Will Botox Injections Help My Painful Clenching Problem?

Q: I was wondering if I could get a Botox procedure done in my masseter muscles to help with my teeth clenching. I have tried mouth guards and it doesn’t solve the problem because I’m also clenching my teeth a lot when I am awake. Please send me any information you can regarding this issue.

A:  I have used Botox for masseter muscle injections for clenching and bruxism for the past five years. I have yet to see a patient who has not had some near immediate and significant improvement of their clenching afterwards. The duration of the pain relief will last as long as the Botox is effective, generally around four months or so. This makes perfect sense as the clenching is muscular in origin. While it can also involve the temporalis muscle, the large masseter muscles are certainly a major source of the  clenching problem. While the simultaneous use of oral splints still has a role, particularly to prevent excessive tooth wear, the direct injection of a true ‘anti-spasm’ agent into the muscle is undoubtably more effective and immediate. (results within a week or less)

I have found that the starting dose of Botox is 25 units per side. Both sides are only done if the patient feels that the pain is on both sides. Many patients will have only a one-sided or unilateral source of masseter pain and clenching. The injections are placed in the lower half of the masseter. If a line is drawn from the earlobe to the corner of the mouth, the injections are placed in the part of the masseter muscle that lies below that imaginary line. This is a simple office procedure that is both quick and fairly painless. Compared to cosmetic Botox injections in the forehead, masseter muscle injections are surprisingly more comfortable.  

Dr. Barry Eppley

Indianapolis Indiana