Bruxism
What is Bruxism?
Bruxism is a condition in which you grind, gnash, or clench your teeth. If you have bruxism, you may unconsciously clench your teeth when you’re awake, or clench and grind them during sleep. If bruxism is mild, it can be managed and may not cause many issues.
However, if it’s more severe and frequent, it can lead to short term issues such as earache, stiffness/tightness in the shoulders, facial and jaw ache. Or long-term issues such as teeth sensitivity, damage to the teeth and jaw disorders, like temporomandibular joint disorder (known as TMD or TMJD).
Why does bruxism occur?
There are many factors which can lead to teeth grinding, and it’s often a combination of physical, psychological, and genetic factors. If patients suffer from an abnormal bite, where the teeth do not come together properly, or they have crooked or missing teeth, this can cause bruxism. Awake bruxism can be due to emotions such as stress and anxiety, tension, anger, or frustration. People who experience lifestyle stressors account for the majority of bruxism cases.
Sleep bruxism can also occur. This is when anxiety from work or at home can manifest itself subconsciously when the person is sleeping. This continued tooth grinding and jaw clenching wears away the enamel on the teeth and can lead to more permanent damage. Sleep bruxism can tend to be inherited from other family members.
Bruxism can also be an uncommon side effect of some psychiatric medications. Similarly, people who smoke or drink excessively or take recreational drugs can develop bruxism. It can also be associated with some medical conditions such as Parkinson’s disease, dementia, epilepsy, sleep-related disorders, and ADHD.
What are the signs and symptoms of Bruxism/TMJD?
The signs and symptoms of bruxism/temporomandibular joint disorders can be as varied as the causes, but you may experience one or more of the following symptoms:
- Teeth can appear shorter or get worn down
- Teeth or fillings can break or fall out
- A change in your bite and how your teeth meet
- Clicking, popping, or grating sounds when you move your jaw
- Difficulty opening and closing your mouth or a ‘locking’ jaw
- Pain or discomfort in your jaw muscles, especially when you eat or yawn
- Pain in front of your ears, which may spread to your face, head, neck or upper back
- Migraines or headaches
- Pressure behind your eyes or inside your ears
How to stop bruxism?
There are several ways to get bruxism treatment. Lifestyle changes can help mild cases but in severe cases, joint surgery may be needed. Splints and mouth guards can be worn during the night to prevent grinding teeth in sleep. These are designed to keep teeth separated to avoid the damage caused by clenching and grinding.
A mouth guard, like the ones used by sports people, is a flexible rubber shield which covers the teeth to prevent grinding. Mouth splints are made from hard plastic and are specifically made to fit over you upper and lower teeth to stop grinding teeth at night. However, some individuals may require further treatments.
We can provide you with a Complimentary Bruxism Consultation to discuss the different options and suitability. We offer: –
- A Complimentary Bruxism Consultation
- A treatment appointment to include occlusal splints/mouthguard therapy or Botox therapy or a combination of both (this is usually the best outcome).
- An occlusal assessment and occlusal splints/mouthguards- £220-320
- Botox therapy- £400-500
- A Complimentary Review Appointment
FAQs
Complimentary Bruxism Consultation to discuss the different options and suitability.
Treatment appointment to include occlusal splints/mouthguard therapy or Botox therapy or a combination of both (usually the best outcome).
Occlusal assessment and Occlusal splints/mouthguards- £220-320
Botox therapy- £400-500
Complimentary Review Appointment
Botulinum toxin Type A (Botox®) contains a specifically prepared naturally occurring purified protein that originates from bacteria. It has been used in clinical practice for more than 10 years.
It is injected into a specific muscle and temporarily blocks the release of acetylcholine. This causes a temporary cessation of nerve signals reaching the muscle which prevents the muscle from contracting. The muscle is then relaxed, which reduces the forces of clenching, but still allows normal functioning for chewing and speaking.
Botulinum toxin is approved in the UK for the treatment of several medical conditions including migraine, muscle spasm and hyperhidrosis (excessive sweating).
Tell your clinician if you are suffering from any illness and inform them if you are taking any medication. These may affect treatment with Botulinum toxin.
To avoid bruising, do not take aspirin or anti- inflammatories prior to treatment.
Tell your clinician if you are pregnant or breastfeeding your baby because this treatment is not advisable during this period.
Tell your clinician if you have had any problems in the past with previous injections of Botulinum toxin or with injections in general.
Tell your clinician if you have any inflammation in the muscles or skin where your doctor plans to inject.
Tell your clinician if you have had any problems swallowing.
Tell your clinician if you have had any surgery that may affect the area to be injected or if you have any pending operations.
Botulinum toxin comes in the form of a powder and is mixed with saline to form the solution which is then injected into the muscle.
Dr Nisha Patel / Suzanne Patel will ask you to clench a few times in order to understand your facial muscles, she will then disinfect your skin and mark the injection sites before injecting the treatment at several points.
To limit complications, it is recommended;
Not to rub or massage the treated areas for 24 hours after treatment.
To cleanse the areas gently, without rubbing it that evening
To avoid bending down and not to do any tiring physical exercise (gym, exercise class) or take a sauna the same day
The results of treatment are seen within a week of injection, and maximum effect may be seen 5-6 weeks after injection. Treatment has been shown to be affective up to 4-6 months after injection. At least 3 months must pass between treatments.
As with any medicine, the injection of Botox® may cause side effects for some patients. Do not worry when you read this list of side effects, you may not have any.
Side effects usually occur within the first few days of injection and are temporary.
The most common side effects are headaches, skin redness, local muscle weakness and facial pain.
Other side effects may be associated with the injection (bruising, redness, pain, burning, stinging, and swelling).
Botox injection to the masseter muscle is very safe. Once the treatment has kicked in, there may be tiredness from heavy chewing of hard foods (such as steak). This starts after 1 week and can last a couple of months.
The strength of the bite goes down in 30% of people after a week. This recovers after 3 weeks as other muscles become stronger.
There can be some sagging of the skin if the muscle shrinks faster than the skin. Very rarely a sunken appearance develops on the cheeks. This is because the upper fibres of the muscle shrink down. Also rarely, Botox may spread to nearby muscles causing as an uneven or lopsided smile. Sometimes its not possible to smile as hard as before. This is temporary and wears off.
Sometimes a part of the muscle that has not taken the medication may become too active, and cause a bulge. This is usually when the top (superficial) part of the muscle does not take the medication. This can be treated with a further dose of Botox injection at 6 weeks and is included in the original price.
In a study of over 2000 treatments, the rate of side effects were as follows:
- Reduced bite strength for a temporary period – 30%
- Bruising at the injection site – 2.5%
- Headache – 0.6%
- Bulging of part of the muscle that needed more treatment – 0.5%
- Sunken cheeks – 0.4%
- Sagging – 0.2%
- Reduced smile height – 0.15%
Adverse reactions possibly related to the spread of toxin distant from the site of administration have been reported very rarely with Botulinum toxin (e.g. muscle weakness, difficulty swallowing or pneumonia due to unwanted food or liquid in the airways).
Tell your clinician immediately if any of the following signs or symptoms appears:
Difficulty swallowing
Difficult breathing
Difficult speaking
Muscle weakness
Allergic reaction (swelling of face and airways)
Book your Complimentary Bruxism Consultation today with Dr Nisha Patel and Suzanne Hogan
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