Is There Really a Role for Botox in Treating TMJ Disorders Holistically?

Over the years, Dr. Abdulla has helped hundreds of patients find long term relief from TMJ pain. Most often, treatment involves oral appliance therapy enhanced by supportive therapies such as ultrasound and myofascial release. The typical patient experiences significant improvement within the first few weeks.

But every so often, she’ll have a treatment-resistant case. This hardly means that the patient is fresh out of luck, though. One option that’s proven especially effective for tough nut cases of TMJ disorder (TMD) is something you might associate only with cosmetic procedures: Botox.

Whether used cosmetically or therapeutically, Botox works by keeping targeted muscles from contracting by blocking signals from the nerves to the muscles. This is how it’s able to smooth out the lines and wrinkles of a face and how it’s able to alleviate some forms of joint and muscle pain.

For temporomandibular issues, injections can be given in the masseter and temporalis muscles – the chewing muscles – to relax them and help tame a clenching habit. Sometimes, a single shot is all it takes, while in other cases, a series of injections over time is needed to bring about lasting improvement.

The use of Botox in dentistry is still pretty new, so while studies so far have been promising, they’ve also been inconsistent. Some of that is due to big differences in study design and quality; some, to the challenges of studying pain in any kind of standardized way. As the authors of one review of the literature noted, “pain is a subjective symptom,” hard to assess in a routine way across multiple studies.

But while this has kept Botox from being considered a first line treatment for TMJ disorders, some studies do suggest it may be especially beneficial in certain situations, such as treatment-resistant TMD.

This was the case with a small but compelling 2019 study in which 25 TMD patients were progressively treated with different therapies, starting with medication. If that didn’t work, physical therapy was added to the regimen. If that didn’t work, splint therapy was added.

Nine patients who had limited success with these therapies were given Botox injections – and their condition improved markedly, with no side effects reported when the research team followed up six months later.

Using Botox “for the treatment of muscular temporomandibular joint disorder,” the study authors concluded,

is a viable treatment option in the case of patients who do not respond to conservative treatment methods.

And those patients are pleased. Here’s what one woman with a treatment-resistant TMJ disorder had to say about her experience after her first treatment, which she wrote about in an article for the Canadian site Slice:

It worked better than I could have expected, and it’s safe to say that I’ll be re-booking my appointment in a few months. I’m now two months post-procedure and my jaw very rarely clicks, even when I actively try to demonstrate it to friends while talking about the experience, opening my mouth ridiculously wide to try to hear that once-familiar pop.

Certainly, Botox isn’t for everyone, nor is it something we offer routinely. But when all else has failed, it’s something we can offer to help our patients recover from the debilitating effects of TMD. Whether they go that route or not is their choice, as is the case with any treatment. Our role is to provide diagnosis, treatment options, and information so each patient can make truly informed decisions about their dental care.

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