Bruxism and hypertonicity of the masticatory muscles

Botulinum toxin type A preparations are better known in our country as Botox and are firmly associated with getting rid of early wrinkles. But there are a number of inaccuracies here. Firstly, Botox is not a group of drugs or an active substance, but a trade name for a very specific drug, which, nevertheless, has become a household name, that is, it is used to refer to all similar drugs in general. And secondly, the range of tasks for such tools is much wider!

What are the advantages of botulinum therapy with Botulax in the treatment of bruxism?

Myorelaxation Complete relaxation of tight masticatory muscles and elimination of painful spasm.
Long-lasting effect After one procedure, the relaxing effect lasts for several months.
Quick relief from pain The drug begins to act immediately and gently relieves stress and discomfort.
Point effect The medicine is administered to strictly defined points and does not affect the functioning of other facial structures.
Getting rid of a bad habit You will quietly get out of the habit of clenching your jaw and aggravating the consequences of bruxism.
Maximum safety The drug does not cause addiction and is completely eliminated from the body.

There is a solution for each case!

1 procedure

1 Botulax procedure Gentle and safe effect For mild cases of hypertonicity of the masticatory muscles RUB 15,000. 15,000 rub.
3 procedures

A course of 3 Botulax procedures Gentle and safe effects For moderate and severe stages of hypertonicity RUB 35,000. 35,000 rub.

Botulinum therapy can help if you have a habit of clenching your jaw tightly and grinding your teeth, you suffer from increased abrasion of enamel and destruction of crowns.

About trismus

Trismus can occur at any time, immediately after or even years after treatment. This condition may occur in the following cases:

if you have a tumor affecting the bones, muscles and nerves that control the opening of your mouth;
after surgery on the head and neck organs;
after radiation therapy in the head and neck area.

Trismus can occur when fibrosis (scarring) develops during the healing process of tissue after surgery. In addition, fibrosis may worsen years after radiotherapy.

If you cannot open your mouth wide enough, it will be difficult for the health care provider to examine your mouth. In this regard, problems may also arise with:

oral hygiene (keeping the mouth clean and brushing teeth), which can lead to bad breath, tooth decay and oral infections;
chewing and swallowing, which may make it difficult for you to eat and drink;
speech;
kisses;
insertion of a breathing tube, for example if you ever need general anesthesia (a drug given to keep you asleep during an operation or procedure);
carrying out routine dental treatment.

When trismus occurs, its treatment is very difficult. This is why it is important to prevent trismus and treat the condition as early as possible.

to come back to the beginning

Symptoms of hypertonicity of the masticatory muscles and bruxism

the chewing surfaces of the teeth become worn and flat (the cutting edges disappear),
tooth enamel chips, wedge-shaped defects appear, fillings fly out, teeth quickly decay, become loose, gums hurt,
you experience discomfort when opening your mouth, while eating or yawning - there are clicks, crunching sounds,
you or your loved ones notice that you are grinding your teeth - the characteristic grinding appears mainly at night (the so-called “night bruxism”), when it is difficult for a person to control himself during sleep,
cramps the jaw - you cannot fully open or close your mouth, the jaw seems to be blocked,
it is difficult for you to keep your mouth open for a long time, overexertion and pain appear during bruxism,
when talking or chewing, you feel that your facial muscles are “clogged”, tired,
when you are angry, tense or just working in concentration - your mouth is tightly closed, your lips are pursed, your teeth are closed, you are literally clenching your jaw,
there are problems with your bite – your teeth don’t fit together correctly, your jaws are misaligned relative to each other, causing you to bite your cheeks or tongue,
after concentrated work or under stress, you often have a pressing sensation in your temples, pain and dizziness,
you notice ringing and noise in your ears,
Over time, the lower half of your face has become visually square, heavy,
there are problems with posture - you are slouched, your lower back hurts, your neck is stiff, one shoulder is higher than the other.

If you find one or more signs in yourself, then this is a reason to consult a specialist for medical help. And the first step is a comprehensive diagnosis and search for the causes of hypertension.

We approach the treatment of bruxism comprehensively! We carry out in-depth diagnostics, find the exact cause of facial muscle spasm and eliminate it using advanced methods - safely and with high results.

Free consultation

The main causes of bruxism in adults and jaw strain

psycho-emotional reasons: nervous overstrain, prolonged stress, difficult experiences of situations,
dental reasons: prolonged absence of teeth, malocclusion, diseases of the temporomandibular joint, complete or almost complete absence of teeth, inconvenient and poorly made crowns and dentures, fillings that are too high, injuries to the dental system,
disorders of the musculoskeletal system: injuries and curvature of the spine, poor posture, asymmetry in the work of the core muscles,
neurological causes: epilepsy, birth trauma, brain and central nervous system damage,
other reasons: taking certain medications, smoking, abuse of caffeine-containing drinks.

“We always take a comprehensive approach to solving problems of hypertonicity of facial muscles. First of all, we look for causes from the maxillofacial apparatus - we carry out a full diagnosis and examination, evaluate the functioning of the masticatory muscles, identify the patient’s characteristic habits and collect a medical history. If necessary, we refer the patient to specialized specialists - a neurologist, psychotherapist, etc. It is very important to cure hypertonicity - at least so that the patient in the future can safely begin high-quality dental restoration: implantation, prosthetics or treatment.”

Aida Vladimirovna Jutova, implant surgeon, periodontist, work experience of more than 10 years make an appointment

Numbness of the face

Stroke

Diabetes

36834 March 16

IMPORTANT!

The information in this section cannot be used for self-diagnosis and self-treatment.
In case of pain or other exacerbation of the disease, diagnostic tests should be prescribed only by the attending physician. To make a diagnosis and properly prescribe treatment, you should contact your doctor. Numbness of the face: causes of occurrence, what diseases it occurs with, diagnosis and treatment methods.

Definition

Numbness of the face occurs when the sensitivity of skin and muscle receptors to various impulses is impaired. This symptom may develop gradually or appear suddenly. Loss of facial sensitivity is described as burning, tingling, sometimes pain, and in some cases as a complete absence of sensation. When the face is numb, the color of the skin over the affected area may change in the form of pallor or redness.

In severe cases, sensory impairment is accompanied by a decrease in the motor function of the facial muscles.
Types of facial numbness
Any external influence, be it heat or cold, light touch or strong pressure, leads to activation of skin receptors and muscle structures. Each receptor is associated with a specific type of nerve fiber that transmits a specific type of sensitivity (sensation of pressure on the skin, vibration, stretching of the skin, and temperature sensitivity). An impulse is generated in the receptor, which is sent through nerve fibers at high speed to the nerve ganglia, which are a collection of sensory neurons. This is where primary information processing occurs to activate vital reflexes. Subsequently, the impulse goes to the brain, where it is processed in special nerve centers, and the person feels pain, pressure, vibration, etc. Thus, we can talk about the following types of sensitivity disorders:

Violation of surface sensitivity
occurs when receptors (temperature, tactile, pain, etc.) and nerve fibers of the facial skin are damaged.
Violation of deep sensitivity
occurs when the receptors and nerve fibers of the facial muscles are damaged.
Violation of complex types of sensitivity
. A similar type of disorder occurs when the cerebral cortex is damaged. There is no recognition of two different stimuli that simultaneously affect the skin, or the person cannot determine the location of the touch.

Possible causes of facial numbness
In many cases, numbness in different parts of the face is short-term, passing within a few minutes.

Such episodes can occur when the head is positioned in an awkward position, for example during sleep.

This occurs due to compression of the nerve fibers and a temporary disruption of impulse conduction. There is a burning and tingling sensation in the affected area. Partial loss of sensitivity is observed with prolonged exposure to the cold due to vasospasm. After gradual warming of the skin, sensitivity is restored.

However, facial numbness can be a symptom of a serious medical condition.

Acute cerebrovascular accident, or stroke

– a common cause of sudden numbness of the face in combination with a violation of facial activity. Hemorrhage or blockage of brain vessels by a thrombus (blood clot) occurs, acute oxygen deficiency and damage to neurons with disruption of their functions develops. Symptoms develop unexpectedly, sometimes accompanied by headache.

The main signs of a stroke are: numbness of the face and limbs on one or both sides, sudden weakness, speech impairment (inability to clearly pronounce words), drooping of the corner / corners of the mouth, uncoordination of movements.
If these symptoms appear, you should immediately seek medical help. A cerebral aneurysm
can cause numbness in the face due to compression of nerve fibers and sensitive centers of the brain. It usually develops gradually; at the onset of the disease, symptoms may be completely absent. Numbness first affects one area of the face (for example, perioral), and with further growth of the aneurysm, the affected area gradually expands. Sensations may also change: from tingling, burning at first - to a complete absence of sensations later.

There is a danger of rupture of a cerebral aneurysm; in this case, the symptoms are similar to those of a stroke and appear quickly.
Trigeminal neuritis
often accompanies inflammatory diseases of the oral cavity (caries, periodontitis), ear (otitis), paranasal sinuses (sinusitis, frontal sinusitis, ethmoiditis), parotid glands (mumps). The branches of the trigeminal nerve are irritated, which can lead to numbness in the corresponding areas of the face.

Impaired sensitivity with increased tone of the masticatory muscles

occurs due to compression of the branches of the trigeminal nerve by muscle fibers. Hypertonicity of the masticatory muscles is characteristic of damage to the temporomandibular joint due to arthritis and arthrosis, incorrectly selected braces, and certain diseases of the pharynx, for example, peritonsillar abscess.

Diabetes

– with this disease, the process of utilization of glucose from the blood is disrupted, which leads to damage to the vascular wall and disruption of the nutrition of nerve bundles. In the absence of maintenance therapy, tingling and partial loss of sensitivity in areas where the blood supply is impaired may occur.

Numbness of the face in multiple sclerosis

occurs due to demyelination (disappearance of the outer sheath) of the nerve fibers of the trigeminal nerve. Numbness is often preceded by severe pain not only in the face, but also in the limbs.

Tumors of the brain and its membranes

lead to impaired sensitivity in the facial area due to compression of the neurovascular bundles or tumor growth in them.

Which doctors should I contact if I have facial numbness?

If your face becomes numb, you should consult a neurologist or therapist. In some cases, consultation with an otolaryngologist, endocrinologist, or dentist may be required.

Diagnosis and examinations for facial numbness

Depending on the suspected cause of facial numbness, the following laboratory and instrumental studies may be required:

clinical blood test;

Botulinum therapy as one of the methods for treating hypertension and bruxism

Botulinum toxin type A, which is used in medicine and cosmetology, is able to relieve spasms and relax overstrained muscles, specifically reducing their activity or immobilizing them completely. But not forever, but only for a certain period of time - during this time the body adapts to new circumstances and stops overstraining a certain area. That is, the therapeutic effect for a diagnosis such as “bruxism” lasts for a long time, which is confirmed by numerous reviews from patients.

How it works?

Botulinum toxin type A is a neurotoxin produced by the bacteria Clostridium botulinum. It blocks nerve impulses from the central nervous system to muscle fibers. That is, in fact, the drug paralyzes a certain muscle without transmitting motor commands from the brain to it.

In medicine and cosmetology, it is used in ultra-small and highly purified forms - that is, it is not poisonous or toxic to the body!

The drug is injected into clearly defined points in order to affect only a specific muscle and not affect the work of others. The dosages are harmless, and the blocking is reversible. Over time, the drug is completely eliminated from the body - usually this takes from 5 to 7 months. Gradually, neuromuscular conduction in the area is restored, and mobility returns to the muscle - but since it has “rested,” the spasmodic fibers are smoothed out, and the body adapts and normalizes the load.

Botulinum toxin only relieves hypertonicity and allows the muscle to relax. This is the basis of its well-known cosmetic effect - smoothing out wrinkles by blocking the work of facial muscles. That is, it is wrong to think that you can “pump yourself up” with botulinum toxin preparations - they do not in any way increase the volume of soft tissues.

To relieve excess tension in the masticatory muscles, we use the drug Botulax for intramuscular injection with 99% active substance content, thereby increasing the speed of onset and duration of the therapeutic effect. And thanks to the high degree of purification of the drug, the risk of adverse reactions is minimized. The dosage and course are selected by the doctor strictly individually!

Facial hyperkinesis

Facial hemispasm and paraspasm, blepharospasm are diseases associated with uncontrolled contraction of facial muscles. They are very similar to neuropathy, neuritis, and facial nerve paresis.

Facial muscle control is structured as follows:

Nerve cells of the cortex and subcortical nuclei of the brain send nerve impulses to the brain stem, to the control centers of the facial nerve;
These centers distribute impulses along the nerve fibers and send them along the nerve, like an electrical cable, directly to the facial muscles;
Each tiny nerve fiber causes its own microscopic section of muscle to contract.

Causes of facial hyperkinesis:

An error in the functioning of the subcortical nuclei of the brain, as a result of which excess uncontrolled nerve impulses are sent to the facial muscles, which lead to spasm;
Excessive stimulation of the facial nerve centers in the brain stem;
Irritation of the facial nerve itself after it leaves the brain.

In the first and second cases, this is the result of damage to the nucleus or center due to neuroinfection, multiple sclerosis, blood supply deficiency or tumor. In the third case, the disease occurs even with slight compression of the root of the facial nerve in the area of its exit to the base of the brain by an altered vessel (entanglement of the nerve by an artery), a tumor, or compression in the thickness of the parotid salivary gland in some of its diseases.

Even doctors often confuse facial hyperkinesis with neuropathy, neuritis of the facial nerve. We will definitely understand the causes of the disease and provide the necessary treatment.

Indications and contraindications for botulinum therapy of masticatory muscles

Indications

pain in the temporomandibular joint area,
limited mouth opening,
clicking, crunching, discomfort when moving the lower jaw,
pathological abrasion of enamel,
overstrain of the masticatory muscles, their soreness and heaviness,
preparation for implantation, classical prosthetics (especially veneers), orthodontic treatment.

Contraindications

pustular skin lesions, ulcers, acute infection in the area of the masticatory muscles,
viral and infectious diseases in the acute stage,
neuromuscular diseases (myasthenia gravis),
constant use of certain medications and antibiotics,
pregnancy and lactation period,
bleeding disorders,
diabetes,
allergic reactions to the components of the drug,
oncology and severe mental disorders.

Main stages of treatment

Step 1. Preparation for the procedure

A doctor, for example, an implant surgeon or an orthopedist, may refer you to the botulinum therapy procedure for comprehensive preparation before installing implants or dentures. But you can also contact your dentist yourself with complaints about the symptoms of dental bruxism. On the recommendation of a doctor, after consultation and diagnosis, you can begin the injection course.

No complicated preparation is required. 2-3 days before the procedure, it is advisable to eliminate alcohol and reduce the consumption of tea, coffee and energy drinks, as well as stop taking blood thinning medications and antibiotics.

Experienced doctors who follow safety precautions! Our specialists have undergone appropriate training, are certified and accurately calculate the dosage of the drug. We carry out treatment carefully, safely and with results!

Step 2. Administration of the drug

The procedure itself takes on average 20 minutes. The doctor conducts a follow-up examination and marks points for drug administration.

The doctor takes the ampoule out of the refrigerator and opens the disposable syringe with the medicine in front of you - this way you will make sure that the storage conditions and sterility of the drug are observed. How many units of Botox are needed for bruxism? The specialist will calculate the dose individually, based on the severity of the symptoms, and divide it into 3-4 parts - that is, you will be given several small injections in different areas of the muscle. For injections, disposable sterile syringes with thin needles are used, so the procedure is almost painless. But for greater comfort, the injection site can be numbed.

Step 3. Rehabilitation period

The drug begins to act immediately, but gains maximum strength gradually - over about 10-14 days, during which the spasmodic area completely relaxes. At this time, it is undesirable to overheat and overcool the problem area: that is, you will have to limit physical activity, trips to the bathhouse and sauna, as well as to the pool.

It is also important in the first days to touch your face as little as possible and not to steam or massage the injection sites.

The effect of the drug lasts up to 7 months, but may weaken faster depending on individual characteristics. Your doctor will tell you at your follow-up appointment whether you need a repeat course.

How long does it take to cure trismus?

Typically, full muscle recovery can take one to three weeks, depending on the cause of the trismus. More time will be needed for fractures of the jaw, which must heal properly and subsequently develop.

To prevent trismus of the masticatory muscle, you must:

do not cause diseases of teeth and gums;
get vaccinated against rabies and tetanus (rabies and, as a result, lockjaw can be fatal);
In case of blows or damage to the jaw, seek emergency help from dentistry;
avoid stressful situations, nervous tension;
when engaging in contact sports, wear special helmets and mouthguards for protection;
undergo regular preventive examinations with a trusted dentist. These are the doctors who work in the 32 Dent network of clinics, where you will be happy to see you at any time. Contact us!

Disadvantages of treating bruxism with Botulax

It is important to choose an experienced, certified doctor who has trained and has official approval for botulinum toxin injection therapy - this is a rather complex procedure with its own subtleties. If the rules of storage, selection of dosage and administration technique are not followed, complications may occur. And if hematomas, bruises or slight swelling basically go away on their own, then difficulties with swallowing and chewing should be eliminated together with a doctor.

Our doctors have been trained and certified - treating hypertonicity with botulinum therapy in our clinic is completely safe

Why is botulinum therapy not enough to eliminate hypertension?

You need to understand that Botox treatment in dentistry, like orthopedic treatment of bruxism (that is, the manufacture of special protective mouth guards for teeth during bruxism), is only an additional, and not an independent method. Botulinum therapy protects against the consequences of muscle strain - that is, visible relief will actually occur after administration of the drug. The spasm will go away, the muscles will relax, you will stop involuntarily clenching your jaw and thereby injuring your teeth. But as soon as the effect of botulinum toxin wears off, the problem may return, albeit to a lesser extent.

Of course, if it was just a formed habit based on nervousness, and the causes of bruxism are psychosomatic or neurological, then during treatment you have a good chance to completely get rid of it. But if the source lies in other pathologies and disorders, then you also need to address them: take care of your posture, solve bite problems, restore damaged teeth, replace low-quality dentures, etc. And botulinum therapy will become an effective comprehensive measure.

Why are mouthguards needed for bruxism?

Another additional way to treat hypertonicity of the masticatory muscles in adults is to wear a special protective mouth guard (they are also called a “mouth guard” or “bruxism trainer”). These are plastic and dense overlays for teeth, which are worn mainly at night, and in case of severe symptoms, worn during the day. They are made from hypoallergenic materials in a dental laboratory individually for the patient or at the factory, if we are talking about mass production.

But this is also an auxiliary measure - a mouth guard helps muscles relax, protects against tooth wear and the consequences of bruxism, but does not remove the cause of hypertonicity.

protection of enamel from cracks, chips, increased abrasion due to involuntary clenching of teeth,
protection of artificial crowns, dentures (including those on implants) or brace systems from damage,
relieving tension and pain in masticatory muscles and joints,
protection against movement and displacement of teeth due to constant pressure on them,
gradual return of the jaws and joints to the correct position in the event of their displacement (of course, only individual mouthguards for bruxism made by a doctor work this way).

Facial pain: causes, diagnosis, treatment

Pain in the facial area can be dull or sharp, short-term or chronic, affecting only one side of the face or both. But the reaction to this pain is always the same: the desire to get rid of it as quickly as possible. Facial pain can be caused by injuries, neuropsychiatric disorders and infectious and inflammatory diseases. We invite you to learn more about the most common sources of facial pain and common symptoms.

Tooth abscess

Anyone who has had to deal with a tooth abscess at least once in their life knows firsthand what unbearable, incessant pain is. A dental abscess is an acute inflammation caused by a bacterial infection in the pulp (the inner part of the tooth that contains the nerves and blood vessels). Most often, damage occurs due to advanced caries, gum disease or mechanical trauma to the tooth. The most common symptoms include: constant throbbing pain, swelling of the face, redness of the gums, unpleasant taste in the mouth, and increased body temperature. Remember that an abscess is a serious disease, so if you have the above signs, immediately contact your dentist, who will help you get rid of the pain and prevent complications from occurring.

Dry socket

After the removal of one of the permanent teeth, a blood clot forms in its place, which serves as a barrier to infection entering the wound and promotes its rapid healing. However, if the blood clot is not fully formed, disintegrated, or washed out, bone tissue and nerves are exposed, which can result in a painful condition called dry socket. The symptoms of a dry socket and an abscess are similar: severe pain, facial swelling, bad breath, and fever. If these symptoms appear, you should visit the dentist or surgeon who performed the tooth extraction.

Temporomandibular joint dysfunction

The temporomandibular joint (TMJ) allows us to open and close our mouth. Anything that interferes with the normal functioning of the TMJ can cause facial pain. The causes of the disorder may be associated with involuntary clenching of the jaw and grinding of teeth, as well as malocclusion. Facial and TMJ pain often occurs as a result of arthritis, injury, and dislocation. If you notice any clicking, crunching, or pain when you move your jaw, visit your orthodontist as soon as possible. Drug therapy, physiotherapeutic treatment, massage and myogymnastics, wearing occlusive splints or mouthguards help solve the problem.

Headache

People who frequently experience headaches report that facial pain combined with a migraine or cluster headache can be very severe. Such pain usually affects one side of the head and face. Pain is usually concentrated around the eyes, although for migraine sufferers the pain may radiate to the teeth and jaw. For minor pain, over-the-counter pain relievers usually help, but if the pain gets worse, don't wait to see your doctor.

Sinusitis

Extensive facial pain, including dull pain in the upper jaw and teeth, can be caused by sinusitis (inflammation of the paranasal sinuses). Other common symptoms of this condition include nasal congestion, pressure around the eyes and cheekbones, swelling of the cheeks or eyelids, ear pain, bad breath and fever. Inflammation with sinusitis often causes toothache, since the roots of the upper molars are adjacent to the bottom of the maxillary sinuses. Sinusitis can often be treated with regular cold and flu medications, but if symptoms persist, be sure to contact your primary care physician or ENT doctor.

Trigeminal neuralgia

Trigeminal neuralgia (trigeminal neuralgia) is a chronic disease characterized by attacks of severe pain in the innervation areas of the trigeminal nerve, the largest cranial nerve that transmits sensory information from the face to the brain. Specialists at the Scientific Center for Neurology believe that trigeminal neuralgia most often occurs as a result of compression of part of the trigeminal nerve by blood vessels. As a result, even a light touch to the skin, for example, when applying makeup or while brushing your teeth, can provoke recurring pain attacks - from a slight tingling to extremely intense, shooting or stabbing pain. Injections, medications or surgery help relieve pain and prevent relapses of the disease.

Herpes zoster

Many of us had chickenpox (chickenpox) as children. After an illness, the virus remains latent in a person’s nerve fibers for many years, without causing any damage to his health. In the future, when the immune system is weakened or in old age, the virus may reactivate, which causes herpes zoster (shingles). The infection manifests itself in the form of rashes along the affected nerve endings. The patient begins to experience severe pain and a tingling sensation on one side of the body, headache and joint pain, fever and chills. Herpes zoster can also affect the nerves of the face, causing drooping eyelids, facial paralysis, changes in taste, blurred vision, or hearing loss. At the first signs, immediately consult a doctor who will help you alleviate the symptoms by prescribing a course of antiviral and potent anti-inflammatory drugs.

Since the causes of facial pain are very diverse in nature, the best way to get rid of problems is a comprehensive diagnosis of the disease. By carefully studying the symptoms, a therapist or dentist will be able to make the correct diagnosis and choose the most effective treatment tactics.

Choosing a sleep guard for bruxism: types and price

Firstly, there are universal and individual options: finished products are produced in factories using standard templates, and custom-made mouth guards are made exactly to your measurements.

Also, as we mentioned, mouthguards are not only night guards. The vast majority of patients suffer from teeth grinding during sleep, but a number of people cannot control jaw clenching during the day - for such cases, there are options for daytime overlays that are more invisible and do not affect pronunciation.

A mouthguard for teeth against bruxism, especially a night guard, can be bought at a pharmacy (either in Moscow or in any other city). It costs about two to three times less than a custom-made one. The quality depends on the manufacturer, and universal options have limitations in size and shape, so they simply may not fit the dentition. But the most important limitation, which patients often forget about, is that a ready-made onlay should be purchased on the recommendation of a dentist, and not self-medicated. Alas, without diagnosing and searching for the causes of spasm of the masticatory muscles, a ready-made mouth guard will do more harm than good.

Therefore, it is better if the mouth guard is made individually - based on a cast of your jaws. Individual mouthguards for bruxism, made for sleep, take into account anatomical features to the smallest detail and do not overload the teeth. And if you need to wear the veneer during the day, then it should match the shape of the teeth so that it is truly invisible when communicating. You can order such a mouthguard for bruxism in dentistry by contacting your doctor about this problem.

The doctor will also give recommendations on how long a day it is best to wear a mouth guard, how to care for it, and when the product should be replaced.

Results of surgical treatment of paralysis of facial muscles

The result of these operations (with the exception of static correction) does not appear immediately. As a rule, the result appears after 4-8 months - the first weak movements appear, which gradually intensify with mandatory adherence to the specialist’s recommendations. This is due to the fact that nerves re-grow, according to the literature - up to 1 mm per day. First, sensations appear in the form of “lumbago”, “running goosebumps”, etc. This indicates the growth of the nerve along the nerve fibers. The first movements are quite weak, since the muscles have been without load for a long time, so it takes time for their functional restoration, and it is necessary to constantly load them rationally. Thus, rehabilitation plays a very important key role in the final outcome. And the patient must be prepared for daily exercise and not immediate results.

What happens if hypertonicity of the masticatory muscles is not treated?

The masseter muscle, which moves the lower jaw, is the most powerful in the group of facial muscles. By contracting, it is capable of creating a force of up to 80-100 kg (compare - in order to chew food efficiently, we use barely 10% of this force).

Chronic spasm and overstrain of such strong masticatory muscles creates excess pressure on the teeth, periodontal tissues and temporomandibular joints. From here, many unpleasant consequences for the jaw system and health in general develop along the chain:

abrasion of enamel and reduction in tooth height,
chips and cracks, various enamel defects,
frequent caries,
overload of periodontal tissues and the development of gum diseases - in particular, dangerous periodontitis,
failure of fillings, crowns and dentures,
threat to implants, the possibility of their overload and loosening,
swelling and inflammation of the masticatory muscles,
dysfunction of the temporomandibular joint, pain and discomfort when chewing,
deterioration of blood circulation and tissue nutrition in the area of muscle spasm,
increased headaches, dizziness, noise and pain in the ears,
overstrain of the neck and back muscles, development of posture problems,
violation of facial aesthetics: angular jaw, deep wrinkles around the nose and lips, haggard face and reduction of the lower third.

Correction of bite by treatment of dysfunction of the temporomandibular joint

We usually don't think about how our jaw moves. When most people talk about bite, they mean teeth. But, as mentioned above, the bite is an entire system that controls the position of the jaw. Here are its components and their role:

The role of muscles

Figure No. 4 Opening, closing the mouth, chewing and swallowing occurs due to the work of a large number of muscles.

The opening of the mouth is ensured by the muscles located in the neck. The muscles that support the mandible are located behind the jaw and run under the cheeks to the frontal and postauricular areas.

The most powerful muscles responsible for chewing are located in the cheek area.

Figure No. 5 Our body strives to carry out all functions with the greatest rationality and the least amount of energy. Therefore, normally, the chewing muscles hold the jaw in a position in which the teeth are separated by 1-2 mm.

Figure No. 6 From this rational position, the lower jaw moves hundreds of times a day until the teeth close to swallow.

All this happens subconsciously. Our brains are hardwired for a process called proprioception.

With proper bite and jaw position at rest, most muscles are in a relaxed state.

If your teeth don't close quite correctly, your muscles can adjust, causing your jaw to close in a pattern that causes excessive tension, spasm, and muscle fatigue over time.

In this case, the position of physiological rest of the lower jaw (when the teeth are not closed) is not accompanied by muscle relaxation, as it should be with normal occlusion, but, on the contrary, leads to their constant tension.

The role of joints

Figure No. 7 The lower jaw moves thanks to the joints. called the temporomandibular joints, or TMJs.

Think of the joint as a ball in a basket - the articular head (ball) moves in the recess of the skull (basket). Between them there is a soft tissue layer (articular disc).

The position of the articular head (condyle) in the corresponding depression of the skull (fossa) is largely determined by the bite (occlusion) - the position where the muscles hold the jaw.

Figure No. 8 If the system is balanced, the condyles are located in the center of the glenoid fossa and the disc, located between the articular head and the glenoid fossa, moves freely in the joint when opening and closing the mouth.

Figure No. 9 If the masticatory muscles adapt to the incorrect position of the jaw, they can hold the head of the joint in a displaced position, negatively affecting its function. This often causes the articular disc to become dislodged, preventing it from moving normally in the joint until it moves completely into its normal position when the mouth opens. When this happens, a clicking sound occurs.

The intensity of the click can vary from a barely perceptible vibration to a very loud sound.

This sound is often a sign of abnormal joint function, which in turn may be associated with a malocclusion.

The role of posture

Posture also plays a significant role in occlusion. The mandible and lower limbs can be considered interdependent parts of the human skeletal system. If any of these parts are negatively affected, other parts of the skeleton may be affected.

Let's check this by slightly closing our teeth. Pay attention to which teeth closed first. Then tilt your head back as much as possible and clench your teeth again. Don't be surprised if the first contact is on other teeth this time. By changing the position of your head, you thereby influence the balance of the entire skeletal system (and your bite in particular).

The same thing happens when you get a filling. Lying in the dental chair under anesthesia, it seems that the filling is not in the way. But after the anesthesia wears off and you get up from the chair, you notice that the filling is higher than the rest of your teeth. This is why in neuromuscular dentistry, the bite is assessed in the sitting position - the position in which your jaw is normally located. If you evaluate the bite in a sitting position, leaning back, the jaw also moves posteriorly. This situation is different from the usual one.

Photo No. 10,11 In an experiment on rats, an oversized filling was made on one lateral tooth on the right side. A week later, an x-ray examination revealed deformation of the entire spine. After leveling the occlusion by making a filling on the lateral tooth on the left, the shape of the spine was restored.

Figure 12 Since there is a direct connection between all parts of the musculoskeletal system, head position undoubtedly affects occlusion, and can cause tension in the neck and back muscles. Figure No. 13 When the lower jaw moves back as a result of malocclusion in childhood or wear of teeth over time, the neck moves forward and the head is thrown back. This, in turn, significantly increases the load on the muscles of the neck and shoulder girdle. Therefore, most people with an anterior head position experience neck pain or neck muscle tension. Figure No. 14, 15 Often, displacement of the lower jaw due to malocclusion is accompanied by rotation of the first and second cervical vertebrae, which leads to severe deformation of the entire cervical spine.

Just as changes in jaw position can cause changes in posture and lead to pathology in the cervical spine, changes in the spine can affect jaw position and occlusion.

The role of breathing and sleep apnea

Figure No. 16 Displacement of the lower jaw back often leads to a narrowing of the airway due to deformation of the cervical spine and posterior displacement of the tongue, which follows the lower jaw. In order to increase the clearance of the airways, the muscles move the neck further forward and tilt the head back.

In this case, the artery that carries blood to the brain along the spine can sharply bend in the area of the first and second cervical vertebrae, causing disturbances in the blood supply to the brain.

Narrowing of the airways and impaired blood supply can cause sleep apnea - a short-term cessation of breathing during sleep.

Repeated stops in breathing lead to a significant change in the metabolism of the entire body and, as a result, can become one of the triggers for diseases such as hypertension, diabetes, myocardial infarction, stroke, etc. Therefore, the untreated condition of sleep apnea is responsible for reducing life expectancy by 20%.

Now you understand that occlusion is much more complex than just the way the teeth are closed! And malocclusion can cause not only early tooth loss, but also cause serious pathologies such as diabetes and myocardial infarction and even reduce life expectancy.

Is it possible to undergo implantation for bruxism?

Only on condition that an integrated approach is applied to implantation and subsequent installation of the prosthesis. In order for your new teeth to serve you for a long time, we carefully plan the entire course of treatment from start to finish: we conduct in-depth diagnostics, identify related problems that may affect the result, take measures to eliminate them, and step by step work through the entire course of the operation and prosthetics.

For example, our patients often experience bruxism and problems with the temporomandibular joints due to the fact that the dental system has not been working properly for a very long time - the teeth were destroyed, the load was distributed unevenly. In itself, the return of all teeth through complex implantation is already a treatment for such conditions, since we think over dentures taking into account the correct functioning of muscles and joints, normal closure of the dentition, etc. But the body will need time to adjust to normal functioning. And that is why in cases of bruxism we are taking additional measures - increasing the number of implants installed for the entire jaw, making prostheses reinforced with a frame and made from more durable materials, and making protective soft mouth guards.

But if bruxism in adults cannot be cured only by dental methods, since the problem is not with the jaw system, but with the same psychosomatics, then we refer the patient for treatment to a specialized specialist - and return to dental restoration afterwards. We care about your health and do everything to ensure that the achieved treatment results last not just for a couple of years, but throughout your entire life.

Prevention of bruxism: how to help yourself

By prevention we mean measures that prevent dental hypertonicity and bruxism in adults, because without finding the cause and monitoring a specialist, treating them at home is an unsafe activity, as with any disease. So if you notice alarming symptoms, your first step is to get diagnosed and get a plan to comprehensively eliminate this problem.

You may need the help of several specialists (neurologist, dentist, gastroenterologist, ENT doctor, psychotherapist), because bruxism occurs in different people for very different reasons. You may be prescribed courses of physiotherapy, taking certain medications (for example, magnesium supplements), but all this, of course, is very individual.

Self-help measures are helpful if you discuss them with your doctor. For example, you can do a light relaxing massage against bruxism in the area of the chin and temples. There are also a number of exercises that can help relieve muscle spasms; it is useful to repeat them regularly before bed. Relieve general stress: sleep enough hours, walk more in the fresh air, reduce the amount of coffee and strong tea, take relaxing baths with herbs, avoid anxious situations.

All this will help consolidate the results of complex professional treatment and forget about unpleasant symptoms.