Oral Medicine · Bruxism and jaw muscles
Teeth grinding and jaw clenching (bruxism) cause jaw pain and headaches, wear and fractures in teeth and restorations, and sometimes enlarged chewing muscles. Botox injections into the masseter muscles reduce clenching force, easing pain and the load on your teeth, without affecting your ability to speak, smile or eat. Treatment is performed at the clinic by Dr. Andra Rettman, a specialist in Oral Medicine, after a full diagnosis of the underlying cause.
Bruxism is involuntary activity of the chewing muscles: clenching or grinding the teeth, during sleep or while awake. Many people are unaware of it until signs appear:
Causes vary: stress, sleep disorders (including sleep apnea), certain medications, caffeine and alcohol. That is why treatment starts with diagnosis, not with an injection.
Botox (botulinum toxin type A) temporarily and precisely weakens the muscle it is injected into. Injected into the masseter (the large chewing muscle at the angle of the jaw), and sometimes the temporalis, it significantly reduces clenching force. The result: less muscle pain and fatigue, fewer headaches, and less load on teeth and restorations.
Worth knowing: Botox reduces the force, not the habit. Chewing, speaking and smiling are preserved, but the cause of grinding remains, so treatment is often combined with a night guard, stress management or a sleep evaluation.
Recent systematic reviews show that Botox injections reduce pain and bruxism intensity compared with placebo. It is, however, an off-label use of the product, so the decision is made after an examination and a detailed explanation.
| Stage | Approximate timing |
|---|---|
| Onset | Within a few days |
| Full effect | About two weeks |
| Duration | Usually 3 to 6 months |
| Change in jawline (when muscles are enlarged) | Gradual, over several weeks |
Treatment is repeated as needed. For some patients the effect lasts longer with repeated sessions, and the dose is adjusted each time.
| Night guard | Masseter Botox | |
|---|---|---|
| What it does | Protects teeth from wear and spreads forces | Reduces muscle contraction force |
| Effect on muscle pain | Partial | Significant for many patients |
| Comfort | Requires getting used to sleeping with it | No appliance needed |
| Duration | Years (with maintenance) | 3 to 6 months per session |
In many cases combining both works best: the guard protects the teeth, Botox reduces load and pain. The recommendation is tailored after examination.
Botox is reversible, and any effect fades as the product wears off.
The cost depends on the number of units needed, determined by muscle size and grinding intensity, so it is quoted after the examination. Botox for bruxism is not part of the Israeli health basket; some supplementary or private insurance plans may participate, check with your insurer. We can provide a receipt and medical letter for submission.
Bruxism involves muscles, joints and teeth, so treatment is best given by a clinician who diagnoses the whole system. Dr. Andra Rettman is a specialist in Oral Medicine and a senior physician in the Oral Medicine Department at Hadassah Ein Kerem, experienced in facial and jaw pain and in Botox injections. Other causes of pain are ruled out, and your plan combines the right tools for you. Treatment is available in English and Hebrew.
Usually 3 to 6 months. It starts working within a few days and peaks after about two weeks, and can be repeated as needed.
A very fine needle is used and the procedure takes minutes. Most patients describe only mild discomfort.
Yes. The dose is set to reduce clenching force while preserving chewing, speech and your smile. Very hard foods may feel more tiring in the first weeks.
It depends. The guard protects the teeth, while Botox reduces force and pain. When there is wear or valuable restorations, combining both is often recommended.
When the masseters are enlarged, treatment may gradually slim the jawline over several weeks. The purpose here is therapeutic; the aesthetic change is a side benefit.
When pain comes from tension and overload in the chewing muscles, usually yes. When the joint itself is the problem, further evaluation and sometimes other treatments are needed, which is why diagnosis comes first.
Pregnant or breastfeeding women, patients with neuromuscular diseases such as myasthenia gravis, or with an active infection in the area. Tell your doctor about all medications you take.
The price depends on the number of units needed and is quoted after the examination. It is not covered by the health basket; some supplementary or private insurance plans may participate.
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