Grinding your teeth? Botulinum toxin may help

Jan 18, 2018

People who grind or clench their teeth in their sleep, a condition known as bruxism, may get help from injections of botulinum toxin, according to a small study published in the January 17, 2018, online issue of Neurology®, the medical journal of the American Academy of Neurology. The drug blocks the signals that tell muscles to contract.

The study of 22 people found that those who received shots of onabotulinum toxin-A were more likely to improve on assessments of their teeth grinding and clenching symptoms than people who received a placebo injection.

“This is a very common problem with no established treatment, so these results are encouraging,” said study author William G Ondo MD, of Houston Methodist Hospital in Texas and a member of the American Academy of Neurology. “A larger study is needed to confirm these exciting results.”

For the study, the participants were assessed and spent the night in a sleep lab to measure their teeth grinding and clenching symptoms. Then 13 of them received botulinum toxin injections in their chewing muscles while the other nine received placebo injections. After 4 to 8 weeks, the participants spent another night in the sleep lab and had repeat assessments.

None of the people receiving the placebo improved on the main test, which was the patient’s overall assessment of symptoms, while six out of the 13 people who received the drug were rated “much improved” or “very much improved.”

Participants also rated their symptoms and pain on a scale of zero to 100, where 50 meant there was no change. Those receiving the drug said they had fewer symptoms and less pain, with average scores of 65 on both scales, while those receiving the placebo had no improvement, with average scores of 47 and 42.

There were no serious side effects. Two participants who received the drug said they had a cosmetic change in their smiles.

The main limitations of the study were the small number of participants and the lack of any widely accepted way of measuring bruxism, Ondo said.

Other treatments for teeth grinding and clenching include mouth guards, which help prevent tooth damage but may not stop the grinding and clenching, and behavioral and drug treatments that have either not been tested with clinical trials or have had mixed results.

The study was supported by Allergan Pharmaceuticals, the maker of onabotulinum toxin-A.

Source: News Release
American Academy of Neurology
January 17, 2018