The Role of Trauma and Whiplash Injury in TMD
The effects of direct or indirect trauma to the jaw and temporomandibular joint (TMJ) can have both short- and long-term consequences. This chapter will explore direct and indirect trauma in relation to temporomandibular disorders (TMDs). Definition of tr
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The Role of Trauma and Whiplash Injury in TMD Sonia Sharma, Richard Ohrbach, and Birgitta Häggman-Henrikson
Abstract
The effects of direct or indirect trauma to the jaw and temporomandibular joint (TMJ) can have both short- and long-term consequences. This chapter will explore direct and indirect trauma in relation to temporomandibular disorders (TMDs). • • • • • • •
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Definition of trauma and role of injury Micro- vs. macrotrauma Epidemiology of trauma Direct trauma and TMDs TMD and whiplash injury Consequences of trauma: pain and functional disturbances Considerations for treatment in relation to TMD and trauma
Definition of Trauma and Role of Injury
In 2004, an intriguing if not unsettling commentary by Langely et al. identified that there is a substantial problem with defining injury [1]. Most research has relied on the “energy definition” for defining injury, described as “damage to the body S. Sharma · R. Ohrbach Oral Diagnostic Sciences, University at Buffalo School of Dental Medicine, Buffalo, NY, USA e-mail: [email protected]; [email protected] B. Häggman-Henrikson (*) Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden e-mail: [email protected] © Springer Nature Switzerland AG 2019 S. T. Connelly et al. (eds.), Contemporary Management of Temporomandibular Disorders, https://doi.org/10.1007/978-3-319-99912-8_2
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produced by energy exchanges that have relatively sudden discernable effects.” However, the authors noted that what is meant by “damage to the body” is not readily interpretable. Often, injury has been defined as external causes of injury, which is circular. One may assume, however, that researchers using such type of circular definition have implicitly considered some form of tissue damage as a necessary consequence of specific kinds of events. Clearly, there are significant problems regarding the nuanced understanding of “injury,” problems that impact profoundly on its scientific investigation. Many methodological problems exist within injury epidemiology [2]. It is a relatively young field, and consequently data about injury as an epidemiological exposure are sparse. Firstly, as described above, injury has been defined in a variety of ways. Secondly, approaches used to monitor injuries are diverse, ranging from reports on death certificates for fatal injuries to specific injury surveillance systems (e.g., traumatic brain injury systems) and to registries that attempt to record all injury events. Furthermore, because the spectrum of injuries is quite broad, the sources used to monitor injuries are largely defined by the type of injury, the level of severity, and the legal implication of the injury. Most injuries are relatively minor and can be managed without any professional medical attention and therefore are self- reported, whereas more severe injuries will require medical attention by a professional if not hospitalization, and the most severe injuries can be fatal. These factors affect
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