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Case Studies: TMJ Dysfunction

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The symptoms of temporomandibular (jaw) dysfunction (aka TMJ or TMD) are highly varied and can comprise one or more of the following: pain with chewing or at rest in the joint area, clicking or popping of the joint, open or close locking of the jaw, tooth or teeth pain (mimicking cavities or infection), facial and/or neck pain, headaches, tinnitis (ringing in the ears), and hypobaroacusis (stuffy ear with or without decreased hearing).


One of the primary causes of TMD is trauma (motor vehicle accidents, sports injuries, dental work, etc.).1-26 Restoration of normal temporomandibular joint (TMJ) function must be made via normalization of neurological control over the muscles that govern the TMJ. Abnormal neural input from the central nervous system due to upper cervical joint dysfunction (from traumatic injury) can result in abnormal TMJ muscle coordination. Following the trauma to the upper cervical spine and temporomandibular joint, symptoms can be triggered immediately or can take months or years to develop.

The purpose of IUCCA upper cervical chiropractic care is to reverse the trauma-induced upper neck injury; thereby reducing irritation to the nerves in the brain stem and spinal cord that control neuromuscular function in the face and jaw. While many TMD sufferers recall specific traumas such as head injuries, auto accidents or falls, some do not. An upper cervical examination utilizing Laser-aligned Radiography and Digital Infrared Imaging is necessary in each individual's case to assess whether an upper cervical injury is present and whether benefit from IUCCA upper cervical care can be achieved.


TMJ Case Studies


"Whiplash: Information For Drivers, Pedestrians, and Athletes" by Erin Elster, DC. The Atlas Files. June 2000.

1. Friedman MH, Weisberg J. The craniocervical connection: a retrospective analysis of 300 whiplash patients with cervical and temporomandibular disorders. Cranio 2000 Jul; 18(3): 163-7.
2. O'Shaughnessy T. Craniomandibular/temporomandibular/cervical implications of a forced hyper-extension/hyper-flexion episode (ie, whiplash). Funct Orthod 1994 Mar-Apr; 11(2): 5-10,12.
3. McKay DC, Christensen LV. Whiplash injuries of the temporomandibular joint in motor vehicle accidents: speculation and facts. J Oral Rehabil 1998 Oct; 25(10): 731-46.
4. Kolbinson DA, Epstein JB, Burgess JA. Temporomandibular disorders, headaches, and neck pain after motor vehicle accidents: a pilot investigation of persistence and litigation effects. J Prosthet Dent 1997 Jan; 77(1): 46-53.
5. Garcia R Jr, Arrington JA. The relationship between cervical whiplash and temporomandibular joint injuries: an MRI study. Cranio 1996 Jul; 14(3): 233-9.
6. Kronn E. The incidence of TMJ dysfunction in patients who have suffered a cervical whiplash injury following a traffic accident. J Orofac Pain 1993 Spring; 7(2): 209-13.
7. Pressman BD, Shellock FG, Schames J. MR imaging of temporomandibular joint abnormalities associated with cervical hyperextension/hyperflexion (whiplash) injuries. J Magn Reson Imaging 1992 Sep-Oct; 2(5): 569-74.
8. Epstein JB. Temporomandibular disorders, facial pain, and headache following motor vehicle accidents. J Can Dent Assoc 1992 Jun; 58(6): 488-9, 493-5.
9. Burgess J. Symptoms characteristics in TMD patients reporting blunt trauma and/or whiplash injury. J Craniomandib Disord 1991 Fall; 5(4): 251-7.
10. Mannheimer J, Attanasio R, Cinotti WR. Cervical strain and mandibular whiplash: effects upon the craniomandibular apparatus. Clin Prev Dent 1989 Jan-Feb; 11(1): 29-32.
11. Troster L. Temporomandibular disorders: culprit or accomplice of the post-traumatic myofascial pain dysfunction syndrome? A physical therapist's perspective. Alpha Omegan 1998 Oct; 91(3): 25-30.
12. Ferrari R, Leonard MS. Whiplash and temporomandibular disorders: a critical review. J Am Dent Assoc 1998 Dec; 129(12): 1739-45.
13. Bergman H, Andersson F, Isberg A. Incidence of temporomandibular joint changes after whiplash trauma: a prospective study using MR imaging. AJR Am J Roentgenol 1998 Nov; 171(5): 1237-43.
14. Howard RP, Bowles AP, Guzman HM. Head, neck, and mandible dynamics generated by whiplash. Accid Anal Prev 1998 Jul; 30(4): 525-34.
15. Howard RP, Hatsell CP, Guzman HM. Temporomandibular joint injury potential imposed by the low-velocity extension-flexion maneuver. J Oral Maxillofac Surg 1995 Mar; 53(3): 256-62; discussion 263.
16. Probert TC, Wiesenfeld D, Reade PC. Temporomandibular pain dysfunction disorder resulting from road traffic accidents-an Australian study. Int J Oral Maxillofac Surg 1994 Dec; 23(6 Pt 1): 338-41.
17. Levandoski RR. Mandibular whiplash. Part II. An extension flexion injury of the temporomandibular joints. Funct Orthod 1993 Mar-Apr; 10(2): 45-51.
18. Brady C, Taylor D, O'Brien M. Whiplash and temporomandibular joint dysfunction. J Ir Dent Assoc 1993; 39(3): 69-72.
19. Heise AP, Laskin DM, Gervin AS. Incidence of temporomandibular joint symptoms following whiplash injury. J Oral Maxillofac Surg 1992 Aug; 50(8): 825-8.
20. Kirk WS Jr. Whiplash as a basis for TMJ dysfunction. J Oral Maxillofac Surg 1992 Apr; 50(4): 427-8.
21. Capurso U, Perillo L, Ferro A. Cervical trauma in the pathogenesis of cranio-cervico-mandibular dysfunction. Minerva Stomatol 1992 Jan-Feb; 41(1-2): 5-12.
22. Bedrune B, Jammet P, Chossegros C. Temporomandibular joint pain-dysfunction syndrome after whiplash injury. Medico-legal problems in common law. Rev Stomatol Chir Maxillofac 1992; 93(6): 408-13.
23. Weinberg S, Lapointe H. Cervical extension-flexion injury (whiplash) and internal derangement of the temporomandibular joint. J Oral Maxillofac Surg 1987 Aug; 45(8): 653-6. 24. Moses AJ, Skoog GS. Cervical whiplash and TMJ. Basal Facts 1986; 8(2): 61-3.
25. Ernest EA 3rd. The orthopedic influence of the TMH apparatus in whiplash: report of a case. Gen Dent 1979 Mar-Apr; 27(2): 62-4.
26. Roydhouse RH. Whiplash and temporomandibular dysfunction. Lancet 1973 Jun 16;1(7816): 1394-5.

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