Expert: Gerald Anzalone, D.C. - 4/3/2007

Question
I have been grinding and clenching my teeth for several years and have received dental intervention in the form of a nightguard. Recently, a friend suggested that I seek chiropractic help in alleviating my severe bruxism.

Is there any evidence that bruxism may be alleviated through chiropractic care? And if yes, what type of treatment might I expect, like adjustments to the neck/jaw?  

Answer
Paige,

Temperomandibular joint (TMJ) dysfunction is complicated and may have several causes, including bruxism. TMJ dysfunction may be responsible for a constellation of various symptoms, including chronic headaches, deviation of the jaw, dizziness or vertigo, ringing in the ears, and others. A night-guard supplied by a dentist or oral surgeon is a good step in the right direction toward helping to reduce or correct this problem. Chiropractic may also be of help to you, but I always tell patients that results are case-specific.

When I treat patients with TMJ, I work externally on the myofascial trigger points of the muscles of the jaw, which often gives patients significant relief. I never adjust or manipulate the TMJ with a thrust; I always use a soft-tissue approach.

However, in some cases, patient with TMJ problems may also have joint dysfunction elsewhere in the spine or pelvis, including the neck. It is unclear if these are co-incidental problems or compensatory or associated joint dysfunction. Karel Lewitt, M.D. and Vladimir Janda, M.D., manual medicine practitioners from Prague, Janet Travell, M.D. and David Simmons, M.D., authors of the classic texts on trigger points, and Raymond Nimmo, D.C., a pioneer of chiropractic trigger point therapy, have identified these structural problems in their writings.

I would recommend seeing a chiropractor who is skilled in trigger point therapy; joint manipulation or adjustments may also be part of the treatment, depending on the structural and physical examination findings. A good massage therapist may also be trained in trigger point therapy, and acupuncture could also be helpful for TMJ problems.

I hope that this answers your question.