Teeth guard or botox for TMD, both seem so expensive, any thoughts

[ihatethecold]

Dentist has quoted £750 for a Michigan splint, which is far too much money for me, I have also been told by friends that they are uncomfortable.
The alternative is Masseter botox at £400 but this lasts about 6ish months i think, never had botox before so unsure of this.

I do need something to help resolve the issue of clenching my teeth at night, Its damaging my teeth and causing muscle pain.

has anyone managed to resolve/help this disorder successfully?

As far as I can tell from my useless appointment, my issue is only with the muscles. Which is something to be thankful for I suppose!

Not sure if you were asking those with dentist mouthguards or those with the cheap ones from Amazon 😄 But anyway I'm not sure it actually corrects anything, probably only dentist ones will do that. That said, my jaw felt very out of line when my tmj was at its worse, and my mouth guard helped kind of relax it I suppose. It feels back to normal now. If you can break the habit of the clenching/grinding then I think your normal 'bite' will return.

I have a bite like a bulldog and clench and grind my teeth all night. I have done a huge amount of damage especially to my lower front teeth which my dentist patiently repaired. He actually had a mouth guard for grinding made for my lower teeth and did not charge me. I tried to wear the mouth guard and struggled to sleep in it and even took it out in my sleep! I also tried Masseter botox twice with different practitioners- which made no difference.
But there is a happy ending! One of the reasons I got so much damage was that as a child in the 70s I had a NHS brace and 2 side extractions for overcrowding on my upper teeth but they did not do anything to my lower teeth. My dentist suggested that I could reduce the damage if I had the alignment corrected. I am now on 18 of 19 invisalign trays and my teeth no longer clash. Also wearing the retainers overnight (they are more comfortable than the mouth guard) I cannot grind my teeth and it has trained me not to clench at night. I do not get pain in my jaw anymore or the headaches.
It was not cheap- £3200 - but it has solved a lot of problems for me and will probably save money in the long term on crowns to replace shattered teeth.

I don't get relief, but I don't break or grind down my teeth in the same way as I did... Still biting down, still grinding, still get the tension but it's reduced with the botox and without the tooth surfaces meeting all night.

I find a lower mouthguard best, I chew through the upper ones my dentist makes in about 6 months

I just used the trays you mould for whitening teeth, worked a treat. I was on mat leave, skint and could hardly open my mouth. Probably not the best advice but it worked!

I used them for years when I was skint. Bought them in 100 packs from ebay!

They are very poor quality but I couldn't afford £100 every few weeks when I was chewing through proper dental guards so quickly.

I heard that Masseter Botox can cause issues with jaw and teeth alignment over time. You can get braces made online.

I've ground my teeth for years. Mouth guards protect the teeth but don't solve the issue. I tried Botox. It worked in the sense that the muscles weakened and I couldn't chew toffees but it didn't stop me grinding. I'm not inclined to repeat it as I think it did change things in my jaw (I have a small gap between my teeth where there was no gap before) and I've developed slight jowls as the skin is not stretched so tightly across the jaw due to weakened muscles.

Not good advice where op is suffering problems that may well be made worse by ill advised orthodontic work not overseen in person by a dentist and without the x rays and checks that should be done.
I’ve seen people with healthy mouths lose teeth and/or end up with massive bite and jaw problems from online braces .
No one should be using online braces , it’s not safe and can end up a disaster .

@ihatethecold I've had Botox for this and would highly recommend it IF and only IF done by an experienced doctor. I had it once and it just broke the cycle for me. It was v. expensive though - it needs several injections but honestly worth it - don't skim here.

I had mine done by an experienced doctor who went through all the risks with me - a particular issue is misplaced injections and getting the right 'strength' because the muscles are very strong - too much means you can't chew, too little means it won't work.

Check your practitioner but with the right person, I'd recommend it. Worked very well for me. I used to wake up with an aching jaw and clenched muscles. No more now.

I've had masseter Botox for jaw clenching and it's really helped with reducing muscle pain and headaches (and tinnitus too). The only downside is you will lose muscle bulk in the masseter as it stops being over-worked and slims down. If you're the wrong side of 40 (like me!) the loss of muscle volume in the jawline can make your jowls more pronounced.

It was v. expensive though - it needs several injections but honestly worth it - don't skim here.

Sorry I realised I wasn't clear. I didn't mean several injections in the sense of several visits - I only went once for this and once worked for me like I said.

I meant that on any single occassion when you have Botox for jaw relaxation/teeth clenching, they inject in a number of different places on both sides of the jaw so it is inevitably more expensive than a treatement that uses less Botox.

The only downside is you will lose muscle bulk in the masseter as it stops being over-worked and slims down. If you're the wrong side of 40 (like me!) the loss of muscle volume in the jawline can make your jowls more pronounced.

I didn't have this issue myself but as I said I only had it once and it solved my issue as it broke my clenching cycle.

You coupd ask for a TMJ clinic referral. I did and was seen nhs within a month. Have had x ray and then MRI. Degeneration was identified and I am going to have an op to wash out the joints in the New Year.

I’ve had Botox on my jaw for clenching and it lasts about 4-5 months but definitely weakens the muscles over time, so you can probably stretch it out longer. Costs about £200 a time. I had a custom fit mouthguard made by the dentist for £150 and it was uncomfortable and absolute rubbish so I bought one from Amazon for a tenner which was actually better. Don’t use it at the moment as the Botox is still working ok.

Thanks for all the advice. It’s been really helpful x

These prices seem incredibly high. My guard was made for me by my dentist as an NHS band 2 (so £73.50) and I pay £145 for masseter Botox from a nurse practitioner. West Midlands.

No a mouth guard is a laboratory made appliance and is a band three treatment £319.10 in England.
A Michigan Splint is rather more complicated and would not be offered on NHS , prices will range from £450 upwards depending on materials etc
Botox for TMJ dysfunction rather than for aesthetic reasons should legally only be done by a dentist or doctor otherwise is outside of scope of practice of a nurse practitioner.

I don’t know what to tell you. Perhaps my dentist made an error but it was definitely a band 2 service. I still have the receipt.

Could you point me towards that specific legislation, please?

A laboratory made appliance is band three. In theory if it was made chairside it would be band two (SCI type appliance) but in practice these appliances are a temporary diagnostic tool used only for a couple of weeks and would not be used in NHS practice. www.england.nhs.uk/south/wp-content/uploads/sites/6/2019/06/nhsbsa-mouthguard-guidance-may2019.pdf

I had acupuncture on the NHS.. then l paid private.. after trying everything else.. it worked / works for me..

Not made chairside - they made an impression of my teeth and sent it away. I am certain about the pricing - as I say I have the receipt. I can only assume that they made an administrative error.

I really would appreciate that legislation if you don’t mind. My understanding was that any use of Botox for TMD is technically off-label, regardless of the practitioner’s qualifications.

Sorry misunderstood what you were asking for.
Although you are right that Botox used for TMJ dysfunction is considered as an “off label” use , the diagnosis and treatment of TMJ dysfunction is considered an act of dentistry , so whilst a nurse practitioner can inject Botox into the masseters as a cosmetic proceedure they cannot diagnose or “ treat” TMJ dysfunction .

I have multiple teeth fractures on every tooth from clenching and have a silicone mould. A stabilisation splint has been recommended but quoted over 1500. Even if I nod off on the sofa, I wake up clenching. Mine is caused through stress. Have been advised to get botox but told it wont' break the habit just put it on hold. I feel everyone's pain.