Do you wake up most mornings with a headache or pain in your face and neck? If so, the chances are that you are clenching your jaw or grinding your teeth when you’re asleep. Below, Dr Pradnya Apte explains what teeth grinding and jaw clenching, also known as bruxism, means for you …
We are keeping our teeth for longer than ever before. But in order to keep our mouths in optimal condition, over 50s need to be extra vigilant about risks which can increase as we get older. As you age your teeth shift because you lose bone and your gums start to recede – hence the phrase ‘long in the tooth’.
Teeth grinding or clenching is a surprisingly common habit which is described as being ‘parafunctional’; meaning a behaviour that is outside what your teeth are actually designed to do. The medical name for this is ‘bruxism’. Studies have suggested that as many as 6 million Britain’s experience the condition, however, we often only find out that we are grinding or clenching at a dental check-up.
This is because bruxism can damage the teeth, with many experiencing tooth wear, chipped, cracked or broken teeth and increased dental sensitivity. People can also experience other symptoms such as headaches (especially in the temple area) aching jaws, tightness or clicking in the jaw area, as well as facial pain.
As an aesthetics practitioner who qualified as a dentist, I can see at a glance if a patient consulting me is a clencher. And I don’t need to look in their mouth! This is because many also experience more obvious physical manifestations of their clenching and grinding which shows in their outward appearance as a result the enlarged jaw muscles – which are effectively given a rigorous, frequent ‘workout. Patients often complain that they feel they have a widened jaw, that leaves their face looking larger than they would like and ‘square’ in appearance. Great if you are male, but not many females aspire to looking square jawed.
There are a two main types of grinding or clenching: the most prevalent is nocturnal bruxism, and happens whilst one is asleep. Many people do also grind or clench when awake, usually during periods of sustained concentration, such as driving, or whilst in front of the computer. This type is known as an awake bruxism.
But what is behind the condition and why do so many people unwittingly cause themselves so many complications? The exact cause of bruxism is unknown, but stress and anxiety are major factors.
Women reaching the perimenopause and menopause experience more than the average amount of stress. That’s when so many emotionally challenging life events collide. Sleep problems, ’empty nest’, ageing parents, relationship and health issues, weight gain, energy drain. As a result, a lot of that stress will go to your jaw! The jaw will clench and spasm, grind and gnash and you will be putting a lot of pressure on your back teeth.
Jaw Clenching & Teeth Grinding
From a clinical perspective, helping to manage bruxism can be tricky. Many patients wear a night-time guard or splint to help to reduce the wear and tear they are inflicting on their teeth. However, in many cases these don’t solve the issue. I have seen first-hand, patients bite through the splints, and patients who clench, rather than grind who still put significant pressure on the teeth, jaw and ligaments that hold the teeth in place. For those with chipped or broken teeth, we can carry out dental restorations when necessary. But, if the bruxism continues, which unfortunately is often the case, it is not uncommon for these repairs to fail.
In some of the more severe cases, people take anti-depressants, muscle relaxants and beta blockers. Some people also resort to orthodontic treatment to change the alignment of their jaws to alleviate the condition.
In our clinics, we find that one of the most effective ways to counter the outward signs of bruxism is through the use of Botulinum Toxin ( Botox ). It is particularly popular for those patients who feel that their face has become ‘square’ in appearance. Or perhaps the muscles in their jaw have become enlarged or masculine as a result of their constant jaw movement? The treatment can help ‘slim’ the face as the muscles relax after the toxin injections.
Botox for Bruxism
Most people know Botulinum Toxin can reduce signs of lines and wrinkles around the brow and eyes. But it can also help many other areas of the body. It is particularly effective to help treat bruxism as it blocks signals from the nerves to the muscles. In the case of bruxism, it can help to reduce the activity in the jaw muscles (predominantly the masseter). This, in turn, reduces the clenching forces on the teeth, lessening the damage. Additionally, we can also inject Botulinum Toxin into the temporalis muscle, to help reduce headaches.
Treatment results are not immediate. It can take up to six weeks to experience the full effects and they last four to six months.
If you want to know if your bruxism could be treated with Botox, it’s important to find a qualified clinician. Look for a dentist who offers the treatment as they inject the toxin deep into the muscle around the jaw area. It is imperative that the treatment is administered carefully to ensure that it doesn’t affect the ability to chew and talk. And dental professionals have a deep understanding of the anatomy of the face. They also work in expert centres offering safe treatment.
Dr Pradnya Apte of Skin SouthWest qualified as a Dental Surgeon in 1993, but since 2007 she has focused on her passion, facial aesthetics. She originally trained in Harley Street but now runs her own clinics.