TMJ & Bruxism (Teeth Grinding) Treatment

Bruxism (teeth grinding)

Generally we aren’t aware we’re clenching or grinding our teeth, because it happens during sleep. Sometimes, though, teeth grinding can occur when we’re awake and stressed or anxious. Again, we generally don’t notice because we’re preoccupied with the source of the stress.

What we do notice (or our dentist does) is the havoc bruxism wreaks on our teeth. Signs and symptoms of Bruxism and TMD may include:

Damage to tooth enamel exposing dentine and teeth may appear flattened and worn
Chipped or broken teeth
Fractured teeth/enamel
Loose teeth
Tooth sensitivity

The action of grinding can also damage the tongue, and strain the soft tissues of the jaw, causing jaw stiffness, pain and inflammation.

Bruxism in adults can have a number of causes, these being:

Incorrect alignment of the teeth or jaw
Poor sleeping posture (an incorrect position sending our jaw out of alignment, or compressing the jaw and teeth)
Poor posture when going about our daily lives, again, leaving our jaws out of alignment
Incorrectly performed strenuous exercise
Emotional stress or anxiety
Substance misuse (particularly the use of amphetamines), or taking prescribed medications that lead to jaw tension
Poor dietary choices, leading to illness or dehydration
Caffeine in the diet, leading to increased tension and activity of the jaw
Lack of sufficient sleep and subsequent tension.

Bruxism and TMJ

Temporomandibular Jaw (TMJ) Dysfunction (also known as TMD) is a major cause of facial pain, and is closely related to teeth grinding.

The temporomandibular joint (TMJ) connects your skull and jawbone like a hinge, and allows your jaw to open and close. When you have dysfunction in the joint, it can cause tension and pain. TMJ disorders can be caused by injury, genetics, arthritis, or poor use of the jaw over time.

How do I know if I have TMJ disorder?

A TMJ symptom you may notice is a clicking or popping sound when you open and close your jaw, or even when you chew. This may be due to TMJ. If the clicking is accompanied by pain, it’s worth speaking with a doctor.

There’s a strong association between TMJ disorder and teeth grinding. Long-term teeth grinding can lead to TMJ, and conversely, TMJ can lead to teeth grinding.

With both conditions being detrimental to your jaw and dental health, it’s important to take measures to address them.

How to treat Bruxism and TMJ disorder

There are a number of methods for TMJ treatment and/or bruxism relief, before dental treatments come into it, starting with addressing the causes.

Take a holistic look at your lifestyle, and identify anything that may be leading to the condition.
If you are suffering stress, address the cause of the stress, and undertake activities to reduce stress in your life.
If it’s a postural issue, a physiotherapist can assist by applying massage techniques to relieve tension, assessing your posture, and assigning you exercises to correct postural issues.
If it’s a sleeping issue, take the time to find the right pillow (one that keeps your neck in alignment with your spine).
If it’s dietary, improve your diet, eliminate the use of substances, reduce caffeine, and up your water intake.
Do regular exercises to relieve jaw and neck tension, and use massage techniques to relax your facial muscles. (YouTube has plenty of videos to guide you on the relief of tension and pain associated with teeth grinding and TMD.)
Get quality sleep.

If these methods don’t lead to an improvement in your situation, you may want to try an alternative treatment to combat TMJ pain.

BOTOX® Treatment for Jaw Tension and TMJ Disorder

At Beachside Complete Dental care and Dental Implant centre, we use BOTOX® as an alternative treatment for TMJ disorder and its associated jaw tension and pain. When injected into afflicted facial muscles, BOTOX® for TMJ can relieve symptoms for many patients. Injections often eliminate headaches resulting from teeth grinding, and, in cases of severe stress, BOTOX® can even minimise lock-jaw.

How Does BOTOX® Treat Jaw Clenching, Teeth Grinding and TMD?

BOTOX ® for TMJ works to interfere with the temporomandibular joint’s ability to move. It doesn’t stop it moving completely, but reduces the amount of unconscious movement, and serves to cushion the jaw during activities like talking, eating, swallowing, and other everyday activities. This can greatly reduce the tension in the jaw, and the severity of tension headaches for sufferers.

A non-surgical procedure, BOTOX® injections are administered at our dental surgery and are usually a quick, straightforward and effective method for treating TMJ disorder and teeth grinding. Most patients experience noticeable improvement within one or two days of their first treatment, although relief can take up to a week.

Areas targeted by TMJ Botox ® therapy

The injections are mainly in the temporalis, frontalis and masseter areas (pictured in red below). Additional sites may be injected with Botox, depending on the severity of the pain.

Only the targeted areas injected with Botox will be “relaxed.” (Botox treatment for TMJ disorder will not affect other locations in your body.)

Frontalis area Masseter and Temporalis area

How long does BOTOX ® treatment for TMJ take?

BOTOX ® for TMJ generally takes between 10-30 minutes, although the length of treatment depends on the number of injections needed, as determined by your dentist.

Is BOTOX ® treatment painful?

The BOTOX ® injections may cause pain, but it is generally minimal and brief. Some patients liken the injections to the feeling of an insect bite.

Pain can be reduced by numbing proposed injection sites with a cold pack or anesthetic cream, before commencing BOTOX® treatment for jaw clenching and teeth grinding.

What to expect after a BOTOX ® TMJ treatment

After your BOTOX® for TMJ treatment, muscle tenderness disappears almost immediately. You may experience mild bruising, numbness, or redness around the injection sites, but it is temporary.

Recovering from BOTOX ® TMD treatment

Because the treatment is non-surgical and non-invasive, it’s likely you can return to normal activities immediately. However, to avoid spreading the toxin to other muscles, patients should:

Not rub or massage the area injected
Remain upright for many hours.
Avoid physical activity for 24 hours.

Risks, limitations & possible complications of BOTOX ® injections for TMD treatment

Since this is a non-surgical procedure, the risks and possible complications from using BOTOX ® to treat TMD are infrequent, minimal and temporary. However, as with any medical procedure, there are possible risks and side effects of BOTOX ® .

Possible side effects

The most common reported side effects of BOTOX ® treatments are:

headaches
respiratory infection
flu syndrome
temporary eye-lid droop
nausea.

Less commonly reported is pain and redness at the spot of injection, and muscle weakness. These symptoms are thought to be connected with the BOTOX ® injection and occur within the first week.

There could also be bruising at the injection site.

Limitations

BOTOX ® injections administered around the mouth are less effective in treating TMJ disorder, and can potentially have inconvenient side-effects. The lips are used more than the forehead for activities like chewing, kissing, and talking. These everyday activities may become more difficult after the use of BOTOX ®, and too much BOTOX ® around the mouth can result in drooling.

Another limitation to BOTOX ® injection for TMD treatment is the possibility of developing antibodies that render the treatments less effective over time. This resistance may be delayed by using the lowest effective dose possible, over long intervals.

BOTOX ® injection treatments should be avoided during pregnancy and lactation.