For bruxism (clenching and grinding) and jaw joint (TMJ) complaints, we plan night guards, masseter Botox and occlusal adjustment individually. Wearing a night guard is strongly recommended after veneer and crown treatment.
It is clenching or grinding the teeth without being aware of it.
Bruxism is the clenching or grinding of the teeth without awareness, either during sleep (nocturnal) or during the day (diurnal). Left untreated it can lead to wear of the tooth surfaces, enamel fractures, tooth sensitivity, fatigue in the jaw muscles and jaw joint disorders. In patients who have had restorations (veneers, crowns) or implants, bruxism directly affects how long the work lasts.
Three main approaches are combined according to the case.
Night guard
A hard or soft acrylic guard made to measure following a digital scan. By preventing the tooth surfaces from meeting during sleep, it stops the wear. It is frequently the first line of treatment.
Masseter Botox
Botulinum toxin applied to the chewing muscle (the masseter) reduces excessive contraction of the muscle. The effect begins within three to seven days and lasts four to six months. Considered alongside a guard, the success rate increases.
Occlusal adjustment
Where there is a mismatch in the contact surfaces of the teeth, the bite is brought into harmony with small adjustments. Orthodontic treatment is another option that can be considered over the longer term.
An individual approach to jaw joint disorders.
A clicking sound from the jaw joint, difficulty opening the mouth and pain around the ear and temple are signs of TMJ dysfunction (TMD). A conservative approach is adopted first: a night guard, stress management, heat application, physiotherapy and, where needed, muscle relaxants. In advanced cases an intra-articular injection (PRP or hyaluronic acid) or, rarely, surgery may be considered.
Treatment is planned after clinical examination and, where necessary, CBCT imaging. A multidisciplinary approach (dentist, physiotherapist and, if needed, psychiatry) is helpful in most cases.