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Treating severe bruxism with botulinum toxin.

AbstractBACKGROUND: Locally administered botulinum toxin, or BTX, is an effective treatment for various movement disorders. Its usefulness in treating bruxism, however, has not been systematically evaluated. SUBJECTS AND METHODS: The authors studied 18 subjects with severe bruxism and whose mean duration of symptoms was 14.8 +/- 10.0 years (range three-40 years). These subjects audibly ground their teeth and experienced tooth wear and difficulty speaking, swallowing or chewing. Medical or dental procedures had failed to alleviate their symptoms. The authors administered a total of 241 injections of BTX type A, or BTX A, in the subjects' masseter muscles during 123 treatment visits. The mean dose of the BTX A was 61.7 +/- 11.1 mouse units, or MU (range 25-100 MU), per side for the masseter muscles. RESULTS: The mean total duration of response was 19.1 +/- 17.0 weeks (range six-78 weeks), and the mean peak effect on a scale of 0 to 4, in which 4 is equal to total abolishment of grinding, was 3.4 +/- 0.9. Only one subject (5.6 percent) reported having experienced dysphagia with BTX A. CONCLUSION: The results of this study suggest that BTX administered by skilled practitioners is a safe and effective treatment for people with severe bruxism, particularly those with associated movement disorders. It should be considered only for those patients refractory to conventional therapy. Future placebo-controlled studies may be useful in further evaluating the potential of BTX in the treatment of bruxism.
AuthorsE K Tan, J Jankovic (Affiliation: Department of Neurology, Baylor College of Medicine, Houston, Texas 77030, USA.)
JournalJournal of the American Dental Association (1939) (J Am Dent Assoc) Vol. 131 Issue 2 Pg. 211-6 (Feb 2000) ISSN: 0002-8177 UNITED STATES
PMID10680389 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Botulinum Toxin Type A
  • Neuromuscular Agents
Topics
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Botulinum Toxin Type A (administration & dosage, adverse effects, therapeutic use)
  • Bruxism (complications, therapy)
  • Deglutition Disorders (etiology)
  • Female
  • Follow-Up Studies
  • Humans
  • Injections, Intramuscular
  • Male
  • Masseter Muscle
  • Mastication
  • Middle Aged
  • Movement Disorders (complications)
  • Neuromuscular Agents (administration & dosage, adverse effects, therapeutic use)
  • Safety
  • Speech Disorders (etiology)
  • Tooth Abrasion (etiology)