Teeth Grinding Treatment: Occlusal Splints, Botox, Cost Structure, and Open Bite as a Side Effect

How are splints and Botox different?

An occlusal splint and masseter Botox serve different purposes [2]. A splint is a conservative device worn between the upper and lower teeth to protect them and reduce the strain on the jaw joint, while masseter Botox is an aid that temporarily calms overactivity of the chewing muscles involved in clenching [2]. Neither removes the cause of grinding itself, and managing causes such as stress, sleep, and habits alongside them is described as a given [1].

When DentStat analyzed about 3,100 patient comments on grinding, splints, and Botox in YouTube dental content, questions comparing the cost-effectiveness of the methods and distrust about side effects and tolerance came up repeatedly [4].

Since wearing a splint, my front teeth don’t meet (open bite). Is this a side effect?

Bite changes have been reported as a side effect of wearing the device for a long time without adjustment [2]. Open bite, where only the back teeth touch and the front teeth stay apart, is cited as a typical example, which is why splints are used on the premise of regular checks and adjustments after they are made [2]. However, several factors, such as a pre-existing unstable bite, may overlap, so the cause needs to be identified. If you notice a change, the proper step is not to keep wearing it on your own judgment but to get it reassessed [2]. The comment analysis found much anxiety about open bite [4].

Can I use a mouthguard bought online?

Off-the-shelf mouthguards that don’t fit your bite risk shifting teeth, open bite, and jaw pain [2]. Boil-and-bite products may not fit your bite precisely, so splints are usually made at a dental clinic from impressions to match your teeth and bite [2]. Some patients say it’s fine as long as an impression is taken, but splints come in soft and hard materials with different adjustment processes, so the fabrication method alone does not guarantee safety [2]. If your bite changes or you feel pain after wearing one, the safe approach is to stop and get it checked [2].

Is one Botox treatment enough, or does it build tolerance?

The effect of masseter Botox is temporary, and muscle activity usually returns after several months [2]. For this reason, treatment is sometimes repeated periodically, and repeat treatments and dosage are adjusted based on diagnosis [2]. Side effects such as sunken cheeks are also mentioned, so the recommended approach is to judge it together with managing the cause rather than relying on Botox alone [1]. In the comment analysis, reactions such as “nothing changed after the shots” and questions about tolerance came up repeatedly [4].

How is the cost set, and is it covered by National Health Insurance?

The cost of a splint is made up of several items, not just materials [4]. Detailed diagnosis and bite measurement, the type of device (soft, hard, and so on), and the number of adjustments after fabrication are cited as cost components [4]. Because long-term wear without adjustment can lead to bite changes, the adjustment schedule is built into the cost [2]. Some items such as occlusal splints may be covered by National Health Insurance depending on the diagnosis and detailed criteria, and checking in advance which parts are covered and which are non-covered (not paid by Korea’s National Health Insurance) helps with estimating costs [3].

Common myths and facts

Myth	Fact
Wearing a splint cures grinding	It is a conservative device that protects teeth and reduces strain, and managing the cause alongside it is a given [2]
An off-the-shelf mouthguard is enough	Products that don’t fit your bite risk shifting teeth and pain [2]
One Botox treatment is permanent	The effect is temporary and periodic, so treatment is sometimes repeated [2]
Children grow out of grinding	Grinding in adults often persists or recurs, so the cause needs to be managed [1]

For an overview of conservative treatment, which department to see, and health insurance for TMJ disorders, see the TMJ disorder guide. For dental clinics by region, see Find a Dentist.