When managing a workers’ compensation claim involving a traumatic brain injury (TBI), the clinical focus typically centers on neurological care, cognitive rehabilitation, and mental health support. However, one area that’s often underestimated—but can significantly impact recovery and quality of life—is dental health.

Yes—dental complications can and do arise after a TBI, and failing to address them may prolong recovery, increase pain levels, and even interfere with speech, nutrition, and overall function.

Why Dental Health Becomes a Concern After TBI

• Loss of Consciousness or Facial Trauma
  In falls, motor vehicle accidents, or blunt force trauma to the head, the mouth and jaw are often affected. Teeth may be chipped, loosened, or lost altogether. Yet these injuries may not be noticed immediately if more obvious or life-threatening issues are present.
• Jaw Misalignment and TMJ Issues
  A blow to the head or whiplash can misalign the jaw, leading to temporomandibular joint dysfunction (TMJ). This can cause chronic facial pain, headaches, difficulty chewing, and even ear-related symptoms—all of which can be mistakenly attributed to the TBI alone.
• Bruxism (Teeth Grinding)
  Many TBI patients develop bruxism, either from neurological disruption or as a response to stress and anxiety. Over time, this can lead to enamel wear, cracked teeth, and jaw discomfort.
• Cognitive and Behavioral Changes
  After a brain injury, patients may struggle with oral hygiene routines due to memory loss, decreased motivation, or physical impairments. This can lead to rapid tooth decay, gum disease, and infection
• Medication Side Effects
  Many medications used for managing post-TBI symptoms—such as antidepressants, antipsychotics, and anti-seizure drugs—cause dry mouth, which increases the risk of cavities and gum issues.

What to Look for in TBI Claims Involving Dental Components
As a claims adjuster or nurse case manager, be aware of these indicators:

• Documented facial trauma or broken teeth in the initial injury report
• Complaints of jaw pain, facial tightness, or difficulty eating post-injury
• New dental referrals from neurologists, physical medicine doctors, or speech pathologists
• Cognitive impairment that affects hygiene or self-care
• Requests for custom dental appliances (e.g., mouth guards or splints)

Unexpected But Justified Needs That May Arise

• Full dental exams and panoramic X-rays
• Tooth restorations, crowns, or implants due to injury-related loss
• TMJ evaluations and therapy
• Night guards for bruxism
• Speech therapy when missing teeth affect articulation
• Nutritional support if chewing is compromised
• Coordination between neurologists and dental specialists

The Bottom Line

Dental issues following a TBI are more than cosmetic—they can be functional, painful, and disabling. Recognizing these challenges as valid medical needs can improve claim outcomes, reduce long-term complications, and support a more complete recovery.

Next time you’re managing a brain injury claim, don’t be surprised if a dental referral shows up. Instead, ask: Could this be part of the broader injury picture? Chances are, the answer is yes.