What is bruxism?
Excessive clenching or grinding of the teeth, is called bruxism, and is thought to be caused by physical or psychological stress, or a sleep disorder. If untreated, bruxism can cause excessive wear of the teeth leading to permanent damage of the teeth and sometimes of the jaw joints. Treatments involve repairing worn or damaged teeth with restorations, crowns or inlays, to replace the damaged tooth surface, and making an occlusal splint, or night guard, custom made from hard plastic that fits over the top teeth, and is worn at night to prevent further wear of the tooth surfaces, and to allow the jaw joint and muscles to relax.
TMJ disorders and muscle relaxant therapy
Disorders of the jaw joint, or TMJ (temporomandibular joint) are not uncommon and may lead to symptoms of pain and discomfort in the jaw called temporomandibular dysfunction (TMD) . Patients may complain of earaches, headaches and a limited ability to open their mouth. Other symptoms can include clicking, popping or grating sounds in the jaw joint, pain when opening and closing the mouth, a general tightness and pain in the muscles of the jaw, or broken teeth due to the excessive forces.
Muscle relaxant injection treatments are available for jaw pain caused by excessive tooth grinding. These can reduce the muscle activity of the jaw and provide relief from wear in the joint system, and can prevent the teeth grinding excessively.
Dentists will try to determine the cause of tooth grinding and associated symptoms, and offer a range of treatment options to reduce the discomfort and intervention before the excessive forces damage your teeth. There are several treatment options that can be used to immediately stop clenching or tooth grinding , and hopefully relieve the jaw pain.
People who clench or grind their teeth are able to relieve the pain in the jaw joints and muscles with physiotherapy treatments, pain relief, prescribed sedatives, occlusal splint therapy or therapeutic use of muscle relaxant injections into the jaw muscles.
Current management for bruxism
Current management by dentists for jaw muscle pain caused by grinding or clenching is with occlusal splint therapy or night guards made by the dentist, orthodontics, pain relief, full mouth rehabilitation, muscle relaxant injections, and very rarely, surgery.
Muscle relaxant injections with Botulinism Toxin A can decrease the destructive effects of tooth grinding. A diluted form of the muscle relaxant is injected in the jaw muscle to partially weaken muscles for a period of 4 to 6 months.
Bruxism is a disorder of repetitive and unconscious contraction of the masseter muscle, the large muscle that moves the jaw. Muscle relaxant injections weaken the jaw muscles enough to reduce the effects of teeth grinding and clenching, but not so much as to prevent proper use of the jaw muscle for eating and normal facial movements. A muscle relaxant treatment typically involves injections into the masseter muscles. It takes a few minutes per side, and you can start to expect feeling the effects after 5 days.
What is the muscle relaxant injection?
The muscle relaxant injection is Botulinism Toxin A, a prescription medicine which contains 100 units of muscle relaxant liquid and is a natural, purified protein that is used therapeutically in medicine to relax facial muscles, and is approved by the FDA (US) and TGA to treat medical conditions such as cerebral palsy. It is widely known for its uses in cosmetic work, as anti wrinkle injections.
How are muscle relaxant injections used in dentistry?
Dentists who have undergone appropriate training can use muscle relaxant injections to treat muscular pain and headaches due to muscle contractions in the head and face, focusing on the jaw area.
Severe and undiagnosed tooth grinding and clenching can lead to headaches, pain in the jaw joint, muscles of the jaw, enlarged masseter muscles, tooth wear and broken teeth, and is thought to be cause by fatigue, stress and emotional extremes.
How does the muscle relaxant injection work?
Approximately 90% of all headaches are thought to be caused by muscle contraction. Pain is minimised with muscle relaxant injections into the muscles of the jaws so that they cannot be contracted fully, therefore the pain is minimised.
What does the treatment involve?
Muscle relaxant injections are usually administered by a very fine needle into the muscles that are causing the pain (eg. masseters, temporalis, frontalis) with a selected appropriate dose. The rest of the muscles still can function normally therefore chewing is mostly unaffected. No anaesthetic is required since the procedure has minimal discomfort, with just a slight sting at the injection site. The treatment generally takes around 15 minutes for a full treatment. The muscle relaxant treatment takes around 5 days to begin taking effect and up to 7 days for the full effect to be felt.
How long does it last?
This varies from individual to individual but usually 3-6 months. Repeat injections may result in the effects being prolonged.
Contraindications to using muscle relaxant
- Pregnancy or breastfeeding
- Allergy to albumin
- an infection, skin condition or muscle weakness
- Have Eaton-Lambert syndrome, Lou Gehrig’s disease or myasthenia gravis.
Any surgical or invasive procedure carries risks. Before proceeding, we recommend that you ask any questions that you wish, advise of any associated issues and seek a second opinion from another qualified health practitioner.
What are the Side Effects?
The amounts are carefully measured appropriately for your case and the injection site is very localized therefore the side effects are minimised.
Possible side effects include but are not limited to discomfort, burning/stinging, swelling, redness or bruising around the injection site. Side effects are minimised by using a trained professional and usually minimal.