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Chiropractic Treatment of Temporomandibular Disorders Using the Activator Adjusting Instrument and Protocol

Although the specific mechanisms of chiropractic treatment are not well understood or mutually agreed upon, they are commonly thought to improve the biomechanics of articulating structures.

Chiropractic treatment is most often applied to the spine, but many chiropractic clinicians use well-established protocols to treat other structures, including hands, feet, knees, and even cranial bones, with the belief that they are improving the biomechanical functioning of those structures.

Since articular TMD is believed to involve the biomechanical functioning of 1 or more of the structures within the TMJ, it seems reasonable to suppose that chiropractic treatment of the structures of the TMJ may well have a beneficial effect in cases of articular TMD. That notion is supported by the isolated events described in the case histories referred to in the Introduction and now also by the results of this preliminary study.

Maximum mouth opening was found to improve in every one of the 8 cases that had an outcome measure, with a median of a 9-mm increase.

In view of Kropmans et al [15] finding that 9 mm was the smallest detectable difference, this result suggests clinical improvement. This is further strengthened by noting that all 3 of the cases with less than 9-mm improvement (1 mm, 6 mm, and 7 mm) had high baseline measurements (55 mm, 43 mm, and 47 mm, respectively), with the others in the case series being considerably lower.

VAS measurements were also seen to improve in each of the 7 cases that had both VAS measurements.

The median decrease was 45 mm on a 100-mm scale, with a range of 21 mm to 71 mm. Inasmuch as Kelly12 reports that 9 mm is the minimum clinically significant difference on a scale of 100 mm, the VAS results of this case series indicate a marked decrease in pain for the participants.