Splint or Botox?

What bruxism is: unconscious clenching or grinding, mostly at night, often stress-related. Consequences: worn teeth, cracks, jaw-joint pain, tension headache, thickened chewing muscles with a squared face. About one in five is affected, many without knowing – until the dentist sees the wear.

The bite splint: first choice and an insured service. It prevents tooth contact and protects tooth substance and fillings. But it does not reduce muscle force – many keep grinding with a splint, just without tooth damage. It has to be worn, which not everyone manages.

Botulinum toxin in the masseter: reduces part of the chewing muscle's force so that clenching eases and the muscles shrink over time. Effect after two weeks, duration four to six months, often with longer intervals over time. Side effect: a squared jaw becomes narrower – desired by some, a reason for restraint for others. Chewing remains possible; tough foods are more tiring at first.

Order: first the dentist: rule out tooth damage, assess the jaw joint, make a splint. If pain, headache or muscle thickening remain despite the splint – botulinum toxin as a supplement. Not as a replacement: the splint keeps protecting the teeth.

What else helps: stress reduction, physiotherapy for the jaw, warmth, no chewing gum, alcohol and caffeine in the evening, sleep hygiene. With jaw locking or radiating pain: orthodontics or a TMD clinic.

Legal note: botulinum toxin is not licensed for bruxism (off-label use) and is used as a self-pay service after informed consent. Health insurers generally do not reimburse it.