movement of the injured joints and properly support the jaw so that pain is reduced and healing can occur. It will also prevent further damage to the TMJ area.

Where to find us
Based in Argyll, on the West Coast of Scotland, Stewart Wright currently practices two days per week in Oban.