Case Description

Throughout my career as a Chinese medical practitioner, I have grown used to telling and lecturing about Chinese medicine to anyone who just wanted to hear, sharing research and interests especially in areas where conventional medicine sometimes has a hard time giving a good result.
This is how, over the years, collaborations with M.Ds happen. From my early days at the hospital till recent years.
This interesting case of teeth grinding (bruxism) is the result of my successful collaboration with an Oral and Maxillofacial Dentist.
I have chosen to present this case in order to show you that such collaborations bring a lot of patients with fascinating and challenging situations and that the success of these treatments increases the demands of clients to you.
Working together manages to establish us as a professional, sustainable, and above all effective medicine.
The road to successful collaborations always comes from one common denominator. That is that all medical professionals want to reduce suffering in the world and once you connect to this place it is easy to create collaborations with doctors, physiotherapists, psychologists, occupational therapists, dietitians and more. So yes, it takes effort. It requires getting ready for every possible call, overcoming obstacles more than once, but the result brings incredible professional satisfaction.
Another thing that is important for me to emphasize to you therapists, is to understand the principles and diagnosis of Balance Method and try to avoid the phenomenon in which therapists act automatically.
Hope you enjoy, Adi.
A 26 years old patient is a second-year computer science student, generally healthy, with no background of injuries or bruises. He arrives at the clinic with a cheif complaint of teeth grinding, especially at night. He remembers that in his teens he had a phenomenon of teeth grinding during the day and night, but after the end of high school and during his military service the phenomenon disappeared.
Now he is in a relationship and his partner claims that he grinds his teeth at night and makes such a loud noise that it wakes her up. In addition, during an examination at a dentist, due to the grinding of the teeth, he was recommended to sleep with a special night guard to prevent damage to the teeth, but he is unable to adapt to this.
Other than that, he seems to be in good health. He complains a bit about fatigue and poor mood, presents himself as a relaxed and calm person, but lately feels more tense and irritated. He also complains of neck pain and inflexibility of the neck. He attributes this to prolonged sitting in front of a computer. On examination it appears that most of the pain is actually on the side of the neck and the difficulty is in the movements of lateral flexion and not flexion and extension.
The examination also found a very high sensitivity on the sternocleidomastoid muscle (SCM) as well as in the GB21 area and on the TW pathway in the neck.
The pulse is wiry and strong.
According to quite a few texts of TCM in situations of bruxism, the wood should be examined and the involvement of the Liver Wind can be seen. Also, the wiry pulse directs us to look at the wood meridians and especially the Liver as involved in the disease.
A fairly common differential test is a disease that involves the Stomach and Liver meridians as an observation of the system of the Liver and the area of the Stomach meridian passing through the jaw so we would use the structure of, JUE YIN YANG MING.
However, in our case there was no sensitivity on the jaw and meridian of the Stomach. What’s more, this condition is characterized by a weaker pulse.
Another diagnosis is a structure of fire and wood that describes a state of heat that is in the Liver and affects the Heart and therefore the phenomenon occurs especially during sleep.
However, this phenomenon is characterized by a fast and strong pulse and often a feeling of thirst and a hoarse throat (which we do not have here) or then we will use the structure of SI HT GB LIV.
The third differentiating diagnosis is a condition of excess wood characterized by a wiry pulse and aggravating gnashing of teeth in stressful situations.
Here is the finding of the string pulse along with the high sensitivity in the neck muscles, difficulty in the movements that characterize the Shao Yang. That is why the structure of JUE YIN SHAO YANG was chosen.
I did a Global Balance treatment. I chose the points based on imaging of the jaw and neck area that I found to be sensitive. In this case there were quite low on the jaw and more sensitivity was found on the neck while maintaining the principles of Global Balance.
GB40- 39
TW 4-5 + TW3
In addition to relieving tension and pain in the neck I added on the same side of the Triple Warmer, the point SO JING DIAN.

All points were selected according to sensitivity.
I needled between 2-5 needles in each limb according to varying sensitivity from treatment to treatment.
The sides changed from treatment to treatment.

After 5 weeks of treatment twice a week the grinding of teeth stopped completely. We continued for two more treatments for safety and then a meeting was scheduled a month later only to find out that the therapeutic result had been maintained.

Treatment of conditions defined as internal medicine (as in here a case of stress manifested by grinding of teeth) can be diagnosed and treated according to the principles of the location of the disease and the meridians passing nearby, use a differential diagnosis of Chinese medicine and connect it to the structure. Of course, we need to differentiate between symptoms that characterize meridians that do not always overlap with symptoms that characterize organs, can be diagnosed according to principles of timing and season, can be according to the idea of directional medicine, can be through protocols or ideas like 12 magics and more. We teach the principles of diagnosis in the Tan Israel Center’s Internal Medicine course.

Tips for therapists – In diseases of meridians or diseases of Zhang Fu that appear in ancient Chinese texts and known to Chinese medicine, it is worthwhile to take a look at the differential diagnosis and the symptoms of each differential diagnosis and connect it to the structure. Of course, the final determination should be made after a physical examination and not rely on the text alone as the texts present only the common differential diagnoses and we can always reach a rarer patient. In fact, in the disease of bruxism, the treatment I performed is actually the least common differential diagnosis. I chose to present this case in order to show that the most important thing is to understand the principles and diagnosis and try to avoid the phenomenon in which therapists act automatically.

Israeli Tan Center

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