A narrative review on the use of botulinum toxin in the treatment of bruxism

Abstract

Bruxism, a parafunctional habit characterized by teeth grinding and clenching, is a common condition affecting daytime and nighttime functionality. It can lead to complications, including dental wear, jaw pain, and temporomandibular joint disorders. Despite the widespread occurrence of bruxism, effective treatments remain limited. Botulinum toxin (Botox), initially introduced for cosmetic purposes, has emerged as a promising therapeutic option for patients with bruxism, especially those who have not responded well to traditional treatments like occlusal splints. This review aims to examine the current literature on the use of botulinum toxin in bruxism management, focusing on its mechanisms of action, efficacy, injection protocols, and safety. Botulinum toxin exerts its therapeutic effects by inhibiting acetylcholine release at the neuromuscular junction, leading to temporary muscle paralysis and reduced muscle activity in the affected jaw muscles. Research indicates that botulinum toxin injections, particularly into the masseter and temporalis muscles, can significantly reduce muscle activity and alleviate associated pain, improving patient outcomes. Dosage and injection sites vary across studies, with most protocols involving 10–30 units per site. While botulinum toxin has demonstrated substantial efficacy in the short term, its effects typically last 3 to 6 months, requiring repeated treatments. Side effects are generally mild and transient, with muscle weakness and ptosis being the most common. Although botulinum toxin represents a valuable option for bruxism treatment, further studies are needed to optimize treatment protocols and understand long-term outcomes. This review underscores the potential of botulinum toxin as an effective, non-invasive treatment for bruxism, offering relief to patients who fail to benefit from conventional therapies.