Botox Can Be Used to Treat Teeth Grinding and Bruxism

An off-label use for the injectable could have a huge quality of life impact.

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Michael Stillwell

Stress can manifest itself in a number of ways, but one of the most pervasive is chronic jaw clenching and teeth grinding. There are coffee break discussions exclusively dedicated to complaining about tension headaches, jaw pain, and the discomfort that is related to bruxism, the medical term for the condition. The kicker: aside from reducing stress and wearing a mouthguard while you sleep, the options for addressing the uncomfortable condition are scant.

But there is hope in an off-label use of Botox.

Dr. Dara Liotta, a double board certified facial plastic and reconstructive surgeon in New York City, explains why getting botox in your jaw may just change the game.

What is bruxism?

Simply put, bruxism is teeth-grinding or clenching. If you have bruxism, you may either unconsciously clench your teeth while you are awake, or clench and grind while you are sleeping. Dr. Liotta explains that this can cause pain and fatigue in the jaw muscles themselves, but also headaches—even ear pain.

Is the a visible impact?

Headaches and associated pain aren't the only related effects of bruxism—it can also impact your appearance. "Constant grinding is akin to having your jaw muscle go to the gym day and night. It leads to hypertophy, or the thickening of the chewing muscles, the masseter in particular, which is at the corner of the jaw." The result: it can give a square appearance to the face.

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Michael Stillwell

How can botox stop tooth grinding?

Essentially, injecting botox into the masseter relaxes the main muscle related to bruxism. If you cannot fully contract your muscles, tooth-grinding becomes a lot more difficult.

Botox related to tooth grinding and clenching has two functions. The first is therapeutic: weakening the masseter muscle to improve the related pain from the grinding and TMJ. The second is cosmetic: the injections relax the masseter muscle, thus softening the look of the lower face, taking away the square appearance of the jaw.

How much is typically needed and how long does it take to kick in?

Injections put the Botox directly into the masseter muscle, "at the angle of the jaw," says Dr. Liotta, explaining that she usually starts with 25 units for each side. "When Botox is used to relax the facial muscles, the [aesthetic] effect is typically seen in 7 to 10 days. This follows with Botox to relieve the pain of TMJ or tooth-grinding. You should expect pain relief as soon as a week to two weeks after the injections." Dr. Liotta does note, however, that when used to address the hypertrophy of the jawline, the maximum effect is generally not seen until anywhere from 6 weeks to three months after the injections.

How long do the injections last in the masseter?

Pain relief from the procedure usually last about 6 months after injection, according to Dr. Liotta. "I've found that patients can sometimes stretch appointments to every 9 months if they have been doing the treatment for a while," she adds.

Where are the areas you can inject in the face to help treat the bruxism, aside from the jaw?

The masseter isn't the only muscle in the face that can be injected related to tooth-grinding. The temporalis muscle, located in the temple and the hairline just above the ear, can also be injected with Botox for relief because it is another "muscle of mastication."

How much does Botox typically cost?

According to Dr. Liotta, cost varies on the geographic location, training, and board certification of your physician or dentist, but in general, the cost can range between $850 and $2,000.

Are there any side effects?

"Maybe 10% of patients will tell me that their jaw feels tired when chewing something chewy like a bagel, around a week after injection (when the Botox kicks in), but you get used to the weaker muscle quickly, and this feeling of fatigue fades in about a week," explains Dr. Liotta.

How long do Botox injections for bruxism last?

Anywhere from 6 to 9 months.

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