Bruxism and hypertonicity of the masticatory muscles - treatment
Bruxism and hypertonicity of the masticatory muscles are inextricably linked. Bruxism is a condition in which there is an involuntary compression of the jaws and grinding of teeth. As a result, leading to hypertonicity (tightness) of the masticatory muscles. Often this condition becomes an obstacle to not only implantation, but also conventional dental prosthetics, installation of veneers and even achieving high results of orthodontic treatment. Excessive work of the masticatory muscles will lead to overload of implants, faster destruction of prostheses and increased pressure on certain areas of the dentition. But even in a normal situation, if you have preserved your native teeth, bruxism leads to their more rapid failure. Therefore, the problem needs to be solved. Which leads to… «How do you treat bruxism and is it possible to get rid of it?»
Botulinum therapy is one of the most effective ways to relieve excessive overstrain of the masticatory muscles for a long time, as well as to remove the symptoms of bruxism and get rid of the habit of grinding teeth.
Preparations of botulinum toxin type A are better known as Botox and are strongly associated with getting rid of early wrinkles. But there are several myths that surround it. Firstly, Botox is not a group of drugs and not an active substance, but the trade name of a very specific remedy, which, nevertheless, has become a household name, that is used to refer to all such drugs in general. Secondly, there is a wide range of tasks it can be used for!
What are the advantages of botulinum therapy «Xeomin» in the treatment of bruxism?
- MUSCLE RELAXATION
Complete relaxation of the clamped masticatory muscles and elimination of painful spasm.
- LONG-LASTING EFFECT
After one procedure, the relaxing effect lasts for several months.
- GET RID OF PAIN QUICKLY
The drug begins to act immediately and gently relieves overstrain and discomfort.
- POINT EFFECTS
The medicine is injected into strictly defined points and does not affect the work of other facial structures.
- GETTING RID OF A BAD HABIT
You will imperceptibly get used to clenching your jaws and aggravating the effects of bruxism.
- MAXIMUM SECURITY
The drug does not cause dependence and is completely excreted from the body.
For each case - its own solution!
1 Xeomin procedure
Gentle and safe exposure
For mild cases of hypertonicity of the masticatory muscles
Course of 3 procedures «Xeomin»
Gentle and safe exposure
For moderate to severe hypertension
Botulinum therapy can help if you have a habit of firmly clenching your jaws and grinding your teeth, you suffer from increased abrasion of enamel and destruction of crowns.
Symptoms of hypertonicity of the masticatory muscles and bruxism
- chewing surfaces of the teeth become erased and flat (cutting edges disappear),
- tooth enamel is chipped, wedge-shaped defects appear, fillings fly out, teeth quickly collapse and loosen, gums hurt,
- you experience discomfort when opening your mouth, while eating or yawning - there are clicks, crunches,
- you or your loved ones notice that you grind your teeth - a characteristic grinding manifests itself mainly at night (the so-called "night bruxism"), when it is difficult for a person to control himself in a dream,
- reduces the jaw movements - 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, there is overstrain and pain with bruxism,
- when talking or while chewing, you feel that the facial muscles are "clogged", tired,
- when you are angry, tense or just working hard – your mouth is tightly closed, your lips are pursed, your teeth are closed, you literally clench your jaws,
- there are problems with the bite - the teeth do not close correctly, the jaws are displaced relative to each other, because of which you bite the cheeks or tongue,
- after concentrated work or under stress, you often have a pressing sensation in the temples, aches and dizziness,
- you notice ringing and tinnitus,
- over time, the lower half of your face has visually become square, heavy,
- there are problems with posture - you slouch, your lower back hurts, your neck leaks, one shoulder is higher than the other.
If you find yourself with one or more signs, then this is an occasion 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 spasm of the facial muscles and eliminate by advanced methods - safely and with a high result.
The main causes of bruxism in adults and overstrain of the jaws
- psycho-emotional causes: nervous overstrain, prolonged stress, difficult experience of situations,
- dental causes: prolonged absence of teeth, malocclusion, diseases of the temporomandibular joint, complete or almost complete absence of teeth, uncomfortable and poor-quality crowns and dentures, too high fillings, injuries of the dentition system,
- disorders of the musculoskeletal system: injuries and curvature of the spine, posture disorders, asymmetry in the work of the muscles of the body,
- neurological causes: epilepsy, birth injuries, brain and CNS damage,
- other reasons: taking certain medications, smoking, abuse of caffeinated drinks.
We always approach the problems of hypertonicity of the facial muscles in a comprehensive manner. First of all, we look for causes from the maxillofacial apparatus - we conduct a complete diagnosis and examination, evaluate the work of the masticatory muscles, identify the characteristic habits of the patient and collect the medical history. If necessary, we refer the patient to specialized specialists - a neurologist, psychotherapist, etc. It is very important to cure hypertension - at least so that the patient in the future can begin high-quality restoration of teeth without risks: implantation, prosthetics or treatment.
work experience of more than 35 years
Botulinum therapy as one of the ways to treat hypertension and bruxism
Botulinum toxin type A, which is used in medicine and cosmetology, is able to relieve spasms and relax overstrained muscles, point-by-point reducing their activity or immobilizing them altogether. But not forever, only for a certain period - during this time the body adapts to new circumstances and ceases to excessively overstrain a certain area. That is, the therapeutic effect for such a diagnosis as "bruxism" persists for a long time, which is confirmed by numerous patient reviews.
How does it work?
Botulinum toxin type A is a neurotoxin produced by the bacteria Clostridium botulinum. It blocks nerve impulses from the CNS to muscle fibers. This is whern 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 and not toxic to the body!
The drug is injected at well-defined points in order to affect only a specific muscle and not to affect the work of the rest. Dosages are harmless and the blockage is reversible. Over time, the drug is completely eliminated from the body - usually it takes from 5 to 7 months. Gradually, neuromuscular conduction at the site is restored, and mobility returns to the muscle - but since it "rested", the spasmodic fibers are smoothed, 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 wrinkles by blocking the work of facial muscles. A myth of botulinum toxin preparations is that it can be "pumped up" – which is incorrect. They do not increase the volume of soft tissues in any way.
To relieve excessive tension of the masticatory muscles, we use the drug "Xeomin". With a high degree of purification of the drug, the risk of adverse reactions is minimized. Dosage and course are selected by the doctor strictly for the individually!
Indications and contraindications for botulinum therapy of masticatory muscles
- soreness in the zone of the temporomandibular joint,
- limited opening of the mouth,
- 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.
- pustular skin lesions, ulcers, acute infection in the zone of the masticatory muscles,
- viral and infectious diseases in the acute stage,
- neuromuscular diseases (myasthenia gravis),
- constant intake of certain medications and antibiotics,
- pregnancy and lactation,
- bleeding disorders,
- diabetes mellitus,
- allergic reactions to the components of the drug,
- oncology and severe mental disorders.
The main stages of treatment
Step 1. Preparation for the procedure
You may be referred to the botulinum therapy procedure by a doctor, for example, an implant surgeon or an orthopedist for comprehensive preparation before the installation of implants or dentures. But you can also go to the dentist yourself with complaints of symptoms of bruxism of the teeth. On the recommendation of a doctor, after consultation and diagnosis, you can proceed to an injection course.
No complicated preparation is required. 2-3 days before the procedure, it is advisable to exclude alcohol and reduce the consumption of tea, coffee and energy drinks, as well as stop taking blood-thinning drugs and antibiotics.
Experienced doctors who observe safety precautions!
Our specialists have undergone appropriate training, have certificates 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 an average of 20 minutes. The doctor conducts a follow-up examination and marks the points for the introduction of the drug.
The doctor takes the ampoule out of the refrigerator and opens a disposable syringe with the medicine in front of you - so 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 into different parts 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 anesthetized.
Step 3. Rehabilitation period
The drug begins to act immediately, but it gains maximum strength gradually - about 10-14 days, during which the spasmodic area is completely relaxed. 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 bath and sauna, as well as to the pool.
It is also important to keep touching the face to a minimum in the first days as well as not steam or massage the injection sites.
The effect of the drug lasts up to 7 months but may be less depending on the individual’s characteristics. The doctor will discuss whether a second course is needed and can be booked at reception.
Cons of the treatment of bruxism with the drug «Xeomin»
It is important to choose an experienced certified doctor who has been trained and has official admission to botulinum toxin injection therapy - this is a rather complex procedure with its own subtleties. If you do not follow the rules of storage, selection of dosage and administration techniques, there may be complications. Hematomas, bruises or a slight swelling in principle will pass on their own, then difficulties with swallowing and chewing should already be eliminated together with the doctor.
Our doctors have been trained and certified - to treat hypertension with botulinum therapy in our clinic is completely safe
Why is botulinum therapy not enough to eliminate hypertension?
It must be understood that Botox treatment in dentistry, as well as orthopedic treatment of bruxism (that is, the manufacture of special protective mouthguards for teeth with bruxism), is only an additional, not an independent method. Botulinum therapy protects against the effects of muscle overstrain - that is, visible relief will really come after the introduction of the drug. The spasm will go away, the muscles will relax, you will stop involuntarily clenching your jaws and injuring your teeth with this. But as soon as the effect of exposure to botulinum toxin comes to naught, the problem may return, although to a lesser extent.
Of course, if it was only a formed habit on a nervous basis, there is a good change of completely getting rid of symptoms of bruxism in psychosomatics or neurology after treatment. But if the source lies in other pathologies and disorders, then you need to also deal with their elimination: to engage in posture, solve problems with the bite, restore destroyed teeth, replace poor-quality prostheses, etc. And botulinum therapy will become an effective complex measure.
Why do we need mouth guards 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 "kappa" or "trainer for bruxism"). These are plastic and dense onlays on the teeth, which are worn mainly at night, and with severe symptoms they are worn during the day. They are made of hypoallergenic materials in a dental laboratory individually for the patient or commercially produced in a factor.
But this is also an auxiliary measure - the mouth guard helps relax the muscles, protects against tooth abrasion and the effects of bruxism, but does not remove the cause of hypertension.
- protection of enamel from cracks, chips, increased abrasion during involuntary compression of teeth,
- protection of artificial crowns, prostheses (including on implants) or braces from damage,
- relieving tension and pain in the masticatory muscles and joints,
- protection against movement and displacement of the teeth due to constant pressure on them,
- the gradual return of the jaws and joints to the correct position in case of their displacement (of course, only individual mouthguards for bruxism made by a doctor work this way).
Choosing a mouth guard for sleeping with bruxism: types and price
First, there are universal and individual options: finished products are produced in factories according to standard templates, and custom-made mouthguards are made exactly according to your sizes.
As we mentioned, mouthguards are not only for night-time. The vast majority of patients suffer from teeth grinding during sleep, but a number of people cannot control the compression of the jaws during the day - for such cases there are options for daytime pads which are more imperceptible and do not affect pronunciation.
Mouth guard for teeth from bruxism, especially at night, can be bought at the pharmacy (at least in Moscow, or in any other city). The costs are about two to three times cheaper than made to order. The quality depends on the manufacturer, and even universal options have restrictions on size and shape, so they simply may not fit the dentition. But the most important limitation, which patients often forget, is that the finished lining should be bought on the recommendation of the dentist and not self-medicated. Alas, without diagnosis and search for the causes of spasm of the masticatory muscles, the finished mouth guard will do more harm than good.
Therefore, it is better if the kappa is made individually - according to a cast from your jaws. Individual mouthguards for bruxism, made during sleep, take into account anatomical features to the smallest detail and do not overload the teeth. And if you need to wear the pad during the day, then it should correspond to the shape of the teeth in order to really be invisible when communicating. You can order such a mouth guard for bruxism in dentistry, contacting a doctor with this problem.
The doctor will give recommendations for how long a day it is better to wear a mouth guard, how to care for it and when the product should be replaced.
What will happen if you do not treat hypertonicity of the masticatory muscles?
The masticatory muscle that drives the lower jaw is the most powerful in the group of facial muscles. When reduced, it can create a force of up to 80-100 kg (compare that in order to chew food qualitatively, we use barely 10% of this force).
Chronic spasm and overstrain of such a strong masticatory muscle creates excessive pressure on the teeth, periodontal tissues and temporomandibular joints. From here, many unpleasant consequences for the jaw system and health in general develop:
- abrasion of enamel and reduction of 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 prostheses,
- 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 zone of muscle spasm,
- increased headaches, dizziness, noise and pain in the ears,
- overstrain of the muscles of the neck and back, the development of problems with posture,
- violation of the aesthetics of the face: angular jaw, deep wrinkles near the nose and lips, sunken face and a decrease in the lower third.
Is it possible to undergo implantation with bruxism?
Only on condition that an integrated approach is applied to the implantation and subsequent installation of the prosthesis. In order for the new teeth to serve you for a long time, we carefully plan the entire course of treatment from start to finish: we conduct an in-depth diagnosis, identify concomitant problems that may affect the result, take measures to eliminate them and step by step work out the entire course of the operation and prosthetics.
For example, often bruxism and problems with the temporomandibular joints in our patients are due to the fact that the dentition system worked incorrectly 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 the treatment of such conditions, since we think over prostheses taking into account the proper functioning of muscles and joints, the normal closure of the dentition, etc. But the body will need time to rebuild to normal work. And that is why for cases of bruxism we take additional measures - we increase the number of implants installed on the entire jaw, make prostheses reinforced with a frame and created from more durable materials, make protective soft mouthguards.
But if bruxism in adults cannot be cured only by dental methods, since the problem is not from the jaw system, but in the same psychosomatics, then we refer the patient for treatment to a specialized specialist - and we return to the restoration of teeth after. We care about your health and do everything to ensure that the achieved results of treatment are preserved not for a couple of years, but throughout life.
Prevention of bruxism: how to help yourself
By prevention, we mean measures that prevent hypertonicity and bruxism of the teeth in adults, because without the search for the cause and the supervision of a specialist, their treatment at home is unsafe, as for any disease. So if you notice alarming symptoms, your first step is to go through a diagnosis and get a plan for a comprehensive solution to this problem.
You may need the help of several specialists (neurologist, dentist, gastroenterologist, ENT doctor, psychotherapist), because bruxism in different people occurs for very different reasons. You may be prescribed courses of physiotherapy, taking certain medications (for example, magnesium preparations), but all this, of course, is specific to the individual.
Self-help measures will be helpful if you have coordinated them with your doctor. For example, you can do a light relaxing massage for bruxism in the chin and temple area. There are also a number of exercises that help relieve muscle spasm - it is useful to regularly repeat them before bedtime. Relieve general stress: sleep enough hours, walk more in the fresh air, reduce the amount of coffee and strong tea, take relaxing herbal baths, avoid anxious situations.
All of this will help to consolidate the result of complex professional treatment and forget about unpleasant symptoms.