Symptoms and signs of temporomandibular disorders in individuals with chronic whiplash-associated disorders.

The purpose of this study was to compare the prevalence of temporomandibular disorders (TMD) between individuals with chronic whiplash-associated disorders (WAD) and a group of age- and sex-stratified patients attending a Public Dental Service (PDS) clinic. Fifty-four individuals diagnosed with chronic WAD that were referred to a rehabilitation centre constituted the WAD group. The control group consisted of 66 patients at a PDS clinic (C group). Both groups underwent a standardised examination of the masticatory system comprising a questionnaire and a clinical examination. Eighty-nine per cent of the individuals in the WAD group had severe symptoms of TMD according to Helkimo's anamnestic index of dysfunction (A1) compared with 18% in the C group (p < 0.001). The individuals in the WAD group had also more signs of TMD. The maximum mouth opening capacity was 48 mm in the WAD group and 54 mm in the C group (p < 0.001). In the WAD group 17% had a mouth opening capacity < 40 mm compared with 2% in the C group (p < 0.05). Pain on palpation of the jaw muscles and on lateral palpation of the temporomandibular joints was more common in the WAD group (p < 0.001). Pain on mandibular mobility was reported by 30% in the WAD group and by 3% in the C group (p < 0.001). In conclusion, the prevalence of TMD was higher among individuals with chronic WAD compared with an age- and sex-stratified cohort of patients in a general dental practice. The results indicate that trauma to the neck also affects temporomandibular function.