Vectored upper cervical manipulation for chronic sleep bruxism, headache, and cervical spine pain in a child

Abstract 

Objective

To discuss the management of chronic sleep bruxism in a 6-year old girl.

Clinical features

The patient had morning headaches and cervical spine pain. Due to abnormal tooth wear, bruxism had been previously diagnosed and was verified by observation during sleep. She also had abnormal postural and palpatory findings, indicating upper cervical joint dysfunction.

Intervention and outcome

Bilateral rotary cervical stretching/mobilization and a vectored high-velocity, low-amplitude adjustment were performed in the upper cervical spine, using the atlas transverse process as the contact point. There was complete relief of the chronic subjective symptoms concomitant with remission of the objective signs of joint dysfunction.

Conclusions

Cervical, particularly upper cervical, spine muscle-joint dysfunction should be considered as a potential etiology in chronic childhood sleep bruxism.

Keywords:  Bruxism, Pediatrics, Chiropractic, Cervical Vertebrae, Trigeminal Nerve