Temporomandibular Joint (TMJ) Syndrome/Dental Health

Chiropractic care of a patient with temporomandibular disorder and atlas subluxation Alcantara J, Plaugher G, Klemp, DD, Salem C Journal of Manipulative and Physiological Therapeutics January 2002 • Volume 25 • Number 1

This is the case of a 41-year-old woman who sought care for complaints associated with a cervical subluxation (i.e., atlas) and TMD.

Her complaints began with a left ear infection that was medically treated with oral antibiotics. At the time of chiropractic consultation, complaints included pain at the TMJ (bilaterally), “ear pain,” tinnitus, vertigo, altered or decreased hearing acuity, a sensation of pressure or fullness in both ears and headaches, which she characterized as a throbbing or pounding. She also had a 22-year history of migraine headaches, which were partially relieved by previous chiropractic care.

She did not take her prescribed medications because of adverse reactions (i.e., gastric upset and vomiting).

She was referred to an eye, ear, nose, and throat specialist who diagnosed her with TMJ syndrome. She was referred to a dentist for a possible malocclusion. The dentist found no occlusal abnormalities. Medical recommendations were to apply local heat, reduce talking and yelling and change to a soft diet. The patient reported that her symptoms steadily worsened with these measures.

Chiropractic care consisted of specific adjustments to the atlas subluxation resulting in improvement of the patient’s symptoms. By the third visit, she reported significantly greater improvement on the right than on the left side. By the fifth visit, the patient reported that the right ear was “perfectly fine.” With subsequent visits, she reported continuous improvement, with only the left ear sensation of fullness remaining.

She reported complete relief of TMJ symptoms 2 1/2 months (9 visits) from the onset of chiropractic care. In addition, she reported a decrease in the frequency and severity of her headaches. Before chiropractic care, she related a frequency of 1 to 2 migraine attacks per month. At 1-year follow-up she had experienced no headache symptoms for a period of 9 months. Her TMJ complaints had completely resolved.

Chiropractic/Dental cotreatment of lumbosacral pain with temporomandibular (TMJ) joint involvement. Chinappi AS and Getzoff H Journal of Manipulative and Physiological Therapeutics Vol. 19 No. 9 November/December 1996.

This is the case of a 33-year old woman with centralized lumbosacral pain. After 30 months of chiropractic care she was still experiencing some lower back pain and agreed to see an orthodontist who diagnosed a “Class 11 malocclusion with significant loss of vertical dimension, characteristic of bilateral posterior bite collapse.”

From the abstract:

The cotreatment approach, which integrated dental orthopedic and craniochiropractic care, ameliorated the pain and improved head, jaw, neck and back function. The position of the jaw, head and vertebral column, including the lumbar region, are intricately linked. Orthodontic treatment improved the position of the mandible, which in turn enabled the body to respond to chiropractic care.

The relationship between impacted wisdom teeth, headaches, and persistent cervical fixations. Dawson L, Frolund S. The European Journal of Chiropractic 1992; 40:1-6.

Author’s Abstract:

The study group of 100 patients with one or more impacted wisdom teeth was selected by viewing each patient’s antero-posterior and lateral cervical x-rays. A control group of 100 subjects without impacted wisdom teeth was chosen in a similar manner….after statistical analysis of the data…a significant relationship was demonstrated between impacted wisdom teeth and headaches, headaches and persistent cervical fixations and impacted wisdom teeth and persistent cervical fixations.

A number of instances are cited in which recurrent cervical VSC with concomitant headache were resolved following extraction of an impacted wisdom tooth.

The Dental-Chiropractic cotreatment of structural disorders of the jaw and temporomandibular joint dysfunction. Chinappi AS JR; Getzoff H. Journal of Manipulative and Physiological Therapeutics 1995; 18(7): 476-8.

The position of the jaw, head and neck are intricately linked. The acute symptoms experienced during the initial dental treatment phase were caused by the inability of the head and neck to adapt to maxillary and mandibular changes.

Chiropractic treatments enabled the body to respond positively to the dental changes. As the mandibular position improved, further improvements were indicated by physical testing and X-rays.

Forward head posture: Its structural and functional influence on the stomatognathic system, a conceptual study. Gonzalez H, Mann A. J Craniomandib Pract 1996; 14:71-80.

There is a correlation between forward head posture and TMJ dysfunction.

Birth induced TMJ dysfunction: the most common cause of breastfeeding difficulties. Arcadi, VC, Sherman Oaks, CA, Proceedings of the National Conference on Chiropractic and Pediatrics. Oct, 1993 Palm Springs, CA. Pub. International Chiropractors Assoc., Arlington, VA.

From the abstract:

In a clinical setting, 1,000 newborns were observed and treated (ages one hour to 21 days), for failure and/or difficulty with breast-feeding. In 800 or 80%, birth induced Temporomandibular Joint Dysfunction was found to be the cause. In all cases, the babies were treated with chiropractic cranial and spinal adjustments, with excellent results in 99% of the cases. This paper discusses the basic clinical findings and related newborn discomforts and associated symptomatology.

The above babies were all born with a lay midwife and without drugs in a calm, warm, peaceful setting. All babies were born vaginally. All babies were examined and in all cases a cranial distortion was present due to the birth process which produced a TMJ dysfunction. The TMJ dysfunction interrupted proper suckling mechanics and caused severe headaches and gastrointestinal disturbances.

A multi-faceted chiropractic approach to attention deficit hyperactivity disorder: a case report. Barnes, T.A. International Review of Chiropractic Jan/Feb 1995 pp.41-43.

From the abstract:

An 11-year-old boy with medically diagnosed Attention Deficit Hyperactivity Disorder has been a patient and student at the Kentuckiana Children’s Center for three years...His case shows a history of early disruptive experience, repeated ear infections, consistent temporomandibular joint dysfunction, heavy metal intoxication, food allergy, environmental sensitivity and multiple levels of biomechanical alteration. This report emphasizes the need for care in all aspects of the structural, chemical and mental triangle of health in children with attention deficit hyperactivity disorder.

“He has improved academically and has advanced to the next grade level...he recognizes that he has control over his behavior and there is hope that he will be mainstreamed back into a regular public school setting soon...his mother says she notices improvement in his attention span and temper.

Copyright 2004 Koren Publications, Inc. & Tedd Koren, D.C.