Effect of Physiotherapy on Bruxism and Head Posture

Objective: The aim was to evaluate the effectiveness of a physiotherapeutic intervention to improve the head posture and reduce the signs of bruxism in a group of subjects with bruxist behaviour. Materials and Methods: A blind randomized clinical trial was performed. All the subjects were three to six year old, were healthy, had normal facial morphology and class I occlusion. The individuals were included in the study when their guardians reported bruxism, they presented high level of anxiety in the Conners' Parents Rating Scales (CPRS), two or more signs of temporomandibular disorders (TMD) according to Bernal and Tsamtsouris and dental wear visually evident. For each child, a clinical, photographic and radiographic evaluation of the head and cervical posture were realized with standardized techniques. The dental wear was drawn in dental casts, and processed in digital format. The children were randomized in an experimental (n=13) and a control (n=13) group. A physiotherapeutic intervention was applied to the children of the experimental group once a week, until 13 sessions were completed. Afterwards, the cephalogram, the clinical and photographic evaluation of the head posture and the dental wear, were measured. Also the anxiety, the TMD and the report of bruxism by the guardians were evaluated again. The data were analyzed with the t-test and the Wilcoxon rank sum test. Results: All the children presented a downward head posture and kyphotic position of the cervical spine at the beginning of the study. The subjects of the experimental group showed statistically significant improvement in the natural head posture (p value: 0.013). The anxiety and the guardian's report of bruxism reduced as well. The TMD did not reduce. Conclusion: The physiotherapeutic intervention showed to be efficient to reduce the signs of bruxism and to improve the head posture in the studied children.