My Dentist Says I Clench and Grind. Should I Get Botox?

Many patients are surprised when their dentist points out signs of clenching or grinding. These habits often happen at night or subconsciously during the day, so it’s easy to miss until symptoms like jaw soreness, headaches, or worn-down teeth appear. A common first step is getting a night guard, but patients often wonder: “should I also consider Botox for clenching and grinding?”

Let’s unpack, shall we?

1. What is Clenching and What is Grinding?

• Clenching is the act of holding your teeth tightly together, usually with excessive muscle tension in the jaw. This can happen while awake or asleep.

• Grinding (also called bruxism) involves sliding your teeth back and forth, often while asleep, which creates friction and can wear down enamel.

Both behaviors put a lot of stress on your jaw joint (TMJ), teeth, and muscles, but they aren’t always caused by the same thing.

2. Why We Clench vs Why We Grind

There are several reasons why people develop these habits:

• Clenching (stability-driven): Often happens when the body is searching for extra stability. For example, lifting something heavy or dealing with postural imbalances can cause the jaw to tense as a stabilizer.

• Grinding (airway-driven): More closely linked to airway restriction. If your body senses limited airflow at night, grinding can actually help reposition the jaw or airway temporarily.

• Stress and emotional load: Both clenching and grinding can be amplified by stress, anxiety, or even subconscious coping mechanisms.

This is why a one-size-fits-all solution doesn’t work. Different root causes need different interventions.

3. What is the Purpose of a Night Guard?

A night guard is a dental appliance that protects your teeth from damage. It prevents enamel wear, cracks, and excessive strain on dental work.

But it’s important to know:

• A night guard does not stop clenching or grinding—it just protects the teeth.

• For some patients, wearing a guard can actually make clenching worse because the jaw senses an “object” to bite down on.

So, while night guards are often a helpful tool, they don’t address the “why” behind your TMD.

4. What Does Botox Do? Why Doesn’t It Address the Root Cause?

Botox is sometimes used for TMJ pain because it weakens the overactive jaw muscles, temporarily reducing tension and discomfort.

However:

• It only provides symptom relief, not a cure.

• It does not address airway restriction, postural imbalances, stress, or other drivers of clenching and grinding.

• Long-term use may actually weaken muscles that are needed for proper function, chewing, and jaw stability. This can cause visible muscle atrophy in the facial muscles.

Think of Botox as turning down the volume without fixing the faulty wiring.

5. Better Approaches to TMD: Physical Therapy, Dry Needling, and Oral Myofunctional Therapy

If you want to get to the root cause of clenching and grinding, a more holistic approach is often best:

• Physical Therapy: Restores mobility in the jaw, neck, and upper back; addresses posture and muscle imbalances that drive clenching.

• Dry Needling: Releases overactive muscles, decreases trigger points, and improves blood flow to irritated tissues in the jaw and face.

• Oral Myofunctional Therapy: Trains tongue posture, breathing, and oral function. It can be especially powerful for airway-related grinding and orthodontic relapse.

Together, these therapies not only reduce pain but also improve long-term jaw health and function. Here at Stability In Wellness, we offer all 3 of these effective interventions!

If you are struggling with TMD/TMJ, reach out to book with us in Palm Beach County.

TLDR (Too Long, Didn’t Read):

A night guard can help protect your teeth, and Botox may provide temporary relief, but neither solves the underlying issue. If you’re serious about improving your jaw health and stopping the cycle of clenching and grinding, a comprehensive approach with physical therapy, dry needling, and oral myofunctional therapy is often the best path forward.