Will Botox Help My Clenching?
Q: I want to investigate the use of botox to help with my jaw clenching and teeth grinding. I currently wear an appliance to help protect my teeth, but still clench and have jaw pain.
A: Clenching and the sequelae from it, pain and excessive tooth wear, is the result of overactive masseter muscles. (and sometimes the temporalis muscle as well) No one knows why this muscle hyperactivity occurs although it is blamed on personality types and stress. The exact reason why, however, is unknown. The traditional treatment of clenching uses non-muscular therapies such as dental appliances and anti-inflammatory or anti-spasm drugs. The purpose of a dental appliance (i.e., splint or mouthguard) is primarily to protect the teeth from excessive wear. It does an excellent job of that and there is no better substitute. The other objective of some dental appliances is to break the cycle of muscle spasm through jaw opening (increasing the interdental space and stretching the muscle out) and changing how one’s teeth interdigitate. (bite or occlusion) Their effectiveness in this regard is quite variable. Great claims are made by some as to how beneficial they are. But, in the end, they will work well for some and not for others.
Botox takes a different strategy to the muscle problem in clenching. By directly injecting the muscle into the most spastic and painful areas, these zones of paralysis or muscle weakening that Botox causes can very effectively reduce the muscle spasm and pain. For some patients, it can be a near miracle. For others the relief is still significant. I have yet to see any clenching patient who does not get noticeable relief. Sometimes additional or supplemental injections are needed to get the right dose of Botox after the initial treatment. The relief will last as long as the Botox works, for 3 to 4 months.
Dr. Barry Eppley