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Category: BOTOX®

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BOTOX®

BOTOX® and Dental Improvements

 

BOTOX® is a drug made from the bacterial toxin botulin that is used medically to treat some muscular conditions and cosmetically to remove wrinkles by temporarily paralyzing facial muscles. While the cosmetic use of BOTOX® is widely known, not too many people know that it is also used in dentistry.

Using BOTOX® to make dental improvements

When BOTOX® is injected into a muscle, it attaches to the ends of the nerves that control the muscle. After a few days, the toxin works to block the transmission of the nerve signals that cause muscle contractions. The nerves affected by BOTOX® are connected to motor neurons, but the toxin does not affect the nerves connected to sensory neurons, which are the nerves needed to touch, feel pain and temperature. The nerves are blocked for three to four months before the BOTOX® wears off.

How is BOTOX® used in dentistry?

The use of BOTOX® in dentistry has become more popular in recent years, and research studies are being conducted to investigate its uses. According to the Journal of International Oral Health, BOTOX® has been used to correct lockjaw, Temporomandibular joint dysfunction, parafunctional clenching and the headaches that accompany them.

BOTOX® is often used in dental offices as part of a comprehensive treatment plan, but not as a stand-alone procedure. The dentists who use BOTOX® have to have received appropriate education and training prior to administering BOTOX®.

Before a patient undergoes BOTOX® treatment at their dentists, they should make sure that they understand the risks, benefits and costs by asking questions about their treatment plan and the use of BOTOX® to achieve their desired result.

Are there side effects associated with the use of BOTOX®?

Yes, according to the Food and Drug Administration, if BOTOX® is allowed to accidentally spread through the body, the toxin can cause muscle weakness, swallowing difficulties, dangerous breathing, as well as urinary incontinence. However, resistance to BOTOX® is possible over time if the patient has been given high doses of the toxin repeatedly.

When a patient has developed a tolerance for BOTOX®, a different form of the toxin may be needed to achieve the same results.

Can I get BOTOX® treatment at any dentist?

No, BOTOX® is offered by some dentists, but a lot of dentists do not offer treatment that includes the use of BOTOX®. If using BOTOX® to achieve a treatment goal is important to a patient, they can go online to search for a dentist that offers BOTOX® treatment. However, it is important that they make sure that the dentist is qualified to administer the toxin.

Even though the use of BOTOX® in dentistry still requires a lot of research and education for both the patient and dental health professional, there is a belief that it will become more common in the near future.

Conclusion

BOTOX® is known for its uses in cosmetic surgery, but it also has some dental benefits, which is why dentists have started administering it in their practices. If you are interested in learning more about how BOTOX® is used in dentistry, schedule an appointment with a dentist that provides the service to find out more.

If you or someone you know is experiencing persistent or acute pain in the face or jaw, we invite you to set up a consultation with one of our Orofacial Pain specialists in the NYC metropolitan area. Our office locations and contact information are below.

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BOTOX® Jaw Problems Orofacial Pain TMJ

BOTOX® For TMJ Treatment – Your Questions Answered

As a board-certified orofacial pain specialist in NYC and Long Island, I’ve used BOTOX® for TMJ treatment for over fifteen years. If jaw problems greet you upon waking up in the morning, limit your food choices, prompt you to take pain medications like Advil®, Aleve®, or Tylenol® on a routine basis, and have had a negative impact on your life, BOTOX® injections may be something for you to consider.

7 Common Questions About BOTOX® For TMJ Treatment

BOTOX® for TMJ treatment is a subject around which there is a considerable amount of confusion. To make the best decision for yourself, you should know what BOTOX® is, how it is administered for TMJ treatment, and how to choose the right health provider. Here are 7 of the most common questions I get from new patients and the answers:

1. What Is  BOTOX®?

BOTOX®, or botulinum toxin, is what’s known as a neuromodulator. Neuromodulators reduce the ability of a muscle to contract to its maximum capacity. In BOTOX® for TMJ treatment, it is injected into your temporalis and masseter muscles, which are the muscles that enable you to bring your upper and lower teeth together.

botox for tmj in nyc and long island, donald tanenbaum, BOTOX® masseter, BOTOX® temporalis

When we inject BOTOX® into masseter and temporalis muscles, it partially inhibits their ability to tighten to their fullest extent. The result is a reduction in the force of jaw clenching and grinding – one of the common causes of TMJ pain. When the force is lessened, the pain being experienced is also often reduced.

BOTOX® can also reduce the bulk and size of your jaw muscles. Some patients come to my office simply seeking to change the shape of their jaw or reduce the size of their masseter muscles.

2. What’s The Difference Between BOTOX® For Wrinkles & BOTOX® For TMJ Treatment?

In your face, you have “muscles of facial expression.” These muscles enable you to frown, scowl, flare your nostrils, move your eyelids, and smile. To do so, they pull on your skin. As you age and your skin loses some elasticity, it causes wrinkles to appear.

BOTOX® injections have been found to effectively reduce or even eliminate wrinkles by reducing the ability of the muscles to pull on your skin. But, the forces of facial expression are always present, so the use of BOTOX® injections to reduce wrinkles is a lifetime commitment.

BOTOX® for TMJ treatment works differently – instead of injecting into your muscles of facial expression, the injections are into your “muscles of mastication” (your jaw muscles). During an office visit, BOTOX® is commonly injected into four to six areas in the masseter muscle and three to four areas in the temporalis muscles.

While skin wrinkling is a normal part of aging, overworked and symptomatic jaw muscles are not. They get that way for a reason, regardless of whether you’re 18 or 80.

BOTOX® can be a valuable tool to allow your jaw muscles to heal if your pain and stiffness persist after the risk factors that caused your TMJ problems have been identified, reduced, or eliminated.

3. How Long Does It Take For BOTOX® To Kick-In?

BOTOX® and other neuromodulators, such as Xeomin®, can be life-changing. But the benefits do not kick-in right away, and most people have to wait four days to a week before they experience the first indication of relief. Here’s why:

Your muscles contain and rely on a neurotransmitter called acetylcholine which enables them to contract. After BOTOX® injections, it will take a few days for your muscles to use up their supply of acetylcholine. When the level of acetylcholine drops and is not replenished to its normal level, the positive effects of the injections are usually felt.

4. How Long Will The Benefits Last?

The vast majority of TMJ patients that chose BOTOX® find that their symptoms are reduced even after the first injection visit, though not eliminated. The getting better process is slow, as it takes months for long-term muscle injuries to heal.

The best results are achieved when patients continue to complement the BOTOX® with a nightguard, jaw stretching exercises,  a cautious diet, and ongoing efforts to pay attention to daytime jaw overuse behaviors. For most patients, there is a need for one or two additional injection sessions, spaced three months apart, so that the jaw muscles continue to get the rest they need to recover adequately. Within nine to twelve months, there is often a significant reduction in jaw muscle pain, tightness, and daily soreness.

5. How Many Injections Will I Need?

The full benefits of BOTOX® for TMJ treatment are typically not achieved from just one round of injections. Instead, you will likely require a series of injections spaced three months apart.

BOTOX® is, in most cases, not the first treatment you’ll be offered to reduce your jaw pain, soreness, stiff muscles, and motion limitations. The truth is that other treatments usually get the job done. Most of my patients get better by a combination of treatments such as modifying their diet, jaw exercises, massage, physical therapy, chiropractic care, medications, nightguards, and by non-BOTOX® muscle injections.  And most importantly, trying to reduce or eliminate daytime jaw overuse behaviors such as nail-biting and teeth clenching.

6. What Are The Side Effects Of BOTOX® For TMJ Treatment?

Repeated injections of BOTOX® in masseter and temporalis muscles over a long period of time can cause some problems. If it is not administered properly, the result can be muscle weakness, and an acceleration of joint noises, making it difficult to eat certain foods. It could hollow out your temporalis muscles and flatten the contour of your face.

Therefore, it is of critical importance that when you seek a healthcare professional to administer BOTOX® for TMJ treatment, you choose one who fully understands the anatomy and function of the muscles of mastication and the risk factors that prompted your muscles to become overused.

7. Will I Need Long-Term, BOTOX®  Injection Sessions?

There is always a  small percentage of patients whose chronic jaw muscle pain (often years in the making) require ongoing BOTOX® injections, in a way similar to Migraine sufferers. Here’s why:Muscle pain occurs when muscle fibers are injured or overworked. Injured and overworked jaw muscles, often due to daytime clenching and nighttime grinding, a high level of lactic acid is produced. When the lactic acid builds up to a high level, a muscle’s nerve endings become excessively excited, which leads to persistent pain.

The pain is now not only in the muscles but in the nerves themselves. This condition is called sensitization (think of it as a sunburn). Sensitization is much more challenging to turn off than simple muscle.

Fortunately, BOTOX® can help nerve sensitization, but the results are harder to achieve and maintain. As a result, ongoing BOTOX® injections may be needed for some patients, with a frequency of three to four times a year without an absolute stop date. Careful attention is required for these patients to ensure their jaw muscles do not become excessively weakened.

BOTOX® For TMJ Treatment – The Bottom Line

If your problems have persisted for a long period of time and despite treatment by your dentist,  you’re still suffering, the next step is to find a board-certified orofacial pain specialist that has experience using BOTOX® for TMJ treatment.

If you or someone you know is experiencing persistent or acute pain in the face or jaw, we invite you to set up a consultation with one of our Orofacial Pain specialists in the NYC metropolitan area. Our office locations and contact information are below.

You do not have to suffer every day from the pain and discomfort of TMJ. Relief is available.

More helpful information about BOTOX® from Dr. Tanenbaum:

7 Things To Know If You’re Considering BOTOX® Injections For Your TMJ

BOTOX® for TMJ Pain

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BOTOX®

Reasons to Get BOTOX® from Your Dentist

As surprising as it is, you can get BOTOX® from a dentist! Advancements in the dental niche are always being made. The goal is to offer dental patients simple and effective treatments that can address their dental issues in a safe and efficient manner, and many dentists have undergone training and have used dental BOTOX® to treat their patients for years now. Dental BOTOX® can be used for cosmetic or medical reasons.

About Dental BOTOX®

BOTOX® treatments are an option when conventional dental treatments are not working to address any dental-related problem that you are currently experiencing. BOTOX® treatments provided by a dental professional are becoming more common as more is learned about the many benefits BOTOX® can offer dental patients. BOTOX® works by relaxing muscles in the face and, therefore, can be used to treat dental problems that will benefit from relaxed muscles.

It is indeed safe to get BOTOX® from a dentist. Any dentist who offers their patients BOTOX® treatments must first undergo extensive training. Since they have already undergone years of dental training in order to become a dental professional, they fully understand how all of the facial areas are connected. This is why so many patients are looking to their dentist to address any facial-related or jaw-related problems they are currently experiencing.

Common Reasons For BOTOX® Treatments For Dental Patients

The following is a list of three common reasons why dental patients are choosing to get BOTOX® from their dentist.

TMJ

Dental patients who have been diagnosed with a temporomandibular joint disorder often experience discomfort and/or pain due to this common dental disorder. When BOTOX® is injected into the jaw muscles, it weakens the muscles in a way that stops all of the negative effects that come with a TMJ diagnosis, e.g., clicking or popping sounds, general jaw pain, swelling, and lockjaw.

Headaches & Migraines

Because dental BOTOX® relaxes muscles, it is often used to minimize and even eliminate any discomfort or pain for dental patients who are suffering from constant headaches or debilitating migraines. When BOTOX® injections are strategically placed into the shallow muscles of the head and neck, the muscles in these areas are no longer tense, allowing for less or even no more headaches.

Orofacial Pain

Dental BOTOX® can be used to block nerve signals, which helps to relax muscles and accordingly reduce muscle-related pain. This makes using BOTOX® a great idea for dental patients who are experiencing chronic orofacial pain.

Are you currently in need of BOTOX® treatments?

If you think that getting dental BOTOX® will help you, understand that it is a very safe dental procedure that is used by many professional dentists these days. While you are encouraged to perform your own research in order to understand more about how BOTOX® can help you, for personalized information you will need to make a consultation appointment for more information. Ready to find out whether or not dental BOTOX® is a solution for you?

If you or someone you know is experiencing persistent or acute pain in the face or jaw, we invite you to set up a consultation with one of our Orofacial Pain specialists in the NYC metropolitan area. Our office locations and contact information are below.

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BOTOX® TMJ

BOTOX® For TMJ Pain

Does It Work?

Despite the press advocating BOTOX® for TMJ pain problems, my clinical experience using it over the past 15 years suggests that it represents another supportive treatment at best and may not live up to the hype over the long term.

To start the discussion let’s focus on who is even a candidate for BOTOX®, a chemical agent that can be used to partially reduce muscle contracture. Since most of the commonly seen TMJ problems are orthopedic in nature, patients typically experience muscle and joint pain, limited jaw motion, difficulty chewing, and at times joint clicking, popping and locking.

Those patients whose problem is mainly mechanical – whose jaws click, pop, and lock – are typically not good candidates for BOTOX® injections. BOTOX® for TMJ pain and for people whose jaws have become more prominent due to excessive teeth grinding are more likely to get relief.

If you look at the common muscle problems we encounter with TMJ, the vast majority of patients will get better by:

  • Education, behavior, and diet modification
  • Postural awareness
  • Home exercise
  • Massage
  • Short-term medication

More stubborn problems will get better by adding:

  • Oral appliances
  • A prescription for physical therapy
  • Trigger point injections and/or acupuncture

That leaves only a small percentage of patients who would benefit from using BOTOX® for TMJ pain. It can be very effective in alleviating persistent jaw muscle pain resulting from the accumulation of lactic acid and other irritating substances. What makes people grind their teeth? Teeth grinding for most people is the result of negative emotions (stress), daytime overuse behaviors that fatigue the jaw and/or restless sleep associated with frequent arousals, and at times tooth clenching and grinding. Even when BOTOX® for TMJ pain is used in this select population of patients, success can only be achieved if what caused the problem in the first place is controlled or eliminated. It’s not an easy task!

People who opt for BOTOX® for TMJ pain typically need injections over a period of 9-12 months. If you are among the select few who are candidates, you have reasons to be optimistic. Patients for whom first-line therapies have failed report reduced suffering. Although still clench or grind their teeth they feel less pain as a result.

BOTOX® For TMJ Pain – The Take-Away

BOTOX®does have a place in the management of jaw muscle pain, but it is important to understand that it’s far from the remedy it is made out to be by those trying to sell it as a cure for TMJ problems.

Pain issues and sleep challenges do not have to be lifetime afflictions. You need someone who listens and possesses the knowledge and compassion to get your pain and sleep problems under control. I am that someone – and you’re in the right place.
Dr. Donald Tanenbaum, DDS MPH

If you or someone you know is experiencing persistent or acute pain in the face or jaw, we invite you to set up a consultation with one of our Orofacial Pain specialists in the NYC metropolitan area. Our office locations and contact information are below.

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BOTOX®

How Long Will BOTOX® for TMJ Treatment Last?

BOTOX® for TMJ treatment has become popular as there are many benefits to this approach and the results have proven to be successful for many patients. It is a relatively easy procedure, with little to no side effects. However, BOTOX® is still rather new with regard to treating TMJ. With that being said, many individuals are curious as to how long treatment lasts. While everyone has varying results, there is a general guideline for how long the results will stay intact.

When considering BOTOX® for TMJ, it can be helpful to get familiar with the result times, as it can factor into the decision-making process. Ready to find out more?

BOTOX® for TMJ treatment

Below is an overview of the use of BOTOX® for TMJ treatment, including how long the results typically last.

The BOTOX® procedure

BOTOX® for TMJ is one of the easiest and most straightforward procedures done in dentistry. The appointment takes less than 30 minutes, which cannot be said about most other TMJ treatment procedures. The BOTOX® will be carefully injected into the facial area. Then, the TMJ specialist will gently massage the face and temporomandibular joints to ensure that the BOTOX® disperses itself evenly. Once the procedure is complete, the individual can return home and wait for the results to kick in. Most individuals experience immediate relief, however, for some, it can take up to a week.

How long do BOTOX® treatments for TMJ last?

BOTOX® for TMJ typically produces results that last for a couple of months. For those just starting BOTOX® for TMJ, the specialist may recommend a second and third round of injections within a couple of weeks to ensure effectiveness and longer-lasting results. Once all three rounds have been completed, most individuals will find relief from pain and other related symptoms for as long as a year.

Some individuals are able to find permanent relief from the use of BOTOX® for TMJ. In these cases, follow-up treatment may not be required, other than quarterly appointments with the TMJ specialist to undergo routine injections and examinations.

Other things to note about BOTOX® for TMJ

If treatment with BOTOX® is not successful, the specialist may recommend another route, such as a surgical procedure or bite splint. It is also good to note that in some scenarios, BOTOX® may be used in conjunction with other treatment options, such as physical therapy and the use of a bite splint or nightguard to reduce bruxism.

It is also good to be aware that BOTOX® for TMJ can cause some bruising and slight swelling; however, this usually goes away within 48 hours. After a few rounds of BOTOX®, most individual’s bodies get used to this.

Consult with a TMJ specialist today

When interested in BOTOX® for TMJ treatment, it is necessary to consult with a specialist. Questions and concerns can be addressed, and an evaluation can be done in order to identify goals and needs. From there, a treatment plan can be determined, which will likely include BOTOX®. Reach out today to find out more or to get started with a consultation appointment.

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BOTOX®

Is BOTOX® for TMJ Safe?

 

Want to learn more about how BOTOX® for TMJ works? Because BOTOX® treatment requires injections, many TMJ patients wonder if BOTOX® is safe. Keep reading to learn more about BOTOX® treatment and its safety.

TMJ treatment

Choosing BOTOX® for TMJ treatment is something many TMJ sufferers are looking into to address their discomfort and pain. BOTOX® works because the facial muscles play a large role in how much pain TMJ causes. BOTOX® helps relax the affected muscles, allowing patients to experience little to no pain. It is necessary to visit a TMJ specialist in order to undergo BOTOX® injections, as they have been specifically trained in how to administer it in a safe manner. According to the American Dental Association, possible causes of TMJ disorders include arthritis, tooth and jaw misalignment, stress caused by teeth grinding and dislocation or other injuries.

About BOTOX® safety

BOTOX® is a drug that is made from a toxin, which is why people who are interested in using it wonder just how safe BOTOX® injections for treating TMJ.  BOTOX® treatment is considered a safe procedure when performed by an experienced TMJ specialist. Because BOTOX® injections were approved by the FDA in 2002 for TMJ treatment, TMJ sufferers who are considering this option can feel confident that BOTOX® injections are safe to use for addressing TMJ-related problems.

While BOTOX® is safe, it can cause certain side effects in some people. These side effects include but are not limited to swelling, bruising, headaches and flu-like symptoms. Any side effects a patient experiences are usually both minimal and temporary.

How BOTOX® relieves pain

BOTOX® works by temporarily paralyzing muscles. The fact that BOTOX® is a muscle relaxer, means that it can help reduce muscle contractions that cause pain. Because BOTOX® works by relaxing muscles, it is especially beneficial for TMJ sufferers whose TMJ is a result of teeth grinding or clenching. The relaxing of the muscles specifically helps to relieve jaw tension, as well as prevents the headaches that are so common with jaw-related problems.

How long BOTOX® injections last

Many patients who choose to undergo BOTOX® treatment to address their TMJ problems can expect their treatment to last somewhere between three and five months. It will ultimately depend on a patient’s genetic makeup and how severe their TMJ is. It is important to understand that the longer a patient undergoes treatment, the longer they can go between their treatment injections. This is due to the fact that the muscles are continuously being relaxed through BOTOX® treatment.

Have questions?

Have any questions about BOTOX® for TMJ? Those who have been diagnosed with TMJ can experience minimal pain or severe pain. Those who experience severe pain may have difficulty performing everyday functions. BOTOX® injections is a popular and safe treatment option when performed by a TMJ specialist.

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BOTOX® Jaw Problems Orofacial Pain TMJ

7 Things To Know If You’re Considering BOTOX® Injections For Your TMJ

As an orofacial pain specialist and an expert in the treatment of temporomandibular disorder (commonly referred to as “TMJ”), most patients who seek my care have been suffering from persistent jaw pain, tightness, and soreness due to overstressed muscles – often for years. Tension in the masseter (jaw) muscles are at the root of this disorder and can be caused by several factors, with bruxism being the most common.  

If you’re considering BOTOX® injections for your TMJ, there are a few things you should know.

Bruxism comes in two forms: awake bruxism and sleep bruxism. Awake bruxism is excessive contact of the teeth during the day. Your teeth should never be in frequent contact during waking hours. Consistently clenching or grinding your teeth while sleeping is called Sleep Bruxism. 

Orofacial pain specialists like myself have been carefully turning to BOTOX® injections for TMJ problems for the last few years. While BOTOX® injections were initially approved to reduce facial wrinkles and frown lines, the medical community has recognized its use to help patients who have migraines and other conditions, including TMJ. If you’re considering BOTOX® injections for your TMJ because nothing else has worked, here’s what you need to know and understand:

7 Things To Know If You’re Considering BOTOX® Injections For TMJ

1. BOTOX® Reduces Muscle Contraction

When injected into the masseter muscles, BOTOX® reduces their ability to contract fully. During the 3-4 months after you’ve had injections, your masseters will exert a lower amount of force than normal. While your brain may be telling your muscles to contract with a normal amount of force, as long as the BOTOX® is active, they simply can’t. 

2. BOTOX® Can Provide Some Pain Relief

When BOTOX® is injected into muscles, it causes the muscle to relax, and less lactic acid and other pain-producing chemicals accumulate. As a result, the nerve endings within the muscle tissue become less irritated and sends fewer pain signals to the brain. 

At the same time, BOTOX® also directly reduces the release of pain-producing chemicals (neuro-transmitters) by the nerve endings in the muscles. That’s one of the reasons why BOTOX® reduces pain in migraine sufferers. 

3. BOTOX® Stays Where It’s Put

When injected by a trained clinician, BOTOX® will not typically diffuse into neighboring tissues – as long as the proper volume and technique are used. 

To treat TMJ, BOTOX® injections typically go into your masseter and temporalis muscles, which are the muscles responsible for closing your jaw from an open position. BOTOX® is sometimes also injected into your lateral pterygoid muscles – the ones that allow you to open your mouth and move your jaw from side-to-side.

4. BOTOX® Is Not A Stand-Alone Treatment For TMJ

Symptoms such as jaw locking or clicking are usually caused by loose ligaments and changes in the position of your shock-absorbing disc. BOTOX® injections do not predictably help these problems. Nor can BOTOX® minimize inflammatory pain in your TMJs. 

Locking, clicking, and disc problems require a different level of care. Therefore, an accurate diagnosis is absolutely necessary before BOTOX® injections are considered. When chosen, BOTOX® is commonly complimentary to other TMJ treatments such as medication, oral appliances, exercises, meditation, and physical therapy. This is very important to understand if you’re considering BOTOX® injections for your TMJ.

5. BOTOX® Injections Should Be Administered By A Healthcare Provider Who Has A True Understanding of TMJ Problems

Knowing how to inject BOTOX® is only part of the equation. The practitioner doing the injecting must fully understand how the jaw works, the risk factors that lead to muscle pain and over development, and how a patient’s bite relationships relate to their jaw muscles. A trained dentist or dental specialist is likely best equipped to answer these questions and provide the education that is needed to assure treatment results. 

6. BOTOX® Injections For TMJ Are Not (Usually) A Once-And-Done Therapy 

Most people who end up having BOTOX® injections for TMJ have been suffering for many years. One series of injections alone will rarely if ever, solve the problem. Many patients who find relief after the first series of injections can see their symptoms return, particularly if the pertinent risk factors (what caused the problem in the first place) have not been identified and addressed. If you’re considering BOTOX® injections for your TMJ and plan for only one series of injections, you’ll likely be disappointed.

7. BOTOX® Injections Can Give You A Slimmer Jawline 

BOTOX® is becoming an accepted solution for people who are unhappy with the shape of their jaw. If your masseter muscles are enlarged due to bruxism or daily habits such as gum chewing, BOTOX® injections can be extremely helpful in slimming its appearance.

After a series of injections, BOTOX® will increase the amount of collagen and fat in your masseters and shrink the size of muscle fibers. This is why slimming occurs.  Along with muscle slimming, BOTOX® injections can also weaken the muscles making chewing more difficult. This is why a trained practitioner is advised.

BOTOX®: A Tool, Not A Cure 

BOTOX® injections for TMJ are not a cure. They are, however, a vital tool of orofacial practitioners like me. If your doctor or dentist has tried everything, and you’re still suffering, BOTOX® may be your next step. Make sure that the person who administers your injections is highly knowledgeable, skilled, and trained in using BOTOX® injections for TMJ. 

Choose carefully.

(Learn more here: All About BOTOX® For TMJ)

Live or work in New York City or on Long Island? You can schedule a consultation with me here or call 212-265-0110.

 

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BOTOX® Bruxism Case Studies Facial Pain Jaw Problems Orofacial Pain TMJ Women & Pain

Facial Pain – Is It Bruxism or Is It Bulimia?

TMJ /Facial Pain Symptoms & Eating Disorders – The Connection

As a TMJ doctor, every year I see a number of patients who are suffering from an extraordinarily high level of face and jaw pain. At first glance, the level of suffering they report is much greater than what I commonly see. One such group are people with a history of one particular eating disorder – bulimia nervosa. In these patients, the typical characteristics I see in people with TMJ are not present. Although their symptoms may lead them to believe that their pain is driven by stress-related jaw tension and bruxism (teeth grinding and clenching), the telltale signs are simply not there. That’s when I ask myself, is it bruxism or is it bulimia?

 

Is It Bruxism or Bulimia? A Case Study

Marci was 26 when she arrived at my office some three years ago. For several years she’d been dealing with debilitating jaw and face pain almost daily. The pain was centered at the angles of her jaw on both sides and it had become, as she described it, “unmanageable.”

Pain was ruining her life.

Many doctors and therapists had tried to help Marci find relief. She’d been prescribed pain medications and muscle relaxers. She’d been treated by physical therapists. She had acupuncture and trigger point injections. She even tried wearing an oral appliance to bed, thinking her problems were the result of bruxism.

Frustrated and discouraged, Marci was still suffering – with no resolution in sight.

 

4 Clues That Bruxism Was Not The Culprit

At first, Marci didn’t share her entire medical history with me. Possibly because she was embarrassed or simply didn’t think there was a connection. However, even without knowing her full history, several clues pointed to the fact that Marci’s pain was not caused by bruxism, but instead was a result of bulimia:

  1. No signs of the kind of tooth wear characteristic of bruxism were detected.
  2. Her masseter (jaw) muscles were not rock hard and well-built, typically a sign of bruxism.
  3. The biting surfaces of her lower molars showed a complete loss of enamel.
  4. Her face was extremely puffy.

So, Why Did I Ask If It Was Bruxism Or Bulimia?

In order to answer the question, is it bruxism or is it bulimia, each clue pointed to the answer. You see, bulimia can wreak havoc in the mouth because frequent vomiting exposes the teeth to acid, which can dissolve their protective enamel. This is seen on the back of the upper front teeth and in the center of the lower back teeth where regurgitated acid can pool. And, over time, frequent vomiting can cause the parotid gland (the largest salivary gland) to become inflamed and enlarged, resulting in acute nerve pain in the overlying jaw muscles and prompting facial puffiness.

 

Facial & Jaw Pain Caused by Bulimia – Treatment

Probing deeper into Marci’s medical history, I concluded that it was indeed bulimia, not bruxism that was the cause of Marci’s pain. Now it was time to offer a plan of treatment. I prescribed the medication nortriptyline (a once-popular antidepressant) that, when used in small doses has been shown to be effective in reducing pain in muscles by quieting nerve excitation. It is thought to work over time by increasing the activity of serotonin in the brain, according to the Mayo Clinic.

Marci also had a series of BOTOX® injections in her masseter muscles at my office, designed to not only reduce muscle tension but to also diminish the release of nerve-irritating chemicals. (See BOTOX® Injections For TMJ – 6 Things You Need To Know)

She was also given a custom-made topical salve containing a mixture of anesthetic, nerve membrane stabilizers, and anti-inflammatory medications to rub over the sore areas of her jaw three times a day.

A Much Happier Existence

Four weeks into treatment, Marci reported that her pain was more than 40% reduced. A second series of BOTOX® injections months later provided even better results. With her pain reduced, she was more motivated than ever to continue talk therapy, which she had started in an attempt to get a handle on her bulimia.

Today, Marci comes into my office every 4-6 months for a refill of her nortriptyline prescription and occasional BOTOX® injections. She’s nearly pain-free, almost bulimia free, and she leads a much happier existence.

 

Do You Know Someone Who Has Bulimia?

If you or someone you care about has bulimia and is suffering from facial and /or jaw pain, it is quite possible that a relationship exists. It’s very important to answer the question, is it bruxism or is it bulimia, so the right treatment can be put into place.

Although strategies like those used in Marci’s case won’t provide a cure, they can go a long way towards improving the quality of a suffering person’s life.

Live or work in New York City or on Long Island? You can schedule a consultation with me here or call 212-265-0110.

3 Frequently Asked Questions About BOTOX Injections in Masseter Muscles Donald Tanenbaum DDS
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BOTOX® TMJ

3 Questions & Answers About BOTOX® Injections For TMJ

BOTOX® first became popular as a way to reduce wrinkles and facial lines. But being treated with BOTOX® injections for TMJ problems has become very popular. It is effective in treating pain and/or overactive muscles – when administered by a trained and experienced professional.

As an orofacial pain specialist, I often turn to BOTOX® for TMJ symptoms in patients whose pain has not responded to traditional first-line therapies such as exercises, medications, relaxation techniques, oral appliances, etc.,

If you’re at a point where nothing has provided relief from your painful TMJ symptoms, BOTOX® injections for TMJ could be the next step. BOTOX® is injected into your masseter muscles – the big muscles that bring your teeth together and bulge when you clench your teeth.

Naturally, a lot of questions pop up when I recommend BOTOX® injections for TMJ to my patients. Here are three of them:

3 Frequently Asked Questions BOTOX® Injections For TMJ

“One side of my face has a more developed masseter muscle than the other side. Will BOTOX® for TMJ improve the symmetry of my face?”

Yes, BOTOX® injections for TMJ can be used to achieve facial muscle symmetry. But here’s the important thing to know. It must be injected with a protocol that will selectively reduce the muscle bulk. Both the location and volume of BOTOX® used must be carefully planned to achieve the result desired.

Don’t go forward until you find a practitioner who is highly trained and experienced in this type of treatment.

“How do I know if, or when, I will need more BOTOX® injection for TMJ?”

BOTOX® is injected into the jaw (masseter) muscles for one of two reasons: The first, and most common, is to reduce pain. The second reason that patients opt to have BOTOX® injected into their masseters is to slim down their jaw profile. Many people develop large, bulky jaw muscles as a result of clenching and grinding their teeth, which is called Bruxism.

If pain was the reason you chose BOTOX®, you’ll know you need more treatment if the pain returns and you have controlled all the risk factors that brought on the pain in the first place. If your pain is significantly diminished or completely gone, you may not need more injections.

For pain relief, the current protocol has defined waiting a period of three months between injections.

If achieving a slimmer-looking jaw was your reason for pursuing BOTOX®, what you see in the mirror is the indication that you need more BOTOX®. It is likely that more than one session of BOTOX® injections will get the job done, so keep that in mind.

In addition, if you have not learned to reduce the behaviors that made your jaw muscles larger, or addressed the impact of sleep bruxism if present, results will take longer to achieve and may never be fully satisfying.

Learn about the behaviors that cause enlarged jaw muscles and what you can do about them here.

“If I just stop chewing gum and eating hard food, will my bulky jaw slim down so I don’t need BOTOX® injections?

Your bulky jaw is the result of your masseter muscles being overworked over the course of many years. If you simply stop those activities your muscles aren’t going to slim down on their own. You are probably a good candidate for BOTOX® injections for TMJ.

But as long as you continue the behaviors that made your jaw bulky in the first place, such as teeth grinding and clenching, the results of the BOTOX® won’t last long. 

The Bottom Line

BOTOX® can be highly effective as a treatment for the pain and jaw bulkiness that are symptoms of TMJ problems. However, if administered improperly it may not work or even produce some very unpleasant outcomes. 

How To Find A TMJ Specialist

To find an orofacial pain specialist who’s trained and experienced in your area, go to this website www.aaop.org. Look for a specialist in your area with the designation Diplomate. If you live in the New York City metropolitan area, feel free to call my office at 212-265-0110 to discuss your case. I’d be honored to help you feel better.

Have more questions about BOTOX® for TMJ in the masseter muscles? Feel free to comment below:

Who To Choose: BOTOX Injections For Jaw Problems Dr. Donald Tanenbaum
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BOTOX® Bruxism Jaw Problems Nightguards & Oral Appliances Orofacial Pain

BOTOX® For Jaw Problems – Who To Trust

The effectiveness of BOTOX® to erase the signs of aging is well-known. But BOTOX®, as you may have heard, can be used to treat a number of medical conditions, as well. As the popularity of BOTOX® has grown so has the number of people who are willing to inject it. BOTOX® for jaw problems, including symptoms associated with TMJ (temporomandibular joint dysfunction), is no exception.

If you’re reading this article you’re possibly experiencing jaw pain or know someone who is. I’ve been treating patients for jaw problems for over 30 years, and during most of that time, I depended upon oral appliances (also called tooth protectors, night guards, or bite plates) as part of first-line therapy to help my patients. Countless people are a tremendous amount of relief from the devices and some won’t consider sleeping without them.

Unfortunately, a small percentage of people do not get relief from first-line TMJ treatment, and some of them develop even more jaw symptoms when using them. If you’re one of these folks, you may be considering injections of BOTOX® for jaw problems as many others are, too.

However, it’s critical for you to understand that BOTOX®, like the oral appliances that help so many of my patients, will not cure your jaw problem. You must address the reasons your jaw got into trouble in the first place.

For BOTOX® for jaw problems to work effectively, it must be injected into both the masseter and temporalis muscles. And, the injections will likely need to be repeated for a time at three-month intervals. Your jaw is a complex structure and is integral to the quality of your life.

You need to be extremely careful about who you choose to administer BOTOX® injections. In some cases, BOTOX® doesn’t work and may even do more harm than good.

BOTOX® For Jaw Problems Is A Serious Decision

First, it’s critical that you are evaluated by an experienced orofacial pain specialist before you have BOTOX® injected into your delicate jaw muscles. Orofacial pain specialists have a specific focus on jaw problems and they have the experience, education, skill and knowledge to determine if BOTOX® for jaw problems will help you.

Here are five scenarios where BOTOX® for jaw problems can be appropriate:

1. You Overuse Your Jaw Muscles

When jaw muscles become overworked, over-built, and consequently, sore and painful, it can be for a variety of reasons. Most people know that TMJ symptoms can be caused by grinding and clenching your teeth at night. But, there are a lot of other causes of TMJ that happen during the day such as gum chewing, nail or cuticle biting, gnawing on pens or pencils, or even bracing your jaw muscles as you work, especially when you sit for hours at a computer.

I do administer BOTOX® for jaw problems in my practice, but not before I work closely with a patient and help them modify or eliminate the overuse behaviors that caused their problems in the first place. Many strategies including muscle-stretching exercises, breathing exercises, and relaxation techniques are very effective and non-invasive. If the overuse behaviors are not addressed and changed, BOTOX® for jaw problems has little – or no – benefit.

2. Your Jaw Muscles Bulge

BOTOX® for jaw problems is predictably effective when a patient’s jaw muscles are so overbuilt that they bulge even when they’re contracted. 

3. You Have Jaw Pain Only On One Side

If your jaw pain is not the same on both sides, before you choose BOTOX® injections, you must be examined by a medical professional who is educated and experienced in the relationships between teeth, bite and jaw postures and how they influence muscle health, overdevelopment and pain. BOTOX® injections must be placed strategically and it’s critical that the correct amount is injected into each muscle site. It’s critical that the person administering the injections has a great deal of expertise.

4. If You Have A Locked Jaw

It requires some deep investigating to determine when and if BOTOX® injections are the right treatment for patients whose jaw locks frequently or has been locked for a while. A locked jaw can be due to a myriad of factors. Figuring out why it’s happening in the first place is critical before you consider BOTOX® for jaw problems. Only an experienced orofacial or TMJ specialist can make the right decision

5. Your Jaw Is Clicking

Constant clicking in the jaw joint is usually due to a problem in the ligaments, bones and/or cartilage. Although a clicking jaw can be caused by overuse behaviors like the ones stated above, BOTOX® for jaw problems won’t help if the clicking has become persistent. In fact, BOTOX® can cause even more jaw clicking. If your jaw is clicking and it’s accompanied by pain, a thorough examination by an orofacial pain specialist is your first step. The last thing you need is more problems.

Conclusion

I have been treating patients with jaw problems for over 35 years and BOTOX® or jaw problems is becoming more and more important. But it’s only one of the ways I help my suffering patients. The instinct I’ve developed from my years in practice combined with my focus on science enables me to determine when, and if, BOTOX® is the correct treatment option in each case, where it should be injected and the correct amount of medicine to use.

If you’re considering BOTOX® for jaw problems related to TMJ, lockjaw, clicking or pain, please let an experienced orofacial pain specialist evaluate you before making the decision.  To find an orofacial pain specialist in your area, link here.

I was interviewed on Good Morning America about BOTOX® for jaw problems. Click here to view the interview.

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BOTOX® Bruxism Jaw Problems TMJ

Bruxism Can Change The Shape Of Your Face

As an orofacial pain specialist, I’m often asked if bruxism can change the shape of your face.

Here’s a story about a young woman named Sarah who came into my office a couple of weeks ago with her mother. Sarah is a 17-year old, college-bound, high achiever who was convinced that the shape of her face had undergone a dramatic change during the past few years. She was particularly concerned about her jawline. She felt that her jaw muscles looked bigger and more pronounced than before.

When I work with a new patient the first thing we do is sit down, relax, and have a conversation. I usually learn more during this conversation than I do from the physical examination. During my conversation with Sarah I asked her a lot of questions about her life and carefully listened to her answers. It didn’t take long for me to begin to see where her problems started. The physical examination reinforced my hypothesis.

In order to understand what happened to Sarah’s face we must take a look at the master muscles; they are the muscles that control the movement of the jaw. Masseters are like all other skeletal muscles in your body in that they will maintain a baseline shape and size when used normally. And, like all other skeletal muscles in your body, they will change in size and shape when over-used. It’s the same as when you workout your biceps in order to change the size and shape of your arms.

Each time you close your jaw or even swallow, you are using your masseters. Normal chewing and swallowing will not cause them to change in shape or size. What makes masseter muscles change, is when they are contracted over and above what is considered normal, over a long period of time. Since the masseters define the shape of your jaw, over-use behavior can actually change the shape of your face.

By chewing gum, biting your nails, biting your cuticles, chewing on pens, or even holding your glasses between your teeth, you are using your masseter muscles way beyond what they were designed for. Some people hold and clench their upper and lower teeth together during the day without realizing it and over a period of time this causes their masseter muscles to bulk-up.

Also of concern is sleep bruxism. Hundreds of thousands of people grind or clench their teeth while they’re sleeping. This excessive teeth grinding, jaw movement side to side-to-side, and/or clenching in a static, braced position plays a huge factor in the enlargement of the masseters and consequently, the shape of the jaw. So, the answer is:

Yes, Bruxism Can Change The Shape Of Your Face

To reduce the impact of bruxism on the masseter muscles, I normally provide my patients with a custom-fitted oral appliance (also referred to as a night guard). The oral appliance is a very effective tool in reducing the impact of grinding and clenching. But an oral appliance will not stop over-use behavior.

Although Sarah wasn’t complaining about pain, soreness and stiffness are also common effects of bruxism. Imagine how sore your hand would be if you kept it in a fist for most of the day and night. Jaw over-use is just like making a fist in your face, and it can create excruciating pain for many people.

Let’s go back to Sarah. Through our conversation I was able to identify the main reasons that her jawline had changed so dramatically. It turns out that she is a long-time gum chewer, a nail biter, and a nighttime clencher. Sarah has literally been working-out her masseter muscles every day and night for years.

An oral appliance strategy as been put into place that will reduce the impact of Sarah’s sleep bruxism. Next, The next step is for her to change her daytime over-use behaviors. Today, Sarah is wearing the oral appliance at night and working hard to correct her daytime over-use behaviors.

An additional approach that could work for Sarah is BOTOX®. BOTOX® is a popular cosmetic therapy that has the potential to diminish the forces of nighttime bruxism. It works by diminishing the capacity of the masseters to contract, with the result often being a reduction in the bulk of the over-used muscles.

Today, Sarah is wearing the oral appliance at night and working hard to correct her daytime over-use behaviors. But before I will go forward with BOTOX® for Sarah, she must convince me that she understands that if she does not correct the daytime over-use behaviors, BOTOX® is not an option.

Here’s The Takeaway: If you have noticed changes in the shape of your face or your jawline, it’s probably not your imagination. Find a dentist that has special training in bruxism as soon as possible.

I invite you to follow me on Facebook, Twitter or LinkedIn to keep up with all the new research and case studies in this field (and with Sarah’s progress).

BOTOX® for teeth grinding is in the news! I was recently interviewed on ABC’s Good Morning America on the topic, Can BOTOX® be used to treat teeth grinding?  Click the link to watch the segment.

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BOTOX® Bruxism Jaw Problems

Case Study: 10 Years of Teeth Clenching

Last week a 44-year old woman came in to see me concerned with the fact that the her face had become more and more “square-shaped” over the past ten years. She openly revealed that working full time and raising three kids had been no easy task for her and that she often went through the entire day with her teeth clenched. I explained to her that those ten years of teeth clenching had essentially been causing her to make a “fist in her face” for all those years. With that kind of daily stress on the muscles, it’s no wonder that her face had changed!

The end result of her clenching behavior was that she had “buffed” her jaw muscles. They bulged outwardly just like your biceps would as a result of lifting weights every day over a prolonged period of time. Remarkably, my patient never experienced any pain in her face or her jaws, which probably would have caused her to seek help sooner. The issue for her now, however, was the change in her appearance.

My examination (not surprisingly) revealed that she had bulky and powerful jaw muscles (masseter) that bulged outwardly when her teeth were clenched together. Even the muscles in her temples bulged! Over the decade this patient had actually increased the size and number of muscle fibers giving her a ‘Clint Eastwood’ look.

The first hurdle in treatment was to get the patient to actually change her acquired behavior and learn to live in the world with her teeth apart during the day. The clenching tendency that she had developed was likely the result of trying to cope with her daily stresses, some of which were not under her control. Relaxation and breathing techniques were reviewed, and she began to use an oral appliance during the day to create awareness. This was the first part of the plan. As experience has taught me, just stopping new muscle building does not effectively reduce the bulk of jaw muscles in a predictable fashion. Once built, these muscles tend to stay large as a result of normal daily activities. So what next?

BOTOX® Injections:
In order to actually decrease the size of her well-built muscles, we needed to reduce the ability of these muscles to contract forcefully on a day-to-day basis. This is where BOTOX® can really help. We administered three BOTOX® injections into the patient’s masseter muscles; each injection session approximately three months apart. With time, the BOTOX® led to muscle atrophy (size reduction and less strength) without compromise of eating or talking along the way. The result was a return to a more normal jaw profile.

To assure a lasting result my patient has to continue participating. This means teeth apart during the day and wearing the bite plate appliance at night (to diminish the impact of her night clenching). Some simple jaw stretching exercises are also required to keep the jaw muscles supple.

Although it took almost one full year from start to finish, this cosmetic makeover has truly made a difference in slimming my patients’ facial profile that was the end result of years of muscle building. This is probably the only time that reducing muscle bulk actually can make someone look better!

BOTOX® for teeth grinding is in the news! I was recently interviewed on ABC’s Good Morning America on the topic, Can BOTOX® be used to treat teeth grinding?  Click the link to watch the segment.

is it tmj or is it a tumor? donald tanenbaum dds
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BOTOX® TMJ

Is It TMJ or is It a Tumor?

In my practice, most patients are referred by their dentist, physician, or other health care professionals because they are experiencing facial pain or the common symptoms of TMJ/TMD (Temporomandibular Joint Disorder), which can include one more of the following: ear pain, jaw pain, limited jaw motion, joint noise, the inability to bring teeth together, facial tightness, and headaches often focused in the temples.

At times, however, the patient’s description of their symptoms and the history of their problem indicates that though their complaints are familiar, the origin of their problem may relate to an underlying medical disease or condition that has yet to be discovered. In other words, things are not what they seem to be!

For instance, the following medical conditions (a small sample) can produce the signs and symptoms of a TMJ/TMD problem:

  • Sinus Tumors
  • Acoustic Neuromas
  • Thyroid disease
  • Lyme Disease
  • Tumors in the Salivary Glands
  • Blocked Coronary Artery Tumors in the Neck
  • Facial neuralgias

Though these conditions occur much less frequently than a common jaw ailment, they must be considered when a patient’s TMJ symptoms are not responding to common therapies and/or progressing over time. Once a specific diagnosis has been made, the treatments put into place will address the disease first, with the result of the secondary symptoms easing or disappearing over time. Unfortunately, at times if making the proper diagnosis is delayed, and the TMJ structures (muscles or joints) are treated instead of the real problem, suffering will continue.

From another perspective, there are times when the treatment for a diagnosed medical problem in the head and neck region requires surgery or radiation therapy. As a result of these treatments, however, jaw motion can become limited, and pain may develop that is continuous or related to jaw function. This, for example, can occur following surgery to remove a brain tumor, which requires cutting through the muscles in the temple.

As a result, scarring can occur, leading to diminished jaw motion. In the presence of these outcomes, however, there are a number of traditional TMJ therapies that can aid in the restoration of jaw function and regaining comfort. These could include:

Clearly, then, facial pain and jaw-related problems are complicated at times. Your thoughts are welcome:

BOTOX for TMJ
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BOTOX® Bruxism TMJ

Case Study: BOTOX® for TMJ

At times we are challenged by patients with chronic pain and soreness in their jaw muscles. Though these patients have received benefits using oral appliances, performing home exercises and massage techniques, using medications and even going for physical therapy, they continue to suffer as a result of daily and continuous aching pain in their face. Though we may not fully understand why their muscles continue to hurt, the use of BOTOX® injections has restored hope for many of these sufferers

Consider the case of Carly a thirty eight year old female with a 20-year history of facial pain and tooth clenching activity during the day and at night. She was first treated while still in high school during the stress of exams and applying to college. Her symptoms however continued through college and into her adulthood often with acute flareups prompting the use of pain medications and muscle relaxants at bedtime. Despite professional treatment and ongoing self care she continues to brace her jaw muscles and clench during the day and wakes up with “my teeth plastered together.” As a result her muscles were paying a price!

With the knowledge that BOTOX® can be used to partially incapacitate muscles, not allowing them to contract forcefully, it’s use in this particular case was clearly indicated. Though not FDA approved for this specific purpose at this time, its use with patients has produced encouraging results. By preventing forceful muscle contraction over three to four months after injection, the sore and tender jaw muscles benefit from increased blood flow bringing oxygen and nutrients essential to healing. As a result Carly’s pain symptoms eased considerably and her days were  no longer consumed by constant massage and mouth opening movements to “loosen my face.”

Most importantly, Carly regained optimism that her problem could be helped though she would likely require additional injections to undue years of muscle compromise. As BOTOX® is not a cure, Carly understood that any efforts she made to keep her muscles out of trouble would go a long way towards maximizing the benefit of the BOTOX®. As a result of this understanding she continues to use her oral appliance at night and practices relaxation breathing techniques frequently throughout the day.

The end result is that Carly is feeling better and realizes that her life does not have to be filled with pain and suffering.

BOTOX® for teeth grinding is in the news! I was recently interviewed on ABC’s Good Morning America on the topic, Can BOTOX® be used to treat teeth grinding?  Click the link to watch the segment.

BOTOX for TMJ
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BOTOX® Bruxism

BOTOX® and Bruxism

In previous blog posts on bruxism, I’ve discussed how teeth grinding can lead to worn teeth, fractured teeth, facial or jaw pain, and a host of other maladies. There are many ways to treat bruxism, and one of the most recent and perhaps unexpected is BOTOX®.

BOTOX® was originally used for treating muscle spasticity diseases such as strabismus (eye misalignment), blepharospasm (eyelid spasm), and torticollis (wry neck). BOTOX® works by temporarily decreasing or paralyzing the muscles it is injected into. The logical extension of this would be to apply BOTOX® to a myriad of other medical conditions in which excessive or intense muscle contractions are causing pain or dysfunction.

It turns out that BOTOX® can in some cases, be a sensible medical application to bruxism, as injections of BOTOX® into the masseter and temporalis muscles – the large muscles that close the mouth and bring the teeth together – can reduce the forces of bruxism to a significant extent.

The Procedure: By injecting small doses of BOTOX® (different levels are used for each patient) directly into the masseter and temporalis muscles, the muscles are weakened enough to diminish the forces associated with involuntary grinding of the teeth and clenching of the jaw. As a result damage due to the TMJs and symptoms of jaw pain and headaches should be reduced if not eliminated after 2- 3 injection sessions over several months. Luckily, chewing and facial expressions will not be effected by BOTOX®.

Reasons to Consider BOTOX®:

  • If you know you are clenching at night but oral appliances are not helping or making your morning symptoms worse.
  • Positive effects can be felt within 10- 14 days even if you have been suffering for month or years.
  • If helpful, the need for medication (muscle relaxants) at bedtime and pain medications during the day will be reduced or even eliminated.

The optimal dose of BOTOX® must be determined for each patient as some people have stronger muscles requiring more BOTOX®.  The effects last for about three months. After a few rounds of injections, many of our patients require no further  injection sessions though we continue to advise the use of an oral appliance while sleeping if tolerated.

If are suffering from bruxism please do not hesitate to contact me so I can assist you in making treatment decisions.

BOTOX® for teeth grinding is in the news! I was recently interviewed on ABC’s Good Morning America on the topic, Can BOTOX® be used to treat teeth grinding?  Click the link to watch the segment.