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
- 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
Dr. Donald Tanenbaum is a specialist with offices in New York City and Long Island, NY. He is uniquely qualified to diagnose and treat facial pain associated with jaw problems, TMJ, referred pain, nerve pain, and migraines. Find out more at www.tanenbaumtmj.com.