Efficacy of botulinum toxin in the treatment of bruxism: Systematic review.

Fernández-Núñez, T et al. Medicina oral, patologia oral y cirugia bucal vol. 24,4 e416-e424. 1 Jul. 2019, doi:10.4317/medoral.22923


Botulinum toxin (Botox) is a neurotoxin that is sourced from the Clostridium botulinum bacteria. When injected, the neurotoxin blocks the release of acetylcholine and, as a result, interferes with neuron signals responsible for muscle contraction. There have been evolving uses for Botox such as management of strabismus, focal dystonias and reducing the look of lines and wrinkles on the face and neck. The type of botulinum toxin used in this research is type A (BTX-A). There has been evidence to show the use of this drug can help managed the symptoms of bruxism. Bruxism is the clenching or grinding of teeth that is the result of the movements of the masticatory muscles. Bruxism can happen while awake or asleep and results in a range of dental-related consequences such as tooth abrasion, hypertrophy of the masseter muscle and discomfort of the temporomandibular joint (TMJ). The cause of bruxism is thought to be multifactorial. This article also compares the use of BTX-A to relieve symptoms of bruxism with other methods.

The data collected was from a range of databases that investigated the effect of botulinum toxin on relieving bruxism. All participants in the studies surveyed had bruxism and half of the group that was studied had BTX-A injected into the masseter and/or the temporalis muscles. The other half being the control group was given saline injections as a placebo or used occlusal splints, medications or cognitive-behavioral therapy.

Several studies have shown evidence of an overall decrease in bruxism events and pain symptoms, when comparing the results of participants who were given BTX-A versus those who were given saline. Those involved in the study also reported greater range in jaw movements including buccal, protrusive and laterotrusive opening. For the study that compared the use of BTX-A against other methods such as behavioural therapy, occlusal splints and drug therapy, the pain was reduced in the botox-injected group over a period of 6 months. Lastly, another study revealed the ability to maintain a longer bite time after three months in those who were given BTX-A.


In conclusion, the use of BTX-A for the relief of bruxism reduced bruxism pain, frequency and increased occlusal force. Participants expressed having an increased quality of life but there are still studies to be done to investigate the long-term effects of using BTX-A, since the participants were reviewed after one year. When given in low doses, BTX-A was shown to have a low chance of side effects and is generally a safe drug to be administered. There were overall better clinical results when using BTX-A compared to drugs, bite guards and cognitive-behavioural therapy.

Research Summary Written By: Rubina Maani, Queens University Belfast – BDS3

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