I've been afflicted with bruxism (teeth grinding) for most of my adult life, which is why I recently tried Botox for teeth grinding, rather than for relaxing wrinkles.
I frequently spend periods of my sleeping hours grinding my teeth and clenching my jaw and it almost always flares up during periods of stress.
However, as bruxism is, in my case and most cases, a nocturnal activity, I have no control over it. I am rarely aware that I am doing it, waking only in the morning with a tight, tense and tender jaw and often an accompanying headache.
Occasionally, I will wake myself up if I am grinding or clenching particularly aggressively, which is a horrible feeling and makes me feel like my teeth are falling out when I wake up.
In 2018, due to a particularly stressful period at my old workplace, it became so bad that I split a tooth (my third molar on the left hand side), resulting in excruciating pain and the immediate extraction of said tooth.
Since then I have worn bespoke gum shields from the dentist while I sleep, which have thus far protected my teeth from further damage. But despite attempts to control it through practices such as meditation before bed and breathing exercises, my bruxism still regularly flares up.
So can Botox for teeth grinding really work?
Bruxism is a condition where you grind, gnash or clench your teeth. According to the Bruxism Association, around 8-10% of the UK population suffers from the condition, which can be classified into awake bruxism and asleep bruxism. (I have asleep bruxism.)
Nearly 80% of bruxism episodes occur in clusters during sleep and a recent study revealed that women are 22% more likely than men to suffer from bruxism. It is also on the rise, with a 2021 report claiming that people were suffering more from bruxism due to the stress of the Covid-19 Pandemic.
The condition is usually caused by stress and anxiety, but bruixism can also be caused by other sleep disorders such as snoring or sleep apnoea. Alcohol, caffeine and drugs can also affect it and I do notice that if I’ve consumed a lot of alcohol before bed, that can often induce an episode.
I visit Dr Ross Perry, whose practice Cosmedics Skin Clinics has clinics in Harley Street, the City of London, Putney and Bristol. Dr Perry explains to me what my Masseter muscles are doing while I am asleep grinding away and what impact it is having on me.
“The muscles in your Masseter, which are your jaw clenching muscles, they basically override all of the normal functions of the Masseter when you are particularly stressed. So what that means is that you'll be clenching without knowing it, particularly at night. And that clenching creates grinding and that grinding wears down your teeth.”
He adds: “It also has a knock on effect onto the other muscles of that part of the face, which gives you painful headaches and so forth. So it's a cascade of effects really just from that and generally it's stress related or can be stress related as a trigger and then it can become habitual. So you do it without even knowing it and then it just gets worse and worse and worse.” Which is exactly what happened with me when I lost the tooth and I do not, I tell Dr Perry, want to experience that again. Which is why I am keen to learn about the effects that Botox - which I have used as a cosmetic procedure in the past to treat the appearance of wrinkles - can have on bruxism.
“The Way that Botox interrupts all of that is it basically reduces the actual function of the Masseter muscle,” explains Dr Perry telling me that the strength of the muscle - which is one of the strongest muscles in the body - will be reduced. I say that this alarms me somewhat and ask if it affect other essential functions? Dr Perry reassures me. “Don't worry, you can still talk, you can still eat, you can still chew as normal, you're just taking the intensity out of [the power] of the muscle.”
I ask Dr Perry if there are any risks associated? “Sometimes if you have very strong muscles, then we have to give you a bigger dose. Now side effects can be dose related and that dose-related side effect would be affecting your facial nerve and that could cause weakness of your smiling muscles and so forth. But it's not common.”
Although it is important to point out that you must always have Botox with a trained and qualified medical professional, as if someone who was not qualified was to insert the Botox in the wrong place around your jaw, then it could have an impact on the functionality of the Masseter muscle. And you wouldn't want to be left unable to smile or eat!
Could ‘botched Botox’ be a thing of the past?
Another aspect of bruxism is that over the past few years it has changed the shape of my face. Whereas once I had a more heart shaped face, with a sloping jawline down to my chin, I have noticed that my jaw is now distinctly more square.
When I clench my jaw in the mirror it is clear that my right hand side, the side with a full set of teeth, has a much stronger muscle and it is rock solid hard when I touch it clenched, like a taught bicep.
This is because I have probably been subconsciously aware that I have a missing tooth on my left hand side, so the right is now working harder when I grind. And like any muscle, when you use it a lot it is going to get bigger and bigger. Dr Perry agrees and explains that a non-medical benefit of this treatment is that it can also help with facial augmentation, especially for those who have developed a more squarer jaw due to teeth grinding, but also because for most people their jaws tend to get squarer as they age.
“So as we age as well, what happens is if you do have a slightly squarer jaw, it becomes more prominent because we lose the volume in the upper parts of our face,” he explains. “So slimming the angle of your jaw down a little bit actually gives you a better proportion of your face. Some people are always a bit worried about creating a bit of a jowling effect because they think, well, okay, if you're losing volume here, it's going to make your jowls a little bit more [pronounced]. But, it's not normally the case because we're not really losing volume, we're just narrowing. The good thing about putting the Botox into this area is it lasts normally twice as long as other areas.”
After applying a topical numbing cream to the area, I had three injections on both sides of my jaw which went deep into my Masseter muscle, with slightly more dosage in my right hand side
It hurt more than anti-wrinkle injections and Dr Ross used slightly more Botox in the muscle on the right hand side, the side that I use more.
“It's a little bit more stingy,” [than Botox for anti-wrinkles] he explains, “but it's less injections because you're only generally putting three or four injections into there and there's two heads to the Masseter muscle. So we generally try and aim for both of those heads, but we do inject deep, so we have to go through the skin down into the belly of the muscle.”
The whole process took no longer than 10 minutes. It was sore in the area for about 48 hours afterwards, which I treated with ibuprofen, but I didn’t notice any significant change in my ability to move the jaw and it certainly didn’t affect my eating or talking.
My Masseter muscles were tender and sore for about two days following the treatment – a marked difference to when I have Botox for wrinkles, for which there are very few after effects.
There was no bruising, however (something that can happen with Botox for wrinkles), but when I moved my jaw it did feel a bit more restricted in movement, which took a while to get used to. Yawning and opening my jaw wide felt a bit weird for a few days.
As my bruxism happens during sleeping hours, it is of course difficult to monitor whether the treatment has had much impact. However, in the weeks since visiting Dr Perry, I have not woken up with a tension headache and while there have been mornings when I wake up aware that I have been grinding or clenching, the tension is definitely reduced.
I have also noticed that my face shape has reverted back to how it used to be and the square jaw-line has dramatically reduced, which is an unexpected bonus.
However, as with all Botox, the treatment will wear off in four to six months. I will definitely return for a second treatment.
A consultation, treatment and follow up with Dr Ross Perry costs £395
