Editing Bruxism (section)

===Botulinum toxin===
[[Botulinum neurotoxin]] (BoNT) is used as a treatment for bruxism.<ref name="Buescher 2007" /> A 2020 overview of systematic reviews found that botulinum toxin type A (BTX-A) showed a significant pain and sleep bruxism frequency reduction when compared to placebo or conventional treatment (behavioral therapy, occlusal splints, and drugs), after 6 and 12 months.<ref name="Bussadori Motta Horliana Santos 2020 pp. 2413–2421">{{cite journal | last1=Bussadori | first1=Sandra Kalil | last2=Motta | first2=Lara Jassiski | last3=Horliana | first3=Anna Carolina Ratto Tempestini | last4=Santos | first4=Elaine Marcílio | last5=Martimbianco | first5=Ana Luiza Cabrera | title=The Current Trend in Management of Bruxism and Chronic Pain: An Overview of Systematic Reviews | journal=Journal of Pain Research | publisher=Informa UK Limited | volume=13 | year=2020 | issn=1178-7090 | doi=10.2147/jpr.s268114 | pages=2413–2421| pmid=33061557 | pmc=7533232 | doi-access=free }}</ref>

Botulinum toxin causes muscle paralysis/[[atrophy]] by inhibition of [[acetylcholine]] release at neuromuscular junctions.<ref name="Glick 2003">{{cite book |vauthors=Greenberg MS, Glick M |title = Burket's oral medicine diagnosis & treatment |year = 2003 |publisher = BC Decker |location = Hamilton, Ont. |isbn = 978-1550091861 |pages = 87,88,90–93,101–105 |edition = 10th }}</ref> BoNT injections are used in bruxism on the theory that a dilute solution of the toxin will partially paralyze the muscles and lessen their ability to forcefully clench and grind the jaw, while aiming to retain enough muscular function to enable normal activities such as talking and eating. This treatment typically involves five or six injections into the masseter and temporalis muscles, and less often into the lateral pterygoids (given the possible risk of decreasing the ability to swallow) taking a few minutes per side. The effects may be noticeable by the next day, and they may last for about three months. Occasionally, adverse effects may occur, such as bruising, but this is quite rare. The dose of toxin used depends upon the person, and a higher dose may be needed in people with stronger muscles of mastication. With the temporary and partial muscle paralysis, atrophy of disuse may occur, meaning that the future required dose may be smaller or the length of time the effects last may be increased.{{citation needed|date=December 2019}}