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?

Grind No More have been transformative for me https://amzn.eu/d/dhvNwv2

(I used to take my expensive mouth guard on my sleep)

I have denplan so just pay lab fees for my guard. Think it's about £50

The dentist did mention one that goes on my lower teeth like the one I have but was a hard splint however the lab couldn't do it so just did a standard lower one but made it thicker

I kept taking my mouth guards out in my sleep (that was a throw back to my braces days, tbh! 🤣), so I had master Botox.

I saw a nurse practitioner, she told me that she usually recommends every 12 weeks for around a year. I had it for a year and a half because my muscles were still quite strong, but I've not had it for nearly 9months now and I don't clench anymore!

She also gave me exercises to relax the muscle which I do out of habit when I'm not doing much.

It's really improved my quality of life, as I was waking with headaches every single day.

But this won't protect the front teeth will it? Mine grind from the front to back, so I need to cover my front 6 or so teeth top and bottom.

No it won’t and more particularly for many grinders it will change their bite significantly because all the pressure is on only a few back teeth , or make grinding worse because the pressure is not across all the back teeth.

Chiropractor sorted me. Just to be a bit left field...

Those of you who have tried Magnesium and it’s not worked… there are different types of magnesium and you really need the Magnesium Glycinate supplements. Those are the best for muscle relaxation.

Please look at a multi faceted approach to sorting the problem (after you’ve got a splint or Botox sorted). Stress plays a massive part in teeth grinding/ clenching.

Also a few prevention things work; reduce caffeine intake, don't chew gum. I get guards for about 150 from the dentist. Works really well.

Yep, I've tried it all.

What works for one doesn't work for another. Stress isn't the only cause either - mine is genetic.

@Lollygaggle sorry to resurrect an old thread, but would you mind sharing your thoughts on michigan splints please? I'm a very heavy clencher and have had tmjd since 2020 because of it. I was really bad at one point, on a pureed diet for a long time due to the pain in my masseters etc. My dentist made me an nti which helped a lot however I've inevitably developed a posterior open bite because of it as ibe been weating it for years. I'm getting a michigan splint tomorrow. Do you find your heavy clenchers have success with these? And any advice on how to tolerate it whilst getting used to wearing it? Also, I know I'll panic if it feels too tight, especially around the molars, I'll feel very claustrophobic. Could I ask it to be adjusted so it's very slightly loose around them? As they say, the best splint is the one the patient will wear!

I’ve moved onto a Michigan splint and no issues at all with it

Should add except for the cost! £750 ish and that was on top of a root canal and crown I’ve spent the best part of 3.5k on my teeth this year

I think my Michigan splint encourages me to clench more. It stops any damage from grinding, but I definitely try to 'grip' it with my teeth while I sleep.

@fivebyfivebuffy glad the michigan is working well for you! Mines is £625, so it better work! That's awful you've had to spend so much on your teeth 😭 I'm sure the michigan has paid it's way x10 if it's prevented the need for further crowns etc. Was your splint very tight to begin with? And does it have a little "ramp" over the front few teeth?

@SutekhsEars I suspect I may clench more with it also, but my main priority is protecting my teeth. My dentist suggested I try amitriptyline whilst getting used to the splint to hopefully help decrease the clenching and help me sleep with it in

The problem is that clenching/grinding and pain/ limited opening is not a disease in itself it’s a symptom , stress/chronic pain is normally the root cause.

Dealing with stress/pain is also a key part of the treatment . Everything from mindfulness to yoga to meditation will help. Changing antidepressants for those on them can help as many antidepressants can make clenching/grinding worse.

Mouth exercises to increase awareness of when clenching is worse and doing simple things like putting your tongue between your front teeth can help.

Niti appliances are very sucessful but some people do develop an open bite like yourself.

Michigan splints can be very successful alongside some of the strategies above , but for some clenchers it just acts like a chew toy and makes clenching worse. Making it too loose on the back teeth makes it more likely to dislodge and more likely to be uncomfortable. Leave it tighter to start off with and then get it adjusted if it’s a problem .

For many Botox (administered by someone who knows what they are doing around the mouth , not a beautician or nurse , preferably a dentist skilled in TMJ problems ) can work where no where else does but it does need repeating.

However for most of patients with severe grinding/clenching issues an approach that includes lifestyle/work changes is what brings the best benefits .

I agree about the stress. My grinding/clenching is a lot better since my divorce was finalised.

I bloody wish mine would improve. I’ve done it since I was 12

I paid about £1200 for a repositioning splint for TMD which reduced my pain levels by about 50%. I was put off the Botox as it only really works once and then it becomes less effective each subsequent time but I have permanent issues with my TMJ which meant I needed a permanent solution. If your TMD is due to grinding or clenching then Botox might work to break the cycle.