With the pinch of a needle, beauty dermatologists equivalent to Michele Inexperienced could make brow wrinkles disappear and deep-furrowed crow’s-feet puff again out like yeasted dough. Botox is completely magic, a bit unsettling, and really in demand: Inexperienced’s New York Metropolis apply has been swamped as People search to provide themselves a “post-pandemic” glow-up. However today, lots of her sufferers aren’t after everlasting youth and intercourse enchantment. When Inexperienced evaluations her schedule for the week every Monday morning, she informed me, “I’m similar to, Oh my god.” No less than 1 / 4 of her Botox appointments are for folks with a unique motive completely: They’ll’t cease clenching their jaw and grinding their enamel.

Throughout the nation, sufferers coping with the meddlesome situation at the moment are turning to Botox—sure, Botox.  “It’s a very talked-about remedy” for individuals who grind and clench their enamel, Lauren Goodman, a L.A.-based beauty nurse, informed me. Bruxism, the official time period encompassing each behaviors, is an involuntary motion that tends to occur when individuals are sleeping at night, for causes together with alcohol and tobacco use, sleep apnea, and stress—maybe why the situation has soared in the US throughout the pandemic. The situation is a tolerable nuisance for many individuals, however the signs can get very actual: With bruxism on the rise, dentists are reporting extra chipped and cracked enamel in sufferers, together with jaw ache and facial soreness. In essentially the most extreme circumstances, sufferers can endure debilitating complications and jaw dislocation. The commonest therapies, equivalent to mouth guards and life-style adjustments, solely generally assist eliminate signs.

That’s what makes Botox so interesting for the latest flood of enamel grinders. Jaw injections calm down the chewing muscle mass that clench and grind with as much as 250 pounds of force—doubtlessly relieving ache and stopping dental points within the course of. It’s not as if each enamel grinder in America is hotfooting it to their nearest Botox clinic, however the process appears to have blown up for the reason that begin of the pandemic. 5 dentists and beauty consultants informed me they’d observed a rise in enamel grinders and clenchers getting Botox. Individuals who have exhausted extra conventional routes are “actually simply dedicated to assuaging their ache,” mentioned Samantha Rawdin, a prosthodontist in New York Metropolis. “If which means getting a needle to the face, so be it.”

However even when Botox has some upsides, it’s hardly the everlasting, sure-thing answer that dentists and sufferers have lengthy looked for. That’s been the narrative all together with bruxism: As a result of there are such a lot of attainable causes, therapies are an informed cube roll—and none of them is universally efficient. “I don’t inform my sufferers I can deal with them,” Gilles Lavigne, a dentistry professor on the College of Montreal, informed me. “I inform them I may also help them handle their situation.” So, how can we nonetheless not all the time know find out how to deal with this extremely frequent ailment?

Botox has been creeping onto the teeth-grinding stage since lengthy earlier than the pandemic. Though it has gained noticeable traction over the previous few years, research on the efficacy of Botox stretches again to the late 1990s. Within the years since, researchers have additionally found that the injections, which briefly paralyze the masseter muscle mass liable for grinding and clenching, can scale back the frequency and depth of bruxism. It’s one among a slew of non-cosmetic Botox makes use of which were recognized for the reason that drug hit the market in 1989: Injections additionally deal with points equivalent to extreme underarm sweating, pimples, and migraines.

Botox for bruxism hasn’t been FDA permitted, so it’s nonetheless thought of off-label—however anybody with a Botox license can legally inject a keen enamel grinder. And a minimum of in concept, Botox has some benefits over different bruxism therapies. Evening guards would possibly forestall you from gnashing your enamel into smithereens when you sleep, however they are often ineffective at stopping the behavior and might even make it worse—particularly when you have sleep apnea, Jamison Spencer, a dentist and sleep-apnea professional based mostly in Boise, Idaho, informed me. Minimally invasive regimes equivalent to yoga, meditation, cognitive behavioral remedy, and bodily remedy are hit and miss. Muscle relaxers could be useful for some sufferers, however these aren’t universally fashionable among the many dentists I spoke with, a few of whom cited America’s opioid crisis as a priority.

When much less invasive therapies don’t work, Botox is likely to be “the following frontier,” Leena Palomo, a professor at New York College’s School of Dentistry, informed me. Grinders and clenchers appear to be studying concerning the injections from quite a lot of sources. Rita Mizrahi, an oral surgeon in New York who provides Botox for bruxism, informed me that her sufferers are usually referred by their common dentists. Others uncover jaw Botox in on-line boards equivalent to Reddit and the beauty network RealSelf, the place typically nameless discussions of the process abound. And a few are studying mainstream-media testimonials or listening to about it from buddies or household—notably as increasingly more People embrace Botox for beauty functions.

At its finest, the process can actually assist sure enamel grinders: Research have indicated that Botox can lower ache ranges. One RealSelf reviewer described attempting evening guards, stress reduction, and slicing out caffeine earlier than getting jaw injections. “Thank goodness for one thing like Botox to return alongside at the present time,” they wrote 4 months after getting the process. The process comes with some beauty adjustments too: Grinding and clenching all evening could be a exercise, which could result in enlarged chewing muscle mass and a sq., boxy face. The injections slim the jawline for a lot of sufferers, giving it “extra of a V-shape,” Inexperienced mentioned.

However Botox has some actual downsides—and loads of dentists are nonetheless hesitant to suggest it. For starters, it’s costly and impermanent. The process usually prices a minimum of $1,000; just isn’t lined by medical or dental insurance coverage; and often received’t final for greater than 4 months. “This isn’t a onetime factor and also you’re good,” Mizrahi mentioned. And like many of the different therapies obtainable, jaw Botox assaults teeth-grinding and clenching signs, however not the trigger. As a result of folks nonetheless must chew, the masseter muscle isn’t completely immobilized—which means that sufferers “will simply grind with much less energy,” Lavigne mentioned.

And all of the risks related to the beauty use of Botox apply right here too, equivalent to bruising on the injection web site, complications, allergic reactions, and fewer fascinating adjustments in facial expressions attributable to misplaced Botox. One RealSelf reviewer skilled no enchancment in jaw ache however the unlucky onset of a creepy grin that resembled a “chucky doll smile.” Another mentioned that their complications disappeared after the process, however so did their cheeks: “I couldn’t acknowledge myself within the mirror and regarded like I had aged 10 years inside a few months.”

That grinders and clenchers are extra often turning to Botox is hardly a pure success story. Early mentions of teeth gnashing exist within the Bible, but we nonetheless don’t actually perceive find out how to make it cease. I do know firsthand how irritating that feels. In January, after attempting (and failing) to open broad sufficient for a crispy hen tender, I used to be lastly motivated to see a dentist—who gave me an evening guard so I’d give up slamming my enamel collectively. I meditate prefer it’s my job, I don’t have sleep apnea or take drugs of any kind, and but I nonetheless gnaw on that hunk of plastic prefer it’s gristle. My jaw doesn’t lock anymore but it surely’s nonetheless tense most mornings. I’m priced out of getting Botox—so, like many enamel grinders, I’m caught in medical purgatory.

Tooth grinding isn’t like a damaged arm, the place trigger and impact are apparent and fixable. “As a result of the origin of [jaw] ache just isn’t singular, you must assault it from numerous modalities,” Mizrahi informed me: “All of the issues that doubtlessly contribute to the ache need to be addressed,” and that may contain fields far exterior dentistry. Even dentists themselves aren’t all the time outfitted with all the knowledge: “We get nearly no bruxism training” in dental faculty, Spencer, the sleep-apnea researcher from Idaho, mentioned.

With all these roadblocks, many sufferers by no means discover out why they’re clenching or grinding, says Alan Glaros, an emeritus professor of dentistry on the College of Missouri at Kansas Metropolis, who’s been researching the difficulty for greater than 40 years. That’s partially as a result of it’s a troublesome downside to not solely deal with, but additionally examine. Bruxism’s many causes intersect “a whole lot of disciplines,” equivalent to dentistry, sleep well being, and psychology, which muddies the analysis course of. Every area is learning the habits, however the outcomes will solely ever inform a part of the story. “Individuals act as if that is all solved, but it surely’s not,” Glaros informed me.

So for now, mouth guards, meditation, and Botox are what we’ve. The remedy, in all chance, isn’t going wherever. “As folks get to know others who’ve responded effectively, I predict that we’re going to see an uptick,” Palomo mentioned. Grinders and clenchers will hold chomping on their plastic evening guards or forking up hundreds of {dollars} a yr for non permanent injections, all in a maybe-successful try to quell their ache. If solely Botox might banish bruxism prefer it does cussed wrinkles.