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BOTOX® Injections For TMJ – 6 Things You Need To Know

Author: Donald Tanenbaum DDS MPH - Board-Certified Orofacial Pain Specialist at New York TMJ & Orofacial Pain

Date: October 6, 2016

During the past few years in my practice as a dentist who focuses primarily on TMJ and orofacial pain problems, I have seen a lot of success using BOTOX® injections for TMJ to treat muscle pain and oral nerve pain.

BOTOX® is not suitable for every patient, however. Care must be taken as to when to use it, how to use it, and who is a good candidate. If you’re considering BOTOX® as part of your treatment for TMJ problems, jaw pain, pain in or around your teeth, or because of a change in the shape of your jaw, please read on:

6 Important Things You Need To Know About BOTOX® Injections For TMJ

  1. BOTOX® is Not a First-Line Treatment for Jaw Muscle Pain
    First-line treatment for jaw muscle pain (and spasm or tightness) is dictated by a careful evaluation to identify why you have symptoms in the first place. For example, it may be necessary for you to change some daytime habits, postures and behavioral tendencies that fatigue the jaw and neck muscles. Or if you clench or grind your teeth at night you may need to wear a protective night guard. In addition, you may get relief from medications, home jaw and neck exercises, breathing exercises, meditation, a change in your diet, or all of the above. Muscle injections or dry needling would be next in line along with visits to a physical therapist, chiropractor or osteopath who would work to promote muscle comfort. The bottom line, however, is that you the patient, must participate in the process of getting better and BOTOX® will not produce the desired goals if the underlying reasons for your pain have not been identified and dealt with.
  2. BOTOX® Will Not Ease Certain Types Of Muscle Pain
    There are times when muscles hurt even though they have not been overused. When life circumstances, emotions or thoughts cause your muscles to tighten and ultimately ache, then BOTOX® injections for TMJ will not likely help. Instead, counseling, talk therapy, cognitive behavioral therapy, and the like may be the right strategies to pursue.
  3. If You Currently Wear a Night Guard
    If you currently wear a night guard and still have morning symptoms of muscle pain or tightness, joint noises, locking, and/or pain, you may be a good candidate for BOTOX®. This is particularly true if you find yourself biting hard on the guard when you wake up in the morning. Keep in mind however, that BOTOX® will be most helpful if you continue to wear your night guard. Two strategies are better than one in this scenario.
  4. If You Can’t Tolerate A Night Guard
    If you have simply cannot tolerate a night guard (and have tried various types, with your dentist’s guidance) BOTOX® injections for TMJ may provide meaningful benefit.
  5. If Your Jaw Muscles Are Too Big
    If your jaw muscles are just too big and visibly over-built, BOTOX® may be an option. One of the predictable things that BOTOX® does is reduce muscle bulk when used over time. BOTOX® has been shown to be effective in producing a flatter and more natural-looking profile. You will likely need three BOTOX® sessions in three-month intervals to achieve the best results. However, jaw bulk may creep back if the reasons your muscles become larger have not been identified and dealt with.
  6. If You Experience Persistent Oral Nerve Pain
    Small quantities of BOTOX® may be helpful if you experience persistent pain in your gum tissue, at the site of a tooth or tooth extraction, or at other sites around your face. Nerve pain inside your mouth or in your face is often due to electrical discharge from the trigeminal nerve. BOTOX® injections for TMJ into the painful sites (often called trigger zones) can provide real benefit, especially if you don’t respond well to oral medications. In spite of being relatively new, this type of treatment is showing promise.

In Conclusion

BOTOX® has become a helpful component in the management of TMJ, jaw muscle pain and oral nerve pain problems. The important thing for you, the patient, is to understand that BOTOX® injections for TMJ are not a cure-all. Careful assessment by an experienced practitioner remains the key to making treatment decisions that will result in a long-term positive outcome. If you choose BOTOX® as first-line therapy without understanding the origins of your pain, you will likely be out of pocket quite a bit of money with nothing to show for it.

Related reading:

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.

Dr. Donald Tanenbaum is a dentist with offices in New York City and Long Island, NY. He is uniquely qualified to diagnose and treat problems associated with facial pain, TMJ and sleep apnea. To make an appointment for a consultation, call: Manhattan: 212-265-0110, Nassau & Suffolk counties: 631-265-3136.

DISCLAIMER: The advice offered in response to your questions is intended to be informational only and generic in nature. Namely, we in no way offer a definitive diagnosis or specific treatment recommendation for your particular situation. Our intent is solely educational and our responses to your actual questions serve as a springboard to discussion of a variety of dental topics that come up in a day-to-day dental practice. Any advice offered is no substitute for proper evaluation and care by a qualified professional.

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