The Use of Botulinum Toxin‐A in the Treatment of Severe Bruxism in a Patient with Autism: A Case Report

Abstract

This case report describes an alternative method for reducing bruxism in a special needs patient who was not a candidate for an intraoral appliance. Bruxism is often seen in patients with special needs and can result in excessive dental wear, temporo-mandibular joint pain, avulsion of teeth and other problems. Current methods of management are not typically effective in this population because most require patient compliance. An 11-year-old male diagnosed with autism and Bannayan-Zonana syndrome received bilateral injections of botulinum toxin type-A (Botox Allergan Pharmaceuticals, Irvine CA) in the masseter muscle. The patient's condition was followed up via post-operative telephone interviews with the parents for 60 days. A reduction in the frequency and severity of bruxism was reported. The only side effects noted were soreness at the injection site and mild, temporary drooling. Although further research is required to determine the optimal doses and injection frequency, botulinum toxin type-A appears to be an alternative method for controlling bruxism in the special needs population.

The Evaluation of the Clinical Effects of Botulinum Toxin on Nocturnal Bruxism

“…Thereafter, botulinum toxin was used for the treatment of bruxism with different origins such as cranial-cervical dystonia [10], Huntington's disease [11], autism [12], and amphetamine addiction [13]. …”

Botulinum toxin in the treatment of tremors, dystonias, sialorrhea and other symptoms associated with Parkinson’s disease

“…Successful use of BoNT to treat bruxism has been described in several case studies [49][50][51][52][53][54]. A case series was reported of 18 subjects with severe bruxism, who were audibly grinding their teeth and experienced significant tooth wear despite medical or dental procedures, to alleviate their symptoms [55].…”

Bruxism: A Literature Review

“…Drugs that have paralytic effect on the muscles through an inhibition of acetylcholine release at the neuromuscular junction (botulinum toxin) decreases bruxism activity especially in severe cases with comorbidities like coma, brain injury, amphetamine abuse, Huntington's disease [68] and autism [69].…”