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Botox for TMJ

Jaw tension caused by teeth grinding, over-active masseter muscles, or jaw clenching due to stress can lead to severe pain and discomfort along the jaw, called the temporomandibular joint, or TMJ, and beyond. So many of us have bitten into something sticky, chewed gum, or chatted with a friend when suddenly we feel a clicking, popping, or painful sensation along the jaw joint. Our jaw muscles are some of the most active facial muscles, operating regularly during the day and often storing tension at night. Unfortunately, this activity can lead to misalignment, stress, and pain along the temporomandibular joint. Characterized by jaw pain, aches around your ear, chronic migraines, and jaw dysfunction that can lead to difficulty chewing and opening or closing the mouth, TMJ disorders can feel like they are keeping you from your highest quality of life. While pain or soreness around the jaw joint and lower jaw do not suggest serious issues for everyone, patients may develop more serious Temporomandibular joint disorders, abbreviated as TMDs, which can suggest chronic facial pain. Luckily, TMD treatment options are available at Dr. Dolores Baran’s office in Royal Oak, including the use of Botox injections.

Botulinum toxin type A, known colloquially as Botox, is an injectable treatment that essentially “freezes” the muscle at and near the injection site. While many patients may hear “Botox” and think about cosmetic treatments to eliminate frown lines and other facial wrinkles, Botox has been FDA-approved to treat many medical conditions, including chronic migraines, blepharospasm, and cervical dystonia. As TMJ disorders are caused by overuse or pain in the masseter muscle of the jaw, the use of Botox acts as a muscle relaxant, which alleviates the tension along the jawline to eliminate symptoms of TMD, including headaches, lockjaw, and jaw pain. If you suffer from jaw pain and soreness, tension headaches, or other frustrating TMJ symptoms, Botox injections in the masseter muscles can provide you with the relief you have been looking for. Botox for TMJ is a common off-label use of Botox that an experienced dermatologist can administer.

Dr. Baran is an expert in the use of botox, including Botox injections to relieve TMJ symptoms and reduce the masseter muscle for facial slimming. Dr. Dolores Baran is an Allergan Platinum injector of Botox, utilizing Botox extensively to treat fine lines around the forehead, neck, crow’s feet, lips, and glabella area for facial rejuvenation. Dr. Baran embraces a less-is-more philosophy and takes a holistic approach to treatment, customizing each patient’s treatment plan to cater best to their concerns and overall aesthetic goals. When you consult with Dr. Baran at her private dental office in Royal Oak, she will work with you to develop a customized Botox treatment plan that leaves you looking and feeling like your best self.


What is TMJ?

The Temporomandibular joint, or TMJ, is where the jaw bone (mandible) connects to the skull (temporal bone), essentially operating like a sliding hinge on either side of the face. The connecting parts of the bones have a cartilage covering and are separated by a small disk designed to be shock-absorbent and keep jaw movements as smooth as possible.

Many patients feel jaw pain or discomfort along this joint. Years of clenching your teeth in waking hours and while you sleep induce an overactive masseter muscle that grows larger and more uncomfortable over time. This jaw tension especially affects patients during sleep, as it causes teeth grinding that can ultimately damage them. Research by the National Institute of Dental and Craniofacial Research has estimated that more than 10 million Americans suffer from TMJ issues and have associated tension headaches, pain, tension, clicking, and grinding. Botox treatment in the masseter muscle to relieve TMJ has become a simple, fast, and effective way to treat bruxism (teeth grinding).


What Causes TMJ Disorder (TMD)?

Due to the strength of the muscles along the temporomandibular joint, temporomandibular joint disorder, known as TMD, is a quite common condition. TMD/TMJ is largely caused by jaw clenching, though many people who clench their jaws will never experience the burning pain and swelling that can occur with TMD. TMJ disorders can also be prompted by injury to the jaw, head, or neck muscles, such as from a heavy blow or impact from the body. Additionally, pain from TMJ can be due to genetic factors or arthritis, as well as when the disk erodes or shifts from its proper alignment.


TMD/TMJ Symptoms

Symptoms of temporomandibular joint disorder (TMD)/TMJ include:

· Jaw pain/ soreness

· Jaw clicking or popping

· Facial pain behind the eyes, neck, or shoulders

· Ringing in the ears

· Headaches ranging from mild, dull aches to chronic migraines

Typically, those who experience symptoms of TMD experience symptoms cyclically. The pain can go away independently or with minimal treatments (such as anti-inflammatories or alternating heating pads and cold packs along the jaw). However, returning TMJ symptoms or longer-term symptoms often cause enough pain to seek medical or dental treatment.

In the past, those suffering from TMJ pain have looked to mouth guards, bite guards, or stabilization splints to improve jaw tension while sleeping, prevent damage to the tooth enamel, and promote oral health. Sometimes, pain is so severe–from swollen jaw muscles to chronic migraines–that patients will experiment with “no-chew” diets, cognitive behavioral therapy, physical therapy, or surgical intervention. Often, these TMJ treatments can lead to inconsistent results, leading to the development of alternative treatments. Botox injections along the jaw are an innovative way to limit, reduce, and sometimes eliminate TMJ/TMD symptoms.


What is Botox?

Botulinum Toxin Type A, better known as the popular brand name Botox, is an injectable treatment produced by the pharmaceutical company Allergan. Botox is a neurotoxin derived from the Clostridium botulinum bacterium. While it is widely recognized as the gold standard for reducing dynamic fine lines and wrinkles, Botox has many cosmetic and medical applications. Botox has been FDA-approved for cosmetic purposes to reduce the appearance of fine lines and wrinkles around the eyes and across the forehead and treat certain medical conditions, including chronic migraines and muscle spasms.

Once injected, the injectable neurotoxin causes controlled, targeted muscle paralysis in the treatment area. The neurotoxin inhibits specific nerve signals that control facial expressions, limiting the movement of particular facial muscles and ultimately “freezing” them. Freezing the muscles causes them to relax, smoothing fine lines and wrinkles and relieving pain or spasms caused by overactive muscles. The effects of Botox remain for approximately four months, with most patients engaging in regular maintenance treatment sessions to uphold the best results. There is essentially zero downtime associated with Botox treatment and few potential side effects. The most common side effects include mild swelling and redness at the injection sites, which resolve independently shortly following treatment.


How is Botox an effective TMJ treatment?

Botox treatment involves the injection of the neurotoxin botulinum toxin type A into certain facial muscles to “freeze” and relax them. TMJ disorders are frequently caused by strain or overuse of the masseter muscles in the jaw. Jaw clenching, teeth grinding, and overworking the masseter or jaw muscles can lead to tension and pain throughout the jawline and around the face. When treating TMD, Botox is injected directly into the masseter muscles. Once injected, the botulinum toxin blocks the neurotransmitters that tell the masseter muscles to contract involuntarily or in excess. This relaxes the masseter muscles, relieving tension, providing pain relief, and eliminating involuntary clenching of the jaw from stress or grinding teeth in your sleep. This makes Botox an extremely effective treatment for TMJ disorders.

Botox injections for TMD are still an off-label use for Botox, meaning that Botox is not specifically approved to treat TMJ disorders. However, several studies have demonstrated that Botox is safe and effective for treating TMD. According to a study performed in 2012, when treating TMD, Botox was shown to alleviate jaw pain and increase the movement capacity of the jaw for up to three months after the injectable treatment was performed. In 2003, a study demonstrated that 90 percent of patients who had not responded to other treatments showed improvement after receiving Botox treatment.


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