Treat Bruxism & teeth grinding with Botox injections

27/11/20

“The increases have been unprecedented and I think partly reflect the enormous extra stress that people are under at the moment but also a general increase in awareness that Botox injections for bruxism and teeth grinding are really effective” Dr Mervyn Patterson

What is bruxism or teeth grinding?

Bruxism often occurs as a result of stress and anxiety where the muscles that we use to chew our food start to contract in an uncontrolled way. This can be a constant tension in the muscles or a more intermittent clenching. Some bruxism sufferers are not even aware they are doing it as it may be their dentist that tells them that they are wearing away their teeth or their partners in bed who can hear the grinding noise when they’re sleeping. Others become aware they are doing it as they awake with pain in the side of their face with some experiencing pain radiating into the jaw joint, head and neck region. As the condition becomes more established headaches can be a daily occurrence.

Does a mouth guard or splint help bruxism?

Your dentist may notice that you are wearing away your teeth or that you are damaging your fillings and crowns. There may also be tell tale signs of biting on the inside of the mouth. Dentists often recommend a splint which looks a bit like a gum shield to protect your teeth and this is important if the tooth damage is significant. However the thing to remember is that the guard will not help prevent the bruxism and may unfortunately aggravate it by holding the teeth slightly apart.

Can your GP help with bruxism?

Some people approach their general practitioner for help with the symptoms of bruxism. When there is significant underlying anxiety and depression it may be helpful to take medication that helps to alleviate these symptoms. An explanation of why the bruxism is happening and receiving medication or counselling for the underlying problem can help. However bruxism can be a challenge to treat as it often persists - once the habit starts it can be difficult to break the cycle. Unfortunately Botox injections for bruxism are not available on the NHS.

What does the treatment of bruxism with botox injections involve?

As part of our interview with the Woodford Medical team we asked Dr Hilary Allan who runs the Cambridge clinic what new patients should expect.

“We start with a detailed discussion with every patient to make sure that we understand if there are any treatable underlying reasons. Mapping out exactly where the key areas of pain are is extremely important so that we can plan the injection sites. Many will just require injection into the masseter muscle, the large muscle on the side of the face that runs from the cheekbone down to the jawbone. In other, more complex cases, the bruxism also involves the temples and side of the head and for these injections into the temporalis muscle may be required. A few will have symptoms radiating into the back of the head and neck and depending on severity more extensive botox injections will be required.”

Referrals from general practitioners and dentists.

Many of our patients are complex cases that have been referred from other doctors and dentists. In some cases they will have received many forms of treatment including botox injections. Often times it is clear that the botox injections have been administered poorly with either inadequate doses or incorrect injection sites having been used. There is no substitute for seeing someone who is very experienced in treating all of the different forms of bruxism.

What potential side effects can occur with botox injections for bruxism?

We caught up with our Independent Nurse Prescriber Nuala Devlin in Belfast to ask about the risk of side effects.

"Significant side effects are unlikely with botox injections into the muscles of mastication. Minor problems such as bruising and discomfort, although very rare and minimal, secondary to the injection procedure are going to be short lived. If the injection into the masseter muscle is placed too anteriorly the smile muscles can be effected. For some this is just an odd feeling that only they are aware of and no one else notices. In more extreme cases the effect on muscle movement can be very obvious and creates an abnormal or uneven smile. Annoying as this side effect can be it is reassuring to know that it will always disappear as the effect of the botox wears away. It is very important to seek out medical practitioners who understand the anatomy of the face and are aware of methods to limit the chances of side effects."

How long will it take for my botox injections for bruxism to work and do they need to be repeated?

We put this question to Oona Zia our Independent Nurse Prescriber at our Essex branch

"The effects of Botox will start to kick in gradually from about day 4 to 5 onwards but we have found that the effect on pain can take in some cases three to four weeks to really show benefits. We review patients at this point and then depending on results we may add further injections of Botox. The effect of Botox normally starts to wear off at about three months so we recommend a repeat treatment at this point to try and break the cycle."

Clinical studies on Botox injections for Bruxism

A study looked at botox injections for a group of 25 women who had suffered from bruxism for anything from one to fifteen years. All but two of the candidates had significant improvement in their pain scores with a single injection of twenty units of botox into each masseter. Only two suffered side effects and these were minimal and short lived.

A much wider literature review of all published articles on treatments for bruxism showed that botox was significantly more effective than dental splints or drug therapy and free from significant side effects. One really pleasing finding from the studies was that even with bruxism symptoms that had been present for many years, botox was still very effective in relieving pain.

Leah Hardy one of the UK’s most respected health and beauty journalists gave us her honest review of her Botox injections for bruxism at Woodford

“I can't swear it stopped it completely- as I said - I'm asleep when it happens, but it recently wore off and I started waking up with the familiar tightness and ache in my jaw and I even started to get toothache from grinding my teeth so hard. I am now booked in for a second treatment, and am very much looking forward to it. I would recommend Botox for bruxism to anyone. In fact, I have recommended it to many people. I think it's completely brilliant!” Leah Hardy UK Beauty Journalist