When you’re in a car accident, there’s no predicting how badly you might be hurt. Injuries to the head and neck are common. People are often aware of whiplash injuries, which the Mayo clinic describes as “a neck injury due to forceful, rapid back-and-forth movement of the neck, like the cracking of a whip.” Less well known are injuries involving the temporomandibular joint (TMJ), which connects the jaw to the skull. What is it that makes TMJ injuries a concern? First, it’s helpful to know more about the temporomandibular joint and the role it plays in your body.

The temporomandibular joints are two joints in between the temporal bone of the skull and the mandible of the jaw, with one on each side of your face. They’re unique in the human body because, despite being separate joints, they must function together as one unit. In between the temporal bone and mandible is the articular disc. This is composed of fibrocartilage, and it helps stabilize the mandible, reduces friction, and aids movement in the joint.

There is also the capsule, which is a membrane that helps link the joint to the articular disc. Alongside that is the retrodiscal tissue, which binds the posterior part of the disc to the joint capsule. That bit of tissue is commonly compromised in TMJ Injuries that involve compression or inflammation. Now that you know more about the temporomandibular joint itself, it’s good to understand how TMJ injuries happen and the effects they may have on your body.

Facts About Car Accident TMJ Injury

An important fact about a car accident TMJ injury is that you don’t have to hit your face or jaw on something to suffer one. Whiplash alone is a common cause of TMJ injuries, as the sudden forces of the impact exert pressure on your lower jaw muscles. This pulls the jaw open and puts pressure on the part of the skull where the jaw attaches. At that point, your head and jaw are experiencing forces acting in opposite directions which will strain your muscles and cause myofascial pain to develop. All this takes place as you’re forced forwards out of your seat and back into it during the impact.

A second common cause of TMJ injuries is displacement of the articular disc that cushions the bones of the lower jaw and skull. These are more common in rear-end accidents, and a displaced disc can limit how far your mouth can open. Finally, the traumatized temporomandibular joint can also develop inflammatory joint diseases like arthritis or synovitis. Arthritis in this case can lead to degeneration of the joint cartilage, while synovitis involves the inflammation of the synovial membrane in the joints. Both can lead to severe pain, stiffness, and swelling. Given how TMJ injuries develop, what kinds of symptoms might a person notice developing as time progresses?

TMJ Symptoms

Very often, TMJ injury symptoms don’t appear right away. These tend to manifest, on average, within a month of a car accident. However, they can appear as late as one year after. They are wide-ranging, and can include

  • Face, neck, and shoulder pain
  • Popping/clicking sensations/noises when you move your jaw
  • Facial swelling
  • Headaches and migraines
  • Locking of the jaw in place
  • Tinnitus/ringing in ears
  • Vertigo
  • Difficulty chewing
  • Depression and anxiety

It’s important to note that TMJ injuries are common following motor vehicle accidents. The American Dental Association has reported that around 1/3 of all whiplash victims develop them, especially women and people ages 20-40. The problems can also linger if left untreated, but what might some of those longer-term effects look like?

Long-Term Effects TMJ

One of the most serious involves losing cartilage and bone mass. This can lead not just to an increased likelihood of jaw dislocation, but actual changes in your appearance. Increased TMJ inflammation can also lead to possible auditory nerve damage, as well as long-term headaches and migraines. TMJ injuries may also trigger bruxism, which is excessive teeth grinding and jaw clenching. This can lead to damage to your teeth by flattening out the chewing surfaces and causing cracks to form. So if you find any of these problems developing, what providers should you see?

Firsts Thing To Do After Car Accident

The first thing you must always do after any car accident is to see a doctor, especially once TMJ injury symptoms appear. Getting this initial diagnosis right away is extremely important, as the earlier your symptoms and injuries are documented in your medical records, the stronger your personal injury claim will be. This initial provider will also often refer you to a dentist or clinic that specializes in TMJ injuries. Once you are referred, you must see those providers right away, as any gaps in treatment will be pounced on by insurance companies as evidence that your injuries aren’t serious. This person will be able to provide you with a complete diagnosis and recommend the best options for continued care. 

Your dentist will usually begin their exam by pressing and feeling points on your jaw as you open and close your mouth to determine areas of discomfort. X-Rays will also be taken to give them a general idea of the condition of your teeth, jaw, and joints, but other tests may follow. Cone beam computed tomography (CBCT) scans may be necessary, and these involve thousands of pictures of your jaw and face being used to create a 3D model. A magnetic resonance imaging (MRI) may also be performed, as these can show the positioning of your articular disc, tissue inflammation, and how your jaw is locking. Ultimately though, even before your TMJ injury has been diagnosed, you’ll want to be looking into the treatment options available to you.

Options to Treat TMJ Injury

There are multiple options to pursue when it comes to treating your TMJ injury. These include eating soft foods like yogurt, soup, and scrambled eggs, while avoiding hard and crunchy (nuts and raw vegetables) and chewy (taffy) foods. These will help you avoid further trauma to the joint. You can apply hot and cold packs to reduce muscle pain, along with taking over the counter medicines like aspirin and ibuprofen. You might also want to wear a splint or mouthguard to avoid aggravating your jaw injuries, especially at night. Massage therapy for your face and jaw is also a possibility.

Further dental care may also be necessary. This could include replacing missing teeth or using braces to realign your teeth and jaw. Speaking to a therapist may be helpful, as TMJ injuries can lead to chronic pain issues, which can lead to depression and anxiety. These may require prescription medication to help you get a handle on them. But if these aren’t enough, what else might you be able to do before scheduling surgery?

At that point you’ll still have multiple treatment options available. Transcutaneous electrical nerve stimulation (TENS) involves using electrical current to relax muscles and reduce pain. Another choice is trigger point injections, where medication is injected into facial muscles to lessen pain. Ultrasound can be used to apply heat to reduce soreness and increase joint movement. It also might be worth using botulinum toxin (AKA Botox) to reduce muscle mass and inflammation.

Alternative Therapies for TMJ

Alternative therapies are another possibility. Acupuncture, where needles are inserted into your acupressure points, may trigger the central nervous system and help stimulate healing. Meditation can help relax tense muscles and slow your breathing, which helps reduce pain and clenching. Biofeedback, which uses instruments to detect stress and tightness, can help you figure out how to relax your muscles. But if surgery is unavoidable, what options do you have?

You might be lucky enough to only need arthrocentesis, which involves using needles to wash out the joint with sterile fluid. It’s usually performed under local anesthesia in a doctor’s office, though removal of scar tissue or putting a disc back into place might require more work. Another surgical option is arthroscopy, which involves being put under general anesthesia so a tiny fiber-optic cable can be inserted into the joint. The attached camera lets a surgeon get a clear idea of what the problem is, as well as the next steps to take.

That next step may be open joint surgery, where you’d also be under general anesthesia while incisions are made to correct serious issues. These include wearing away of bone joints, severe scarring and/or bone chips in the joint area, or even tumors developing around the TMJ. This lengthens your recovery time substantially and has the greatest potential for complications like nerve damage. However, there are times where surgery may be required. Ultimately, whatever form your treatment might take, you’ll want a good car accident lawyer working at your side the entire time.

How Long Can TMJ Injuries Last

TMJ injury treatment can last months, if not years, and your personal injury lawyer can have a major impact on your auto accident settlement. Your attorney will help you find the right TMJ specialist for your specific needs. They’ll also keep in touch with with your providers as your recovery progresses and assist you in locating further medical treatment as needed. Because symptoms can take time to manifest, your auto accident attorney will consult with experts to establish the link between your injury and your car accident. This is especially important if you have any ongoing medical problems that began prior to your auto accident.

When you see a doctor after your car accident, one thing they’ll ask is if you’ve ever experienced any symptoms like those of your TMJ injury. Insurance carriers always look for ways to claim your injuries are due to a prior injury so they won’t owe you anything. As an example, a common point of contention is arthritis, given the sheer number of ways it can develop as people age. This is where hiring a bodily injury attorney is key. By analyzing your medical records and gathering further expert testimony, they’ll be able to show that despite any prior issues, your injuries are solely related to your car accident. This will greatly increase your chances of recovering all your damages, but what might those damages be?

Settling Your Claim

When it comes time to settle your claim, more can be recovered than just your medical and dental costs. TMJ injuries can be painful enough that they impact your ability to earn a living, so your bodily injury lawyer might be able to recover lost wages and potential future earnings. This pain can also affect how you’re able to rest and relax, enjoying the activities you love and spending time with the people you care about. This means another possible avenue of recovery your bodily injury attorney can pursue is pain and suffering and loss of enjoyment of life. Washington State doesn’t place a limit on how much you can recover for these kinds of damages but does ban punitive damages in personal injury cases. If the insurance company won’t make you a just offer, your personal injury lawyer can take your TMI injury case to litigation.

You’ll need to remain in close contact with your car accident attorney as your trial approaches. This is especially true if your pain is still ongoing and your TMJ injuries haven’t healed. You can continue treating as your cases progresses if you feel it’s necessary. Alternative dispute resolution methods like mediation or arbitration are options to avoid going to trial, but sometimes you’ll want a jury of your peers hearing your story. Your trial lawyer will assemble the facts of your case into a story so compelling that each juror will know exactly what it’s like to suffer as you have. No outcome can be guaranteed, but if you choose a knowledgeable and experienced auto accident attorney, you’re more likely to get the settlement you deserve.

Dealing with the aftereffects of car accident-induced TMJ injuries can be incredibly time-consuming. Finding the right doctors can be difficult and dealing with insurance companies can be a nightmare. We here at Park Chenaur and Associates have many years of experience in helping our clients with TMJ injury. We understand just how badly this can upend your life. Let us help you get the justice you deserve.

Whiplash – Symptoms and causes – Mayo Clinic

Temporomandibular Joint (TMJ) Disorders – Cleveland Clinic