29/06/2022

BTX and mouthguards – the surprising answer to bruxism treatment?

An Dental
Lady suffering from bruxism

From burnout to physical and mental stress, we can all agree that the pandemic has brought about some undesirable trends and side effects. In dentistry, we’re seeing a rise1 in bruxism, a condition in which you involuntarily grind or clench your teeth. 

It is not uncommon to grind or clench your teeth from time to time, especially during sleep; however, did you know that regular teeth grinding can cause damage to your teeth and even alter your face shape as the years go by? 

While teeth grinding is often attributed to stress2, it can also be associated with sleep issues and may be an indicator of obstructive sleep apnea.

In this article, allow me to explain the functional impact of bruxism, why it’s important to correct teeth grinding and the role of botox and mouthguards as treatment options. 

How can I tell if I grind my teeth at night? 

Most people are not even aware they grind their teeth until someone tells them or if they come in for a dental visit. As dentists, we can tell if someone is a clencher or grinder just by examining their mouth and jaw. 

If you experience the following signs and symptoms, there’s a high possibility you grind your teeth and should see a dentist ASAP: 

  • A sore, painful jaw 
  • A dull headache starting in the temples 
  • Fractured, chipped or worn down teeth 
  • Increased teeth sensitivity 
  • Tight jaw muscles 
  • A jawline that’s getting more “square”
Illustration of bruxism
Source: Dr Seah Tian Ee of TES Clinic

Can teeth grinding affect your face shape?

When we grind our teeth, we actively engage our masseter muscle (located near your outer cheek and jawline), causing the muscle to grow and become visibly bulky over time. Think of it building muscles in your body with repetitive exercise – except with bruxism, because it is unintentional, it can be hard to stop. 

It’s been found that bruxism can result in an increasingly square or masculine jawline3. In addition, the pressure placed on the joints can result in temporomandibular joint (TMJ) issues.

Grinding teeth vs clenching teeth

So what’s the solution? 

We often correct bruxism with; 

Mouth Guards 

Mouthguards are dental devices that protect and cover your tongue, gums and cheeks from trauma caused by teeth grinding or sports injuries. Wearing a mouthguard while you sleep can help keep your top and bottom teeth separated so they don’t damage each other from the pressure of grinding or clenching.

There are three main types of dental mouthguards, each serving different purposes:

Boil-and-bite mouthguards
- Made from thermoplastic material 

- Usage involves boiling the mouthguard until it softens and then placing it over your front teeth and biting down 

- Not recommended for long term use as it is not made specifically for the shape of your teeth and can cause your bite to shift 
Suck down mouthguards
- Created in a dentist’s office 

- Involves taking a physical or digital impression of your teeth and it comes with different thickness and hardness 

- Much more comfortable.
Hard night guards
- Made from acrylic and used to treat TMJ and severe teeth grinding and clenching 

- As the masseter muscles relax, the lower jaw also relaxes and positions itself to where it’s supposed to be 

- Extremely durable 

- May be thick and uncomfortable
Mouthguard

BTX

While mouth guards can prevent tooth damage, it does not solve the root of the problem – which is the involuntary grinding and clenching. 

This is where I highly recommend Botox4. It’s been clinically proven5 that BTX is a safe and effective treatment for teeth grinding, especially for patients with severe bruxism. 

  • A small amount of BTX is injected into the masseter muscle, the muscle that controls the movement of your jaw.
  • The BTX will block the signals that tell these muscles to contract, preventing the muscle from overworking and relieving the grinding and clenching.
root of the problem bruxism
Source: Dr Seah Tian Ee of TES Clinic

Many patients who do neurotoxin treatment for their bruxism end up with a slimmer lower face – this is because their overworked masseter muscle shrinks back to its original size, resulting in a smaller and slimmer facial appearance.

As an added benefit, the symptoms that present with teeth grinding also reduce or dissipate. And don’t worry – while your masseter muscle is significantly relaxed, you can still smile and chew as per normal. 

At An Dental, we are committed to caring for more than your dental health. That’s why our Dento Facial Esthetics service was conceived – a series of procedures that combine cosmetic dentistry and aesthetic medicine to ensure you look good and feel good. 

Whether it’s correcting functional changes or beautifying your smile, our team of dental surgeons will work with you to ensure your facial features match your teeth. 

Contact us if you have any questions! 

*Written by Dr Marlene Teo and Dr Mabel Chan

References

  1. https://www.straitstimes.com/lifestyle/cracking-under-pressure-dentists-see-more-cases-of-damaged-teeth-in-pandemic
  2. Lavigne, G. J., Khoury, S., Abe, S., Yamaguchi, T., & Raphael, K. (2008). Bruxism physiology and pathology: an overview for clinicians. Journal of oral rehabilitation, 35(7), 476–494. https://doi.org/10.1111/j.1365-2842.2008.01881.x
  3. Aguilera, S. B., Brown, L., & Perico, V. A. (2017). Aesthetic Treatment of Bruxism. The Journal of clinical and aesthetic dermatology, 10(5), 49–55.
  4. Asutay, F., Atalay, Y., Asutay, H., & Acar, A. H. (2017). The Evaluation of the Clinical Effects of Botulinum Toxin on Nocturnal Bruxism. Pain research & management, 2017, 6264146. https://doi.org/10.1155/2017/6264146
  5. Fernández-Núñez, T., Amghar-Maach, S., & Gay-Escoda, C. (2019). Efficacy of botulinum toxin in the treatment of bruxism: Systematic review. Medicina oral, patologia oral y cirugia bucal, 24(4), e416–e424. https://doi.org/10.4317/medoral.22923
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