Botox: The procedure has medical applications, including for teeth grinding, as NI expert Dr Mervyn Patterson of Woodford Medical explains

Symptoms can include an aching jaw, headaches, including migraines, gum problems, ear ache and the danger of tooth enamel being eroded.

The incisors can end up shorter with sharp edges and tiny chip marks, and the canines can be covered in notches. Teeth can also work loose and fillings be gouged out.

Up until recently, treatment for bruxism has been rudimentary, with sufferers usually having to wear a mouth guard at night and/or seek out relaxation techniques.

But Botox injections, more commonly associated with cosmetic procedures, are now being used as a way of keeping bruxism under control.

As someone who has suffered debilitating migraines, chipped teeth and a painful jaw due to bruxism for more years than I care to remember, I knew I needed some help.

Some years ago my dentist suggested a silicone mouth guard to wear at night and ibuprofen for the pain. Both worked for a while, but eventually the pain broke through. The dentist mentioned Botox, something I associated more with wrinkles than teeth problems, as a possible means to help ease the pain, but as yet, it is not available on the NHS in Northern Ireland.

Botulinum toxin type A (from which Botox takes its brand name) is approved for treating the painful symptoms caused by muscle spasticity in 20 different neurological conditions, including stroke and cerebral palsy.

So, after much research into bruxism, its causes and treatments, I discovered a clinic in Belfast, Woodford Medical (www.woodfordmedical.com) that offers Botox, not just for aesthetic purposes, but for the treatment of bruxism.

The company’s medical director Dr Meryvn Patterson explained: “Bruxism is the medical term for a tendency to clench the jaw muscles which if it becomes chronic causes pain in the side of the face and risks damage to the teeth. Sometimes the grinding occurs at night whilst the person is asleep and it may be the partner in the bed who is aware of the noise.

"The sufferer may wake in the morning with pain in the side of the face over the masseter muscle (the muscle used for chewing and jaw clenching) and pain in the jaw joint or temple region. In more severe cases the person is aware of tension or clenching in the muscles throughout the day. On some occasions, it is the dentist who questions whether bruxism is present as they can see damage to the teeth and a chew line on the inside of the mouth.”

Most people think of Botox as a cosmetic procedure, so how can it be used to help bruxism?

Dr Patterson said: “Carefully targeted injections of Botox into the muscles involved help to tone down muscle activity and can give dramatic relief to the pain whilst also acting to stop the underlying habit.

“In the hands of a skilled medical injector the procedure is safe, takes only a few minutes to perform and the person can return to work or normal activities straight away. Typically, the person will have a treatment with a follow-up two weeks later where additional Botox may be required to optimise the result.

“The Botox injections can take up to two to three weeks to work and over that time the pain and habit of clenching gradually subside. In many cases, the results are life-changing and years of very unpleasant symptoms can disappear.”

He added: “Injections into the masseter muscle reduce the size of the muscle bulk and this has a pleasing effect on the lower face by helping to give a slimmer look to the face.”

Dr Patterson said Woodford has always had a large number of patients attending for Botox injections for bruxism but this has risen significantly since the pandemic.

"This is unsurprising given that stress is one of the most substantial underlying reasons for bruxism.”

He said Botox for bruxism is suitable for all – the only main contraindication is pregnancy. “There is no reason to suspect it would be harmful in pregnancy but as with most drug manufacturers, they always recommend avoiding it during pregnancy.”

In February of this year, after years and years of teeth grinding, face pain and horrible migraines, I had injections into the masseter muscles. It was a bit nippy, but not painful. After a couple of weeks, I noticed that when I woke up in the morning I didn’t have a sore jaw, neither did I have the crushing headaches that had almost become a daily way of life for me.

I had been told that the effects last for about four months, but five months on I have not had a single headache; for me that is miraculous. I have suffered no ill-effects, and no, I haven’t acquired that over-Botoxed Hollywood look.

Treatments don’t come cheap. Mine was £450 for the injections and follow-up consultation, but for someone like me, who has spent decades suffering from headaches and migraines, who has missed days off school, then work, family events and once had a migraine every day for three months, the relief has been priceless.