Botox : A possible treatment option for Teeth-grinding?

A patient suffering from bruxism is shown to undergo Botox procedure to reduce the number of episodes of teethgrinding and pain.
Botox therapy is a novel, possible remedy for bruxism.

Botox treatment is a buzz word within the beauty industry. However, it is increasingly being used as a medicinal therapy in cases of neuromuscular problems. With these advances, botox can now be used to treat bruxism (tooth grinding) and ease the pain associated with it.

Today, we’ll lay out the facts about botox to help you decide if it’s a good treatment option for teeth grinding or not ?

Article’s content :

What is Botox ?

Botox is a type of toxin (exotoxin) produced by the bacteria Clostridium botulinum. This toxin affects the nerves, hence termed as a neurotoxin.

Vector image showing bacteria to show the fact that Botox is a refined exotoxin obtained from bacteria clostridium botulinum.
Botox is refined exotoxin obtained from bacteria clostridium botulinum.

Every muscle in the body is supplied by distinct nerves. When the neurotoxin affects a nerve, the muscles regulated by that nerve become nonresponsive, resulting in paralysis.

However, medically approved and purified versions of this exotoxin are commonly used to enhance appearance by erasing frown lines and to treat neuromuscular problems such as wry neck.

What formulations are approved and used in clinics ?

FDA has approved two formulations of botox called Type A and Type B for clinical use. Each is used to treat different disorders. Type A is used to treat teeth grinding (bruxism).

The amount of botox used depends on the patient’s needs, but side effects increase when its over 100 U (units). Hence, a dose of less than 100 U is preferred. Dosage beyond 3000 U (units) are lethal.

Additionally, before using botox, your doctor or dentist might mix it with another solution. This process, known as reconstitution, does not compromise the product’s effectiveness or lead to any contamination.

How does it work ?

Image of neuromuscular junction showing that electrical signals from nerves cause muscle contraction by use of a chemical agent called acetylcholine.
Electrical signals from nerves cause muscle contraction.

As discussed above, every muscle is supplied by a nerve. This nerves transmit signals which cause muscles to contract. A chemical agent called acetylcholine aids in the transmission of these nerve impulses (signals).

Botox inhibits the release of acetylcholine, thus blocking the signal transmission.  As a result, muscles do not contract and continue to be in a relaxed state.

In teeth-grinding, muscles are contracted repeatedly causing pain. Botox injection will reduce this involuntary contractions as nerve signals are not transmitted. This gives time for the muscle to relax and heal, thus, removing muscle pain.

How does it help with bruxism (teethgrinding) ?

Botox treatment has been proven to be effective only in the cases of Nocturnal Bruxism (also known as night bruxism). The recommended dose is injected into Masseter muscle or Temporalis muscle; both are powerful chewing muscles involved in teeth grinding.

Botulinum Type A is generally used in this procedure. Pain relief occurs in 1st to 3rd day while maximum effect is seen post 2 weeks of undergoing treatment. This effect lasts for upto 3 to 4 months.

After the treatment, expect lower pain levels and decrease in the number of episodes of teeth grinding.

Side effects of botox treatment.

Botox when injected as per the prescribed dose, rarely causes any adverse reactions. However, post treatment you may develop the following symptoms :

Image showing a girl suffering from side effects after undergoing Botox treatment. Side effects in form of skin reactions to flu like symptoms may occur.
Side effects in form of skin reactions to flu like symptoms may occur.
  1. Tingling sensation or Skin reaction at the site of injection.
  2. Flu like symptoms along with nausea.
  3. Tenderness at the site of injection.
  4. Partial Muscle Weakness.

If you continue to experience this symptoms for longer then two days then kindly let your healthcare provider or dentist know as soon as possible.

Furthermore, if you undergo this treatments frequently then muscle degeneration (atrophy) can occur.

Is it a permanent solution for bruxism (teethgrinding)?

Vector image showing people asking weather Botox is permanent option or not ? Answer is that  the Botox treatment is not a permanent solution for teeth-grinding.
Remove causative factor, not just symptoms.

No. Botox treatment is not a permanent solution for teeth-grinding. As discussed above it’s effects are short lasting (transient). Thus, you need repeated injections. This increases the overall costing of the treatment.

Moreover, you should remember that this treatment gives relief from symptoms of teeth-grinding (palliative treatment). To cure bruxism you need to remove the causative factor for which different modalities like interventional appliances and physiotherapy may be used.

Conclusion

The concept of botox treatment as a modality to decrease the severity of symptoms of teeth grinding is new. Hence, a general advice for now is that you should exhaust all conventional options of treatment first and then move onto botox.

Remember ! curative treatment which remove the causative factor are needed for comprehensive treatment of bruxism instead of palliative options like botox.

References

Asutay F, Atalay Y, Asutay H, Acar AH. The Evaluation of the Clinical Effects of Botulinum Toxin on Nocturnal Bruxism. Pain Res Manag. 2017;2017:6264146. doi: 10.1155/2017/6264146. Epub 2017 Jul 5. PMID: 28757802; PMCID: PMC5516743.

Azam A, Manchanda S, Thotapalli S, Kotha SB. Botox Therapy in Dentistry: A Review. J Int Oral Health. 2015;7(Suppl 2):103-5. PMID: 26668495; PMCID: PMC4672850.

Hu Long, Zhengyu Liao, Yan Wang, Lina Liao, Wenli Lai,
Efficacy of botulinum toxins on bruxism: an evidence-based review,
International Dental Journal,Volume 62, Issue 1,2012,Pages 1-5,ISSN 0020-6539.

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