Botox Treatment of Bruxism Teeth Grinding with Botox

Aesthetic Medicine Aesthetic Dentistry Warsaw.

At Dr. Anna Bucka’s Clinic on 44 Belwederska Street, bruxism is treated with a Botox-botulinum toxin and relaxation rails. Bruxism is the constant grinding of teeth or their involuntary clenching and most often occurs unconsciously during sleep or consciously during the day. The patient cannot consciously control the force of pressure. This has a number of health and aesthetic side effects. Bruxism can affect people of all ages regardless of gender. About 55% of the population suffers from bruxism which is a civilizational disease. It is a psychosomatic, neurogenic condition. The causes of the disease are not fully recognized, but are associated with prolonged stress. Most often these are mental factors and the dominant factor is prolonged stress, excessive mental tension, trauma or neurosis. The chewing muscles then take over the excessive tension in the body. The striated-skeletal muscles (chewing muscles) allow movement. They act as active elements that dissipate excess energy. The dissipation of energy, as well as the cushioning of short-term excessive forces, is aimed at protecting joints and bones from overloads. The muscles are made up of transversely striated tissue, supervised by the central nervous system. The smooth functioning of the chewing organ, taking into account the superior role of the central nervous system, depends on the psychoemotional state and general state of health. Physiological and pathological processes occurring in tissues through nerve connections affect the functioning of the chewing organ. There is a system of three coexisting functional units:

1. dental- right and left temporomandibular joint 
2. dental-alveolar- periodontal teeth, dental organ
3. dental occlusive system of the lower and upper tooth arches

The interconnectedness of all systems makes it possible to understand the importance of the effect of changes in morphological and functional elements on physiological activities. The functioning of the stomatognatic system is determined by the muscles!  The main element of the stomatognatic system is the lower jaw with chewing muscle syndrome and the temporomandibular joints.

Muscles responsible for the functioning of the chewing organ:

• the masseter muscle (lat. musculus masseter)

• the temporal muscle (lat. musculus temporalis)

• the lateral pterygoid  muscle (lat. musculus pterygoideus lateralis)

• the medial pterygoid muscle (lat. musculus pterygoideus medialis).

The masseter muscles are quadrilateral muscles, stationary trailers are located on the zygomatic arch and facial comb, covering part of the mandible and attached to the lateral branch of the mandible. They have 2 layers: superficial and deep. They are distinguished by a differing direction of fibers by about 90 degrees. In the deep layer, the fibers are laid down and forward, in the higher layer down and backward. Both layers are connected by tendon tissues which gives the mandible exceptional power. Movable fibers are located on the outer surfaces of the lower edges of the branches of the mandible, in the vicinity of the mandibular triangle. The masseter is easy to feel from the outside and from the inside of the mouth. Temporal muscles are among the strongest muscles of the chewing organ.  The shape resembles a fan with extensive skull trailers. There are 3 basic groups of fibres.

Factors predisposing the excessive tightening of chewing muscles are: 

• genetic predisposition
• excessive prolonged stress!
• habitual long-term chewing gum, one-sided chewing of food
• malocclusion, incorrect occlusion, ill-fitting prosthetic restorations, poorly made dental supplements.

Downplaying symptoms can result in more serious complaints related to disorders and degeneration in the temporomandibular joint, deepening of occlusion disorders, inhibited vision or hearing problems. It is especially important to correctly diagnose and treat excessive muscle tone in order to restore proper functioning and eliminate the causes. Often, many people are not even aware of this condition. Symptoms of bruxism cannot be noticed for a long time. Most often, only when nagging, constant pain appears, the patient begins to seek help from various specialists. Only the dentist on a visit during the dental examination can diagnose the patient with bruxism. More often, however, patients report to the dental clinic themselves with pain symptoms and visible changes in the teeth. The dentist during an examination assesses the general condition of the patient, the shape of the face, posture, checks the degree of tension of the masseter, temporal and other muscles, cracking, jumping of the temporomandibular joint, conducts diagnostics of the temporomandibular joint. In an intraoral examination, the dentist examines the symptoms of bruxism on the teeth, chipping, damage to teeth, the presence of any wedge or cavity defects, bites on soft tissues on the cheeks, bites on the tongue, pressing of the teeth on the tongue and occlusion. Extra orally he examines the state of muscle tone. The pressure power of the chewing muscles is 25-50kg/cm2. In bruxism the power of action increases many times. The most frequently recorded short-circuit force measurements in the molars zone in women range from 350 to 500 N and 450 to 700 N in men. The pressure force of the masseter muscles in a healthy person is about 100 kg. In people suffering from bruxism is up to 10x greater than the norm. Chewing forces in patients with bruxism are up to several times greater than those during normal biting and chewing processes. The patient unwillingly clenches his teeth at night when he should be resting and the muscles should be relaxed. 

Bruxism leads to:

• excessive abrasion of tooth enamel, ground teeth become shorter and this disturbs the proportions in height to the width of the teeth

• the appearance of yellow to even brown spots on the chewing surfaces of molars and premolars and on the edges of the anterior teeth, which testify to enamel erosion
• cracks in the tooth enamel, crown cracks, fractures of whole teeth
• hypersensitivity of teeth under the influence of cold, acidic fluids and food
• wedge or cavity defects, over abraded and exposed tooth neck
• baring of the roots of teeth, bone defects until the teeth are loose
• muscle pain in the shoulder girth, headaches and spine, vertebral muscle pain and even hip or ankle pain
• pains when opening and closing the mouth, pain in the temporomandibular joint joints when fully opened especially in the morning or with prolonged opening e.g. during a dental visit, yawning
• cracking of, jerking and changes in the temporomandibular joint, deformation of the discs in the temporomandibular joint
• hypertrophy of the muscles most often by chewing of the muscles of the mandible, excessive muscle tone
• mandibular hypertrophy- facial features change, the mandibular line expands, the face becomes square, flat, unattractive. (According to modern Aesthetic canons, a slender, V-shaped, inverted triangle faces is considered attractive. Also with age, the face often takes the shape of the letter A)
• soreness when touching the cheeks
• pain, tinnitus
• increased tension of masseter, temporal, mandibular hyoid muscles, which can provoke “imitation” headache, toothache, neck pain, initiate migraines
• migraines.

Bruxism is most often accompanied by snoring and night apnea.

The goal of treatment is to reduce muscle strength and protect the teeth. To effectively treat bruxism, it is necessary to diagnose, determine the causes, cure the causes, use complementary multi-specialized medicinal methods. Bruxism therapy- treatment of teeth grinding, clenching teeth is a long-term, multi-stage and multi-specialized therapy. It is necessary to cooperate with specialists in various fields: doctor of aesthetic medicine, dentist, orthodontist, gastrologist, laryngologist, neurologist, orthopedist, psychologist, physiotherapist and others. It is recommended to use biofeedback, a method of controlling the processes taking place in the brain.

It is advisable to combine different methods:

• use of Botox, botulinum toxin to weaken muscle strength
• learning to relax, muscle relaxation physiotherapy, muscle massage, psychotherapy, self-therapy- relaxation exercises of facial and neck muscles.
• a special relaxation rail which protects the surfaces of the teeth. The Transparent Relaxation Overlay, thanks to its silicone structure, weakens muscle tone and additionally protects the crowns of teeth from further abrasion, cracking, destruction. By preventing the clenching of teeth, it prevents congestion of the temporomandibular joint. The muscles are relieved and less tense. The procedure is repeated until the muscles are weaned from intense tightening. It is important to replace the relaxing rail with a new one on a regular basis once a year. The relaxation rail while protecting the teeth, is crushed and destroyed. Prolonged use of the same relaxation rail for more than a year does not protect the teeth. In the dental clinic the dentist obtains the tooth impressions. On diagnostic models, in the prosthetic laboratory in Warsaw, a transparent silicone relaxation overlay on the upper or lower teeth is performed depending on the bite conditions. The patient puts on the relaxation rail at night and, if possible, also during the day.
• carrying out of the correct reconstruction of the occlusion– via preservation or a prosthetic

Botox-the botulinum toxin temporarily blocks neuromuscular conduction. Nerve endings do not send a neurotransmitter so that the muscles cease to contract excessively. The preparation has a local, selective effect and no systemic effect. The toxin is administered precisely only in the muscles to be treated. Botulinum toxin works by safely, reversiblely limiting and weakening muscle activity in a particular area, without impediment to the work of other muscles. The duration of the effect is different depending on the individual predisposition of the patient. Most often it lasts 6-9 months. Administration of botulinum toxin to chewing muscles, helps muscles relax. This causes the gnashing and clenching of teeth especially at night during sleep, eliminating the unnecessary habit of tightening muscles!  The patient gains the correct tone of chewing muscles and bites food with normal strength. Pain complaints subside and the process of tooth abrasion stops! After several administrations of botulinum toxin, the mass of chewing muscles (ruminant muscles) decreases. Reducing the volume of masseter muscles leads to a subtler jaw line and oval of the face as well as slimming of the lower part of the face. The oval of the face becomes more slender and the appearance younger. The Botulinum toxin administration procedure is performed only by an experienced Dentist certified Doctor of Aesthetic Medicine. The doctor determines the appropriate dose of Botox botulinum toxin depending on the purpose of the procedure and the individual needs of the patient. The exact price of the procedure is given by the doctor during the consultation with the patient, specifying the treatment plan in detail. At the Clinic we perform treatments based on the highest quality preparation of botulinum toxin Boccouture of the German company Merz. The highest quality of the preparation guarantees the highest quality of the procedure. The procedure does not require special recovery, the patient immediately returns to normal activity. The effects of Botox appear after 3-7 days. Control of the procedure is after 2 weeks. The full effect of the procedure is after 1 month. The patient feels a pronounced relief and the pain symptoms subside gradually. 

Contraindications for use of botox- botulinum toxin:

• neuromuscular conduction disorders, neurological, neuromotor and muscle disorders (myasthenia)
• taking aminoglycosides, tetracycline, lincomycin, polymyxin, aminoquinolone, gentamycin, neomycin, streptomycin, D-penicillamine, cyclosporine, tubokurarin, pancurion, galamine, succinylcholine within one week prior to treatment, 
• treatment with antispasmodic drugs
• hypersensitivity to the components of the preparation
• pregnancy, breast-feeding
• local skin infection
• cancer
• autoimmune disease e.g. rheumatoid arthritis

After treatment recommendations:

Keep the treated area clean and sterile for 24 hours. On the day of the procedure directly after the procedure, avoid air travel, diving, sauna, physical exercises, swimming, alcohol.

The next stage is to rebuild the correct occlusion articulation. Dental treatment in the first place consists of eliminating the effects of the disease and strengthening the enamel. To alleviate the symptoms of the disease to patients suffering from excessive enamel erosion, enamel damage, wedge cavities, tooth sensitivity regeneration and remineralization of enamel with 100% restorative regenerative Tooth Serum with PrevDent nanohydroxyapatite nHAp is recommended- use Prevdent toothpaste with nanohydroxyapatite nHAp and PrevDent mouthwash for daily oral hygiene. Subsequently the reconstruction of eroded fillings, treatment of cavities and repair to damaged dental crowns, replenishment of dental deficiencies and reconstruction and alignment of the bite can commence.

It is important to visit the clinic with the treating dentist, aesthetic medicine doctor at least every 6 months. Healthy facial muscles provide freedom from annoying pain and discomfort!

Sign up a free consultation and confirm a treatment

• (+48) 601 560 580
• (+48) 22 625 05 48
• info@drannabucka.pl

Dr. Anna Bucka Dental Clinic & Aesthetic Medicine Clinic Belwederska str 44 Warsaw