What is Bruxism?
Bruxism involves grinding and clenching of the teeth, often with unconscious contractions of the jaw muscles. It occurs in 8%-16% of the population and is frequently underdiagnosed. Bruxism leads to dental problems, tooth pain, jaw pain, temporomandibular joint pain, neck pain, headaches, and even tooth loss.
Causes of Bruxism
The exact cause of bruxism is unclear, but several factors contribute to it. These include:
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Physical or psychological stress
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Malocclusion
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Sleep disorders
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Side effects of certain medications
Bruxism often resists treatment due to its psychogenic and neurogenic components. Therefore, managing it can be challenging.
Treatment Options for Bruxism
Various treatment options exist for bruxism, including:
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Oral splints
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Muscle relaxants
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Antidepressants
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Botulinum toxin injections
Botulinum toxin has proven effective in relaxing the masseter and temporalis muscles, alleviating bruxism pain. Multiple studies support its use for reducing grinding and clenching.
Botulinum Toxin for Bruxism
In a recent study by Al-Wayli, 50 subjects with nocturnal bruxism received either botulinum toxin or conventional treatment (pharmacotherapy or oral splints). After 3 weeks, 2 months, 6 months, and 1 year, patients who received botulinum toxin had significantly less pain after just one treatment.
Another study by Lee et al. also showed that botulinum toxin reduced both pain and bruxism. Electromyography of nocturnal bruxism confirmed the results.
Botulinum Toxin in Our Clinic
At our clinic, botulinum toxin is a safe and effective treatment for bruxism-related issues. It helps with:
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Teeth grinding
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Jaw clenching
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Temporomandibular joint pain
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Masseter hypertrophy
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Tension headaches and migraines
We use 50 U of botulinum toxin per masseter muscle (100 U total). In some cases, we also inject 15-20 U in each temporalis muscle. Patients see clinical improvement within 3-5 days. They typically experience muscle relaxation and pain relief for up to 6 months.
Side Effects and Risks
Side effects of botulinum toxin are rare and generally mild. These include:
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Mild swelling
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Bruising
If the injection isn’t done properly, the risorius muscle can become paralyzed. This leads to an asymmetric smile. In cases of underdosing, patients may experience incomplete pain relief, with symptoms returning after a few weeks.
Additional Benefits
Many patients notice a thinning effect in their face and jaw after treatment. This is often appreciated, especially when treating masseter hypertrophy.
Conclusion
Bruxism is a growing issue that causes facial pain, headaches, migraines, and dental damage. Traditional treatments often fail to address these symptoms effectively. Botulinum toxin provides a safe, effective solution with minimal downtime and side effects. It successfully treats both the neurogenic and muscular aspects of bruxism.
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