Dr. David Cheng, Westcoast Smile Dental Studio in Vancouver, has published a landmark peer-reviewed case report in the Journal of the California Dental Association (October 2025) — the first paper in dentistry to document the use of Heart Rate Variability (HRV) biofeedback as a treatment for temporomandibular dysfunction (TMD) and bruxism.
A New Approach to Chronic TMJ Pain
The case describes a 34-year-old patient who had experienced TMJ pain, bruxism, headaches, and sleep disruption for over 20 years.
Instead of relying on splints or medication, the patient was treated using HRV biofeedback and breathing retraining — a process that restores balance to the autonomic nervous system and improves oxygen and CO₂ regulation.
The results were remarkable:
- TMJ pain, masseter tension, and migraines fully resolved
- Sleep patterns normalized
- Anxiety score improved from 16 to 5 (BAI index)
- CO₂ and HRV coherence restored
Within weeks, the patient achieved full recovery and long-term stability — without oral devices or pharmaceuticals.
Heart Rate Variability Biofeedback.
Bridging Dentistry and Neuroscience
Dr. Cheng explains that while traditional occlusal splints protect teeth, they often fail to address the root cause of bruxism and jaw pain — autonomic dysregulation.
“Some patients simply cannot deprogram even after months with splints. By using HRV biofeedback, we can help the body ‘let go,’ calm the nervous system, and allow the muscles to naturally deprogram,” says Dr. Cheng.
This discovery has significant implications for Kois-trained clinicians and others working with occlusal deprogramming and obstructive sleep apnea (OSA) patients.
Research shows that over half of OSA cases are non-anatomical, often driven by stress or dysregulated breathing.
HRV biofeedback offers a noninvasive pathway to restore autonomic balance and improve sleep without relying solely on oral appliances.
Westcoast Smile’s Role in Functional Dentistry
At Westcoast Smile Dental, Dr. Cheng and his team combine advanced functional dentistry, sleep diagnostics, and integrative therapies to address not only oral health but total-body wellness.
The clinic’s approach aligns with emerging science connecting breathing patterns, nervous-system balance, and dental occlusion.
Through continuous innovation, Westcoast Smile remains at the forefront of evidence-based, noninvasive treatment for TMD, bruxism, and sleep-related disorders.
Download the Full Study
Heart Rate Variability Biofeedback in the Management of TMD and Bruxism (PDF)
(Published in the Journal of the California Dental Association, Oct 2025)
If you or someone you know suffers from chronic TMJ pain, bruxism, or sleep issues, visit
to request a consultation with Dr. Cheng.