Bruxism and hypertonicity of the masticatory muscles

Botulinum toxin type A preparations are better known in our country as Botox and are firmly associated with getting rid of early wrinkles. But there are a number of inaccuracies here. Firstly, Botox is not a group of drugs or an active substance, but a trade name for a very specific drug, which, nevertheless, has become a household name, that is, it is used to refer to all similar drugs in general. And secondly, the range of tasks for such tools is much wider!

What are the advantages of botulinum therapy with Botulax in the treatment of bruxism?

Myorelaxation Complete relaxation of tight masticatory muscles and elimination of painful spasm.
Long-lasting effect After one procedure, the relaxing effect lasts for several months.
Quick relief from pain The drug begins to act immediately and gently relieves stress and discomfort.
Point effect The medicine is administered to strictly defined points and does not affect the functioning of other facial structures.
Getting rid of a bad habit You will quietly get out of the habit of clenching your jaw and aggravating the consequences of bruxism.
Maximum safety The drug does not cause addiction and is completely eliminated from the body.

There is a solution for each case!

1 procedure

1 Botulax procedure Gentle and safe effect For mild cases of hypertonicity of the masticatory muscles RUB 15,000. 15,000 rub.
3 procedures

A course of 3 Botulax procedures Gentle and safe effects For moderate and severe stages of hypertonicity RUB 35,000. 35,000 rub.

Botulinum therapy can help if you have a habit of clenching your jaw tightly and grinding your teeth, you suffer from increased abrasion of enamel and destruction of crowns.

Symptoms of hypertonicity of the masticatory muscles and bruxism

the chewing surfaces of the teeth become worn and flat (the cutting edges disappear),
tooth enamel chips, wedge-shaped defects appear, fillings fly out, teeth quickly decay, become loose, gums hurt,
you experience discomfort when opening your mouth, while eating or yawning - there are clicks, crunching sounds,
you or your loved ones notice that you are grinding your teeth - the characteristic grinding appears mainly at night (the so-called “night bruxism”), when it is difficult for a person to control himself during sleep,
cramps the jaw - you cannot fully open or close your mouth, the jaw seems to be blocked,
it is difficult for you to keep your mouth open for a long time, overexertion and pain appear during bruxism,
when talking or chewing, you feel that your facial muscles are “clogged”, tired,
when you are angry, tense or just working in concentration - your mouth is tightly closed, your lips are pursed, your teeth are closed, you are literally clenching your jaw,
there are problems with your bite – your teeth don’t fit together correctly, your jaws are misaligned relative to each other, causing you to bite your cheeks or tongue,
after concentrated work or under stress, you often have a pressing sensation in your temples, pain and dizziness,
you notice ringing and noise in your ears,
Over time, the lower half of your face has become visually square, heavy,
there are problems with posture - you are slouched, your lower back hurts, your neck is stiff, one shoulder is higher than the other.

If you find one or more signs in yourself, then this is a reason to consult a specialist for medical help. And the first step is a comprehensive diagnosis and search for the causes of hypertension.

We approach the treatment of bruxism comprehensively! We carry out in-depth diagnostics, find the exact cause of facial muscle spasm and eliminate it using advanced methods - safely and with high results.

Free consultation

For a perfect oval face and smooth neck skin

"Swing"

Photo: AiF/Eduard Kudryavitsky

Starting position: sit up straight, back straight, pull your head by the crown. Place one palm on your neck as shown in the photo. Don't push! Pull the skin down slightly for light resistance, literally 3mm.

Smile. Stick out your tongue and stretch it upward, as if trying to reach the tip of your nose. Use your other hand to secure the folds around your lips. To perform the exercise, sit on the edge of a chair. Lean back a little and rock back and forth (like on a rocking chair) - the movement is from the pelvis. Repeat 20 times. Watch your posture, keep your back straight! Don't throw your head back.

Result: the corners of the lips are raised, jowls and double chin are reduced, and the oval of the face is improved.

The main causes of bruxism in adults and jaw strain

psycho-emotional reasons: nervous overstrain, prolonged stress, difficult experiences of situations,
dental reasons: prolonged absence of teeth, malocclusion, diseases of the temporomandibular joint, complete or almost complete absence of teeth, inconvenient and poorly made crowns and dentures, fillings that are too high, injuries to the dental system,
disorders of the musculoskeletal system: injuries and curvature of the spine, poor posture, asymmetry in the work of the core muscles,
neurological causes: epilepsy, birth trauma, brain and central nervous system damage,
other reasons: taking certain medications, smoking, abuse of caffeine-containing drinks.

“We always take a comprehensive approach to solving problems of hypertonicity of facial muscles. First of all, we look for causes from the maxillofacial apparatus - we carry out a full diagnosis and examination, evaluate the functioning of the masticatory muscles, identify the patient’s characteristic habits and collect a medical history. If necessary, we refer the patient to specialized specialists - a neurologist, psychotherapist, etc. It is very important to cure hypertonicity - at least so that the patient in the future can safely begin high-quality dental restoration: implantation, prosthetics or treatment.”

Aida Vladimirovna Jutova, implant surgeon, periodontist, work experience of more than 10 years make an appointment

Clinical picture

The first sign of trismus of the jaw muscles is compression of the upper and lower jaws, during which the person cannot make any movements.

Other characteristic symptoms:

pain when trying to make a movement;
swelling, compaction;
limited mobility;
facial asymmetry (with unilateral spasm).

The pain intensifies when palpated. In some cases, there is an increase in temperature and fever. Unilateral spasm most often occurs as a result of injuries and inflammation of the facial region, bilateral spasm occurs in pathological conditions of the body systems.

Trismus has three forms, which is determined by the degree of limitation of motor functions:

with a mild form, the mouth may open up to 4 cm;
with average – up to 2 cm;
in severe cases - up to 1 cm.

The pathology is often confused with a dislocated jaw or arthritis of the joints, which is associated with similar symptoms, so professional diagnosis is necessary to determine the exact cause of the problem.

Botulinum therapy as one of the methods for treating hypertension and bruxism

Botulinum toxin type A, which is used in medicine and cosmetology, is able to relieve spasms and relax overstrained muscles, specifically reducing their activity or immobilizing them completely. But not forever, but only for a certain period of time - during this time the body adapts to new circumstances and stops overstraining a certain area. That is, the therapeutic effect for a diagnosis such as “bruxism” lasts for a long time, which is confirmed by numerous reviews from patients.

How it works?

Botulinum toxin type A is a neurotoxin produced by the bacteria Clostridium botulinum. It blocks nerve impulses from the central nervous system to muscle fibers. That is, in fact, the drug paralyzes a certain muscle without transmitting motor commands from the brain to it.

In medicine and cosmetology, it is used in ultra-small and highly purified forms - that is, it is not poisonous or toxic to the body!

The drug is injected into clearly defined points in order to affect only a specific muscle and not affect the work of others. The dosages are harmless, and the blocking is reversible. Over time, the drug is completely eliminated from the body - usually this takes from 5 to 7 months. Gradually, neuromuscular conduction in the area is restored, and mobility returns to the muscle - but since it has “rested,” the spasmodic fibers are smoothed out, and the body adapts and normalizes the load.

Botulinum toxin only relieves hypertonicity and allows the muscle to relax. This is the basis of its well-known cosmetic effect - smoothing out wrinkles by blocking the work of facial muscles. That is, it is wrong to think that you can “pump yourself up” with botulinum toxin preparations - they do not in any way increase the volume of soft tissues.

To relieve excess tension in the masticatory muscles, we use the drug Botulax for intramuscular injection with 99% active substance content, thereby increasing the speed of onset and duration of the therapeutic effect. And thanks to the high degree of purification of the drug, the risk of adverse reactions is minimized. The dosage and course are selected by the doctor strictly individually!

How to relax facial muscles using folk remedies

There are many tips online on how to relax your facial muscles using folk remedies. Trying such recommendations on yourself without first consulting a doctor is dangerous for two reasons:

High risk of allergic reaction;
Lack of clinical trial experience.

Before entering pharmacies, any medications undergo many years of testing on volunteers. In the case of traditional medicine, you act at your own peril and risk, not knowing how the body will react to the combination of the proposed ingredients.

Indications and contraindications for botulinum therapy of masticatory muscles

Indications

pain in the temporomandibular joint area,
limited mouth opening,
clicking, crunching, discomfort when moving the lower jaw,
pathological abrasion of enamel,
overstrain of the masticatory muscles, their soreness and heaviness,
preparation for implantation, classical prosthetics (especially veneers), orthodontic treatment.

Contraindications

pustular skin lesions, ulcers, acute infection in the area of the masticatory muscles,
viral and infectious diseases in the acute stage,
neuromuscular diseases (myasthenia gravis),
constant use of certain medications and antibiotics,
pregnancy and lactation period,
bleeding disorders,
diabetes,
allergic reactions to the components of the drug,
oncology and severe mental disorders.

Causes of trismus

The problem of spasm of the lower jaw can be associated not only with damage to nerve endings and reflex contraction, but also with other factors:

infectious and inflammatory diseases of the oral cavity;
previous injuries;
unsuccessfully performed anesthesia of the teeth of the lower jaw;
arthrosis of the mandibular joints;
pathologies of ENT organs;
irritation, inflammation of the trigeminal nerve;
purulent processes, etc.

In addition, trismus can be a consequence of pseudobulbar palsy, meningitis, epilepsy, calcium deficiency, etc. Symptoms may first appear after injury, temperature changes, or sudden hypothermia. Sometimes the jaw cramps after opening the mouth wide, for example, after removing a wisdom tooth.

Main stages of treatment

Step 1. Preparation for the procedure

A doctor, for example, an implant surgeon or an orthopedist, may refer you to the botulinum therapy procedure for comprehensive preparation before installing implants or dentures. But you can also contact your dentist yourself with complaints about the symptoms of dental bruxism. On the recommendation of a doctor, after consultation and diagnosis, you can begin the injection course.

No complicated preparation is required. 2-3 days before the procedure, it is advisable to eliminate alcohol and reduce the consumption of tea, coffee and energy drinks, as well as stop taking blood thinning medications and antibiotics.

Experienced doctors who follow safety precautions! Our specialists have undergone appropriate training, are certified and accurately calculate the dosage of the drug. We carry out treatment carefully, safely and with results!

Step 2. Administration of the drug

The procedure itself takes on average 20 minutes. The doctor conducts a follow-up examination and marks points for drug administration.

The doctor takes the ampoule out of the refrigerator and opens the disposable syringe with the medicine in front of you - this way you will make sure that the storage conditions and sterility of the drug are observed. How many units of Botox are needed for bruxism? The specialist will calculate the dose individually, based on the severity of the symptoms, and divide it into 3-4 parts - that is, you will be given several small injections in different areas of the muscle. For injections, disposable sterile syringes with thin needles are used, so the procedure is almost painless. But for greater comfort, the injection site can be numbed.

Step 3. Rehabilitation period

The drug begins to act immediately, but gains maximum strength gradually - over about 10-14 days, during which the spasmodic area completely relaxes. At this time, it is undesirable to overheat and overcool the problem area: that is, you will have to limit physical activity, trips to the bathhouse and sauna, as well as to the pool.

It is also important in the first days to touch your face as little as possible and not to steam or massage the injection sites.

The effect of the drug lasts up to 7 months, but may weaken faster depending on individual characteristics. Your doctor will tell you at your follow-up appointment whether you need a repeat course.

"Cat"

Photo: AiF/Eduard Kudryavitsky
Starting position: lips are relaxed, tongue is stuck out as far as possible. Twist your tongue upward as if you were lapping up water, like a cat. It is very important to feel tension while performing the exercise. Repeat 25 times. Do not purse your lips, make sure there are no creases on your face.

Result: a clear oval face without a double chin.

Disadvantages of treating bruxism with Botulax

It is important to choose an experienced, certified doctor who has trained and has official approval for botulinum toxin injection therapy - this is a rather complex procedure with its own subtleties. If the rules of storage, selection of dosage and administration technique are not followed, complications may occur. And if hematomas, bruises or slight swelling basically go away on their own, then difficulties with swallowing and chewing should be eliminated together with a doctor.

Our doctors have been trained and certified - treating hypertonicity with botulinum therapy in our clinic is completely safe

Our tissues need water

There are many factors that influence muscle loss and reduction. It is important for each of us to consume enough clean water. Average calculation: 30 ml per kilogram of weight. At a young age, we are 70-80% water, and the older we get, the smaller this percentage is. And even if you drink the amount of water your body needs every day, but at the same time drink 5 more cups of coffee a day, you safely “neutralize” this water and remove it, so dehydration continues. Accordingly, our bones, our muscles, and ligaments lose water, but our tissues need it constantly. Therefore, for the beauty of your face, it is important to follow a drinking regime.

Why is botulinum therapy not enough to eliminate hypertension?

You need to understand that Botox treatment in dentistry, like orthopedic treatment of bruxism (that is, the manufacture of special protective mouth guards for teeth during bruxism), is only an additional, and not an independent method. Botulinum therapy protects against the consequences of muscle strain - that is, visible relief will actually occur after administration of the drug. The spasm will go away, the muscles will relax, you will stop involuntarily clenching your jaw and thereby injuring your teeth. But as soon as the effect of botulinum toxin wears off, the problem may return, albeit to a lesser extent.

Of course, if it was just a formed habit based on nervousness, and the causes of bruxism are psychosomatic or neurological, then during treatment you have a good chance to completely get rid of it. But if the source lies in other pathologies and disorders, then you also need to address them: take care of your posture, solve bite problems, restore damaged teeth, replace low-quality dentures, etc. And botulinum therapy will become an effective comprehensive measure.

Acupressure

The procedure is simple, so it is accessible to everyone. It should be done morning and evening, before applying makeup and after removing it. The principle is simple: there are points on the face, lightly rubbing and massaging which you will achieve:

Improved skin color;
Relieving fatigue;
Blood flow to tissues;
Prevention of the appearance of facial wrinkles.

The location of the points and the order of their development is shown in the photo.

Why are mouthguards needed for bruxism?

Another additional way to treat hypertonicity of the masticatory muscles in adults is to wear a special protective mouth guard (they are also called a “mouth guard” or “bruxism trainer”). These are plastic and dense overlays for teeth, which are worn mainly at night, and in case of severe symptoms, worn during the day. They are made from hypoallergenic materials in a dental laboratory individually for the patient or at the factory, if we are talking about mass production.

But this is also an auxiliary measure - a mouth guard helps muscles relax, protects against tooth wear and the consequences of bruxism, but does not remove the cause of hypertonicity.

protection of enamel from cracks, chips, increased abrasion due to involuntary clenching of teeth,
protection of artificial crowns, dentures (including those on implants) or brace systems from damage,
relieving tension and pain in masticatory muscles and joints,
protection against movement and displacement of teeth due to constant pressure on them,
gradual return of the jaws and joints to the correct position in the event of their displacement (of course, only individual mouthguards for bruxism made by a doctor work this way).

Up to what age is correction possible?

For many decades it was believed that the impact would be successful only in childhood, and during primary and secondary school, and not later. But with the development of orthodontics, things have changed. Today, achieving a healthy smile is not difficult at any stage of life - the main thing is that the person himself wants it, so that he is ready to patiently follow a number of medical prescriptions.

What is the problem with correcting bites in adults?

A child's jaw is in the process of growing, so it is more flexible and easier to change. At the age of 15, this is generally easiest to do: the incisors move relatively easily, they are fixed more securely - you have to wear braces for a year, no longer.

For a mature person, a similar procedure will take from 2 to 3 years, because his bone tissue is already formed. It is impossible to expand the space between the teeth, to move them apart; there is simply no free space. In some cases, you even have to remove, say, completely healthy eights.

Another nuance is that, say, at the age of 30, you will also need to consolidate the achieved result, and it will take a long time - from 20 to 40 months. Sometimes people wear retainer structures for almost the rest of their lives. This is explained by the fact that the incisors have already become “accustomed” to their positions and tend to take them again after the braces are removed.

Choosing a sleep guard for bruxism: types and price

Firstly, there are universal and individual options: finished products are produced in factories using standard templates, and custom-made mouth guards are made exactly to your measurements.

Also, as we mentioned, mouthguards are not only night guards. The vast majority of patients suffer from teeth grinding during sleep, but a number of people cannot control jaw clenching during the day - for such cases, there are options for daytime overlays that are more invisible and do not affect pronunciation.

A mouthguard for teeth against bruxism, especially a night guard, can be bought at a pharmacy (either in Moscow or in any other city). It costs about two to three times less than a custom-made one. The quality depends on the manufacturer, and universal options have limitations in size and shape, so they simply may not fit the dentition. But the most important limitation, which patients often forget about, is that a ready-made onlay should be purchased on the recommendation of a dentist, and not self-medicated. Alas, without diagnosing and searching for the causes of spasm of the masticatory muscles, a ready-made mouth guard will do more harm than good.

Therefore, it is better if the mouth guard is made individually - based on a cast of your jaws. Individual mouthguards for bruxism, made for sleep, take into account anatomical features to the smallest detail and do not overload the teeth. And if you need to wear the veneer during the day, then it should match the shape of the teeth so that it is truly invisible when communicating. You can order such a mouthguard for bruxism in dentistry by contacting your doctor about this problem.

The doctor will also give recommendations on how long a day it is best to wear a mouth guard, how to care for it, and when the product should be replaced.

Diagnosis of anomalies

There are obvious cases, such as a pronounced diastema or torsion, you can notice them yourself when standing in front of a mirror. But there are also minor disorders that are no less dangerous to health, and only a specialized doctor can identify them.

Usually, hidden defects are easily recognized by a dentist - when he conducts a preventive examination, removes plaque or places a filling. Then he describes the problem and gives a referral to an orthodontist, who will determine how to straighten the jaw, bite, and a couple of adjacent teeth. To do this, a specialist will conduct a thorough examination of the patient’s mouth with a computed tomography or x-ray.

The anomaly can also occur during life, for example, after injury. Therefore, it makes sense to visit a doctor regularly, every six months, so that he either confirms that everything is in order, or promptly notices unwanted changes, which are easier to stop at the initial stage.

What happens if hypertonicity of the masticatory muscles is not treated?

The masseter muscle, which moves the lower jaw, is the most powerful in the group of facial muscles. By contracting, it is capable of creating a force of up to 80-100 kg (compare - in order to chew food efficiently, we use barely 10% of this force).

Chronic spasm and overstrain of such strong masticatory muscles creates excess pressure on the teeth, periodontal tissues and temporomandibular joints. From here, many unpleasant consequences for the jaw system and health in general develop along the chain:

abrasion of enamel and reduction in tooth height,
chips and cracks, various enamel defects,
frequent caries,
overload of periodontal tissues and the development of gum diseases - in particular, dangerous periodontitis,
failure of fillings, crowns and dentures,
threat to implants, the possibility of their overload and loosening,
swelling and inflammation of the masticatory muscles,
dysfunction of the temporomandibular joint, pain and discomfort when chewing,
deterioration of blood circulation and tissue nutrition in the area of muscle spasm,
increased headaches, dizziness, noise and pain in the ears,
overstrain of the neck and back muscles, development of posture problems,
violation of facial aesthetics: angular jaw, deep wrinkles around the nose and lips, haggard face and reduction of the lower third.

To strengthen the front of the neck

Photo: AiF/Eduard Kudryavitsky
Starting position: back straight. Join your wrists. Place your hands on your neck. Tighten your neck muscles, slightly moving your neck forward, while keeping your head in place. Provide light resistance with your hands. Do it dynamically 20 times. The exercise is performed very delicately. Do not press your head on your hands. To properly activate the muscles during the exercise, you can press your tongue into the upper palate.

Result: tightened, smooth neck skin.

Is it possible to undergo implantation for bruxism?

Only on condition that an integrated approach is applied to implantation and subsequent installation of the prosthesis. In order for your new teeth to serve you for a long time, we carefully plan the entire course of treatment from start to finish: we conduct in-depth diagnostics, identify related problems that may affect the result, take measures to eliminate them, and step by step work through the entire course of the operation and prosthetics.

For example, our patients often experience bruxism and problems with the temporomandibular joints due to the fact that the dental system has not been working properly for a very long time - the teeth were destroyed, the load was distributed unevenly. In itself, the return of all teeth through complex implantation is already a treatment for such conditions, since we think over dentures taking into account the correct functioning of muscles and joints, normal closure of the dentition, etc. But the body will need time to adjust to normal functioning. And that is why in cases of bruxism we are taking additional measures - increasing the number of implants installed for the entire jaw, making prostheses reinforced with a frame and made from more durable materials, and making protective soft mouth guards.

But if bruxism in adults cannot be cured only by dental methods, since the problem is not with the jaw system, but with the same psychosomatics, then we refer the patient for treatment to a specialized specialist - and return to dental restoration afterwards. We care about your health and do everything to ensure that the achieved treatment results last not just for a couple of years, but throughout your entire life.

To relax the chin muscles

Photo: AiF/Eduard Kudryavitsky
Starting position: grab your chin with your fingers, stroke it down. Make sure your lips are relaxed. Repeat 3-5 times. Don't pull the corners of your lips down. Don't overdo it: you can easily get bruises on your chin.

Result: relaxation of the mental muscles, softening of the jawline.

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Prevention of bruxism: how to help yourself

By prevention we mean measures that prevent dental hypertonicity and bruxism in adults, because without finding the cause and monitoring a specialist, treating them at home is an unsafe activity, as with any disease. So if you notice alarming symptoms, your first step is to get diagnosed and get a plan to comprehensively eliminate this problem.

You may need the help of several specialists (neurologist, dentist, gastroenterologist, ENT doctor, psychotherapist), because bruxism occurs in different people for very different reasons. You may be prescribed courses of physiotherapy, taking certain medications (for example, magnesium supplements), but all this, of course, is very individual.

Self-help measures are helpful if you discuss them with your doctor. For example, you can do a light relaxing massage against bruxism in the area of the chin and temples. There are also a number of exercises that can help relieve muscle spasms; it is useful to repeat them regularly before bed. Relieve general stress: sleep enough hours, walk more in the fresh air, reduce the amount of coffee and strong tea, take relaxing baths with herbs, avoid anxious situations.

All this will help consolidate the results of complex professional treatment and forget about unpleasant symptoms.