Is it true Botox for bruxism ( teeth grinding) causes bone loss in the jaw and would any bone loss reverse itself with time?

Question

I’m interested in getting Botox for bruxism, but I have osteoporosis so I’m particularly concerned about bone loss, but on the other hand I’m destroying my teeth from grinding during sleep so I’m trying to assess cost / benefit of Botox for bruxism. Also curious if it does cause bone loss does it reduce bone when injected around skull or cheekbone too or only in jaw? Thanks !

Michael A. Zadeh, MD, FACS · Answer

Botox for Bruxism (Teeth Grinding) is safe when administered by an experienced injector. It does not cause bone loss. I get this treatment myself and it works great! Make sure you see an expert injector to minimize risk of complications. Best wishes.

Martin Jugenburg, MD · Answer

Hi. Botox injection for teeth grinding consists of intramuscular injection of Botox into the masseter muscles. It does not cause any effect on the bone.

Monika Soni, MD · Answer

I sometimes wonder, where do people get their information. Using Botox should not cause bone loss. If you're grinding your teeth, ha e jaw pain, definitely go ahead and be evaluated by a plastic surgeon or a dentist who is proficient in the administration of Botox and start using a bite plate.

Sarita Nair, MD · Answer

There is no evidence that Botox causes any kind of bone loss, Botox is only injected in muscles to help them relax, therefore it will help with the bruxism.  Just be sure your provider is experienced in injecting Botox. 
Best of Luck

Christopher R. Macdonald, FRCS(Plast) · Answer

Thank you for the question.
There is no good evidence that BOTOX for bruxism or treating masseter hypertrophy, causes loss of bone or bone density.
Please be reassured and go find an experienced facial plastic surgeon.
Good luck!
Dr Christopher Macdonald
CRM Aesthetics

Alex Eshaghian, MD, PhD · Answer

Thank you for your question Elami. I understand your concern. Botox is a purified protein used to address wrinkles associated with facial expression. When injected into the skin Botox will relax the muscles and smoothen out the overlying wrinkles. The most common areas of treatment are in the upper face. These include the horizontal lines seen on the upper forehead when one raises the brows, the vertical lines seen between the brows when one frowns (frown lines), and the crow's feet seen around the eyes when one smiles.It is difficult to make an assessment without a formal exam where the entire medical history is reviewed. However, I hope the information provided here is useful.Botox can be placed in the masseter muscle in the lower face to contour the lower face and address pain associated with TMJ. In this area 20-40 units of Botox are used per side. Depending on the reason for the enlargement of the muscle, permanent results may be achieved. For example, some people have a habit of grinding, clenching, or biting their teeth subconsciously. Often times this happens in their sleep when they are not aware of it. Botox placed in this muscle will relax the muscle and the grinding, clenching, and/or biting will decrease. This will reduce the size of the muscle. If the brain gets accustomed to this and the person stops grinding, clenching, or biting, then the muscle will not become enlarged or as enlarged again. However, if the habit starts again, the muscle will likely get larger.
  
To determine if someone is a good candidate for this treatment it is necessary to look at a person’s lower face when biting and comparing it to when the person is not biting. If a bulge is seen on the outer portion of the jawline, then the person is likely a candidate. It can also be felt with the fingers when biting.
Although there are reports that relaxing this muscle will have any effect on the jaw bone, there have been no published studies demonstrating this. Additionally, there are bony changes that occur normally over time, which are often times exacerbated by conditions such as osteoporosis. If I had a patient with the concern described here I would say that it would be safe to have such as Botox treatment and that any bony changes would likely occur anyway as a result of osteoporosis.With any injection, there are risks such as pain, bleeding, bruising, redness, swelling, tenderness, and infection. We take special precautions to minimize these risks such as using a painless technique. We also treat bruises with a laser as early as the next day. Bruises usually resolve within two weeks if untreated. After a laser treatment bruises usually resolve in 1-3 days, but may still take two weeks for full resolution. In addition to these risks, with Botox there is also a risk that the product spreads or diffuses to nearby structures. Spread to nearby muscles can lead to side effects such as the temporary appearance of droopy eyelids or a temporary asymmetric smile.
  
After a Botox treatment, I recommend that my patients avoid heat exposure, alcohol consumption, and strenuous exercise for 24 hours and not lie down flat for four hours. This is because all of these activities may possibly lead to the movement of the product and consequent side effects such as droopy eyelids. Although there have been no definitive studies shown that these actually occur and some physicians do not provide such aftercare instructions, in the absence of data I err on the side of caution and recommend that my patients avoid such activities.
  
Please consult with a doctor for specific recommendations. Good luck!

Blue Medi Spa - Sherman Oaks - Account Suspended · Answer

Botox is placed in the muscle and therefore does not have any effect on the bone.  There is no contraindication for botox if you have osteoporosis.  If you grind your teeth at night placing the right amount of botox in the masseter muscles would greatly improve this.

Shaun Patel, MD · Answer

No, I do not believe that Botox treatments for bruxism and masseter muscle enlargment cause bone loss. Actually, many of providers believe the opposite - that excess masseter muscle activity can lead to bony remodeling of mandible and early signs of aging in the lower face.

Leonard Grossman, MD · Answer

I sometimes wonder, where do people get their information. Using Botox should not cause bone loss. If you're grinding your teeth, ha e jaw pain, definitely go ahead and be evaluated by a plastic surgeon or a dentist who is proficient in the administration of Botox and start using a bite plate. Good luck from New York City

Lance Timmerman, DMD, MAGD - Account Suspended · Answer

I have never seen evidence of this concern, and have never HEARD of a case like this.  Botox, when done correctly, is very safe.

Is it true Botox for bruxism ( teeth grinding) causes bone loss in the jaw and would any bone loss reverse itself with time?

Answers (10)

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