Teeth Clenching, Bruxism and Covid-19


Teeth clenching happens when a person holds their teeth together and clenches their masseter muscles, but without moving the teeth back and forth. In addition to this some people grind and clench their teeth which is referred to as Bruxism. It often happens at night during periods of lighter sleep. Nocturnal Bruxism is particularly hard to control and is one of the most common sleep disorders.

Teeth clenching can result in jaw pain, increased headaches and worn teeth due to repetitive grinding. In severe cases the masseter muscles become hypertrophic because as with any muscle if you exercise it a lot it will enlarge. This process can lead to a widening of the face with misshapen cheeks as well as making the consequences of teeth clenching more severe due to more powerful masseters.

It is no secret that stress levels across the whole population have been rising steadily during the current Covid-19 pandemic. As our stress levels increase we often clench and grind our teeth, which can eventually become habitual.

A recent international study, conducted during the lockdown period in the first wave of Covid-19, published in the Journal of Clinical Medicine found a significant rise in “the symptoms of jaw and facial pain, jaw-clenching, and teeth-grinding — well-known manifestations of anxiety and emotional distress” (Emodi-Perlman et al).

Treatment of Bruxism has traditionally focussed on trying to decrease stress and the use of mouthguards when sleeping. However, there is another option when these efforts have failed.

Using muscle relaxing injections into the masseters reduces the power of these muscles and so reduces the effects of teeth clenching. There is good evidence to show that this strategy works well (Long H et al, Fatih Asutay et al).

In our clinic we have seen a marked increase in the number of patients presenting with Bruxism over the last year. Overall they have found the treatment that we provide very successful.

In fact the injections used for teeth clenching can have two effects, one is the therapeutic weakening of the masseter to reduce teeth grinding and the other is a cosmetic effect. By relaxing the masseters they will appear smaller and this will improve the outline of the face by reducing the square appearance associated with overdevelopment of the muscle (although this effect will not occur for six weeks to three months after treatment).

The procedure is very straightforward and an appointment usually takes about thirty minutes. Having explained the process, cleansed the skin and marked the areas to be treated a series of injections are administered to the superficial and deep fibres of the masseters. Typically it takes between one and two weeks for the treatment to reduce clenching and the effects will last about four months but this time will be longer in some cases. Many of our patients find that the effects seem to last longer the more times that they have the procedure and most have six monthly appointments.

© Dr Edwards Aesthetics 2021


Emodi-Perlman, A.; Eli, I.; Smardz, J.; Uziel, N.; Wieckiewicz, G.; Gilon, E.; Grychowska, N.; Wieckiewicz, M. Temporomandibular Disorders and Bruxism Outbreak as a Possible Factor of Orofacial Pain Worsening during the COVID-19 Pandemic—Concomitant Research in Two Countries. J. Clin. Med. 2020, 9, 3250.

Long H, Liao Z, Wang Y, Liao L, Lai W. Efficacy of botulinum toxins on bruxism: an evidence-based review. Int Dent J. 2012 Feb; 62(1):1-5

Fatih Asutay, Yusuf Atalay, Hilal Asutay, Ahmet Hüseyin Acar, “The Evaluation of the Clinical Effects of Botulinum Toxin on Nocturnal Bruxism”, Pain Research and Management, vol. 2017, Article ID 6264146, 5 pages, 2017