Mandibular whiplash. Part II. An extension flexion injury of the temporomandibular joints.

The single most common contributing factor in the onset of TMJ disorders is cranio cervical trauma. This is strongly supported by the referred literature and a wide range of clinical experience. Trauma is also one of the most frequently overlooked factors when developing an occlusion related treatment plan. Failure to take into account a previous injury that has caused permanent damage to the TMJs could prove to be very embarrassing. If the symptoms are in remission at the initiation of occlusal therapy, a tense situation can arise if an old injury becomes acute during treatment and the patient mistakenly assumes that the occlusal therapy was the proximate cause of the flare up in symptoms. Pretreatment screening for TMJ injuries is extremely important and can have substantial impact on the final therapeutic course.