Through Grinding my Teeth my Masseter Muscle Has Increased? Will It Decrease in Time?

Question

Im 18 years old and have trouble with grinding my teeth at night . I now have a mouth guard to wear through the night to prevent this. My question is will the muscle of my Masseter decrease in time, considering that the cause of it has now stopped ? Like other muscles in the body will it 'Shrink' as it is no longer being used as much ? Many Thanks, Ollie

Young R. Cho, MD, PhD · Answer

Thank you for your question. Botox or Dysport can be a very effective way to contour the jaw line by reducing the masseter shadow through the outer jaw skin.  In addition, it can reduce symptoms of jaw clenching or grinding of teeth at night time.  This is an advanced technique that requires a strong understanding of the underlying anatomy.  Some side effects can results in some very unintented effects.  This can include affecting the smile due to diffusion of the Botox into neighboring smile muscles.  Over treatment can also overweaken your jaw muscles making it harder to chew food and causes your jaw muscles to relax too much when you sleep.The injection technique does vary by physical exam and the goals of the treatment.  Facial contouring goals may change the injection sites themselves to affect different portions of the masseter as well as the dose. The strength of the masseters can be felt by palpation and also helps me to determine dosing.  In general, I start with 15- 25 units of Botox (OR 50-75 units of Dysport) per side for most patients.  If they have very strong masseters, then I may increase the dose, but more commonly ask them to return in three weeks for a touch up.  Once you get the desired result, I let patients know that future treatments may require less to maintain the look or the jaw clenching symptoms, especially if they get treated as soon as they notice the symptoms return.  This can be as soon as three to four months, but in some cases, patients report that it lasts six months or more.  I find it depends on the dose we use and how many times we have done the procedure as the duration may lengthen for patients that repeat it regularly.

Sonia Badreshia-Bansal, MD · Answer

Thank you for your question. Botox will help relax the masseter muscle and can last up to 3 months.  Maintenance is required. The muscle is not shrinking it's just relaxed and will come back when Botox wears off. I hope this helps.

Sam Naficy, MD, FACS · Answer

Your masseter muscles may slightly decrease in size, but not likely enough to change the shape of your face, like injecting the proper dose of Botox would, over time. If you're inclined to have masseter reduction via Botox, visiting a reputable and well trained injector would be a great first step to assess and discuss options and details of what it can do for you.

Mabrie Facial Institute | San Francisco · Answer

Thanks for your question Ollie! Teeth grinding and jaw clenching can both cause the masseter muscle of the jaw to hypertrophy (become larger). Yes, it is true that the less you use a muscle the weaker it becomes as it atrophies (decreases in size). While a mouth guard at night helps to protect the integrity of your teeth from grinding, it does not necessarily stop the masseter muscle from contracting. Your muscle still has the ability to fully contract and remain strong. Treating the masseter muscles with Botox helps to relax and weaken the muscle so it is not able to contract as strongly, and with time it will atrophy. Botox can provide great relief to patients suffering from symptoms of TMJ. 
I've created a video where I review treating the masseter muscles with Botox/Dysport. I hope you find this information helpful in your research!

Nissan Pilest, MD · Answer

You might see some lessening of the muscle protrusion, but the mouth guard is more of a dental-protection device. 

	Botox is successfully used to prevent the strong contractions of the masseter. it can be a help in changing habitual action. But it's not a permanent fix and if the issues that cause the grinding in the first place aren't resolved, the muscle would likely revert to it's "built up" size once the Botox wears off and habits resume.

	If your grinding is from stress (likely), then it makes sense you would look into some ways to reducing your stress levels. Also, becoming more aware in the day of how you physically respond to stress could help.

	One dentist I know gave patients this phrase to say 3 times before going to sleep to help prevent night time grinding: "Lips together, teeth apart" . It might seem too simple, but self talk and self instruction can be quite powerful.

Ramona Behshad, MD · Answer

Using a mouth guard to stop teeth grinding is important in protecting your teeth and your jaw. Over time, this step will also help shrink your masseter muscle. Since you use this muscle daily to chew, however, shrinking of this muscle can be slow (months to years). If you are open to botulinum toxin, this will jump start the process. Repeat treatments may NOT be necessary once you have softened your jawline. This is because the teeth grinding (the cause) will no longer be present.

Purvisha Patel, MD · Answer

It sounds like you are taking steps in the right direction in wearing the mouthguard to help the muscles not increase any more in size. They will likely not get very much smaller however. As previously mentioned, neurotoxin such as Botox, Dysport or Xeomin can be helpful.

Ken Landow, MD · Answer

You're very fortunate to have the problem now rather than 10 years ago before Botox injections into the masseters became widely available...once the masseters enlarge, there's little likelihood they'll shrink spontaneously to a point where the bulge no longer is visible...after one or two injections of Botox into the area, the results take awhile to become apparent...after that yearly maintenance treatment should suffice...and maybe even less frequently if you kick the teeth grinding habit and it was indeed the sole cause of the problem.

F. Victor Rueckl, MD (in memoriam) · Answer

Even though you are taking the right steps and getting the mouthguard, you will probably find the muscles won't change that much. The mouthguard will protect your teeth, but the muscle will still have the ability to flex and contract so often people don't find the muscle changes much. Give it some time and see how it goes for you, but you may want to seek an injector to put some Botox into the masseter muscle to help decrease it.

Through Grinding my Teeth my Masseter Muscle Has Increased? Will It Decrease in Time?

Answers (9)

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