Short answer
Possibly, for some people, but the evidence is still preliminary. Small trials suggest botulinum toxin injected into the jaw muscles may ease jaw pain and stiffness linked to grinding, although results vary and it does not treat the causes. It is an off-label use (outside the product’s approved uses), and whether it is worth considering depends on what is driving the grinding and whether simpler measures, such as a night splint and stress management, have been tried first.
Key points
- Bruxism (grinding or clenching) is usually treated first with a dentist-made mouth guard and by tackling triggers such as stress.
- Bruxism is not one of the approved uses listed in the main botulinum toxin product labelling.
- Trials are small and varied; findings on pain are encouraging but described by reviewers as preliminary.
- The effect is temporary, so treatment would need repeating.
- Side effects reported in trials were mostly mild, including injection-site pain and changes to the smile.
What bruxism is, and why the cause matters
Bruxism is the medical term for grinding or clenching the teeth. An international expert consensus separates sleep bruxism, which is jaw-muscle activity during sleep, from awake bruxism, which involves repeated or sustained tooth contact or bracing of the jaw while awake.2 In otherwise healthy people, the experts describe it as a behaviour rather than a disease, which can be a risk factor for problems such as tooth wear or jaw pain.2
The causes are not always clear. The NHS lists stress and anxiety as the most common cause, alongside sleep problems such as snoring and sleep apnoea (pauses in breathing during sleep), some medicines for sleep, depression or anxiety, smoking, and heavy alcohol or caffeine use.1 Symptoms can include a painful jaw, worn or broken teeth, headaches, earache and disturbed sleep.1
This matters because botulinum toxin only weakens the muscle. If grinding is linked to untreated sleep apnoea or a medicine, injections would not address that, and the underlying problem could go unrecognised.
How botulinum toxin is used for grinding
Botulinum toxin type A temporarily blocks the signal from nerve to muscle. For bruxism it is usually injected into the masseter (the large chewing muscle at the angle of the jaw) and sometimes the temporalis (the fan-shaped muscle at the side of the head). The aim is to reduce the force of clenching rather than stop the behaviour entirely.
Bruxism and temporomandibular disorder (TMD, problems with the jaw joint and chewing muscles) are not among the approved uses listed in the main US labelling for therapeutic botulinum toxin.5 Clinicians can use medicines off-label, but it means the dose and injection pattern have not been through formal approval for this purpose.
What the evidence says
The evidence is Limited. A 2024 systematic review (a structured summary of all relevant trials) of jaw symptoms in sleep bruxism found nine randomised trials, with 137 people in total receiving botulinum toxin.3 Several reported lower pain scores, one reported fewer night-time grinding episodes compared with placebo, and some found less morning jaw stiffness.3
Not every outcome improved; one trial found no difference in mouth opening or biting force.3 Doses, injection sites and follow-up times differed widely, groups were small and no pooled analysis was possible. The reviewers called their findings “preliminary”.3
| Approach | What it aims to do | Main limitation |
|---|---|---|
| Night splint or mouth guard | Protects teeth from wear during sleep1 | Protects teeth but does not stop the muscle activity itself |
| Stress reduction, sleep and lifestyle changes | Addresses common triggers such as stress, smoking and alcohol1 | Depends on identifying the trigger |
| Botulinum toxin injections | Temporarily weakens the clenching muscles3 | Off-label; small trials; effect wears off |
Side effects and open questions
In the trials reviewed, side effects were mostly mild and temporary. Examples included pain at the injection site and changes to the smile, reported in a minority of participants in individual studies.3
A longer-term question is bone. Chewing muscles load the jawbone, and weakening them could in theory reduce bone density. An observational study of 79 women with jaw pain found that bone density in the jaw joint was similar overall in those who had at least two treatment cycles in a year and those who had none.4 However, higher doses were linked to lower density in some areas, and the authors called for further study of higher doses and longer use.4
When to seek medical advice
See a dentist if grinding has damaged your teeth, your teeth are sensitive, or you have pain in the jaw, face or ear. See a GP for help with possible causes such as stress, anxiety, smoking or alcohol, or if a partner notices loud snoring or pauses in breathing at night.1
Common questions
Will botulinum toxin stop me grinding completely?
Unlikely; it aims to reduce the force of clenching, and trials mainly measured pain and stiffness rather than complete stopping.3 Grinding activity may continue at a lower intensity.
Do I still need a mouth guard?
Often yes, because a splint protects tooth surfaces regardless of muscle strength.1 A dentist can advise whether your teeth need ongoing protection.
Is it the same as cosmetic anti-wrinkle treatment?
It uses the same type of medicine, but in different muscles and usually at different doses.3 Assessment should include the teeth, jaw joint and possible causes, not only appearance.
Bottom line
Botulinum toxin may reduce jaw pain from clenching in some people, but the trials are small, the use is off-label and the effect is temporary. Identifying the cause and protecting the teeth usually come first, with injections a possible later option to weigh with a dentist or doctor.
Related reading
- Botulinum toxin (anti-wrinkle injections) guide
- How long does Botox last?
- How to spot fake Botox
- Snoring and sleep apnoea treatments
Sources
- NHS. Teeth grinding (bruxism). NHS website. https://www.nhs.uk/conditions/teeth-grinding/. Accessed 5 November 2026.
- Lobbezoo F, Ahlberg J, Raphael KG, et al. International consensus on the assessment of bruxism: report of a work in progress. Journal of Oral Rehabilitation; 2018;45(11):837-844. doi:10.1111/joor.12663. https://pure.uva.nl/ws/files/31008698/Lobbezoo_et_al_2018_Journal_of_Oral_Rehabilitation.pdf
- Buzatu R, Luca MM, Castiglione L, Sinescu C. Efficacy and safety of botulinum toxin in the management of temporomandibular symptoms associated with sleep bruxism: a systematic review. Dentistry Journal; 2024;12(6):156. doi:10.3390/dj12060156. https://pmc.ncbi.nlm.nih.gov/articles/PMC11203296/
- Raphael KG, Janal MN, Tadinada A, Santiago V, Sirois DA, Lurie AG. Effect of multiple injections of botulinum toxin into painful masticatory muscles on bone density in the temporomandibular complex. Journal of Oral Rehabilitation; 2020;47:1319-1329. doi:10.1111/joor.13087. https://doi.org/10.1111/joor.13087
- Allergan (AbbVie). BOTOX (onabotulinumtoxinA) for injection: full prescribing information. US Food and Drug Administration-approved labelling. https://www.rxabbvie.com/pdf/botox_pi.pdf. Accessed 5 November 2026.
Article history
- — First published.