It’s a TMJ treatment that’s becoming increasingly popular among doctors, dentists, and patients: botulinum toxin injections. Botulinum toxin, commonly known by its trademark BOTOX ®, supposedly helps TMJ by relaxing tense jaw muscles that cause pain, either by making themselves sore or by pinching nerves that might register the pain elsewhere.
TMJ muscle tension can contribute to both tension and migraine headaches, which is why the injections are also increasing in popularity as headache treatments. But there are problems: first the science doesn’t really show that it works, and whether it works or not, the muscle paralysis it creates may lead to serious complications.
Fortunately, there are other ways to relax tense jaw muscles.
A Review Found Little Evidence of Effectiveness
In 2015, a comprehensive review was conducted of all scientific research that had been conducted on the use of BOTOX ® and other botulinum toxins on TMJ pain. Although there were many studies conducted, only 5 met the selection criteria as clinical trials comparing BOTOX ® injection with placebo or another treatment. Of these five trials, two showed a significant pain difference vs. placebo, one showed that BOTOX ® injection achieved the same results as muscle massage, and two studies showed no significant benefit of BOTOX ® injections. These studies only covered a total of 117 individuals, which would be considered quite small for a single study, and divided five ways, it seems like a very small number. Another discussion of the treatment detailed the technique for achieving relief with minimum side effects.
More recently, a study looked at the use of botulinum toxins for the treatment of night bruxism. This study concluded that botox was effective at reducing pain, with only an 8% risk of complications (over the length of the study, which included follow-ups up to six months after initiating treatment.
A 2018 study focused on recurrent dislocation of the temporomandibular joint found that botulinum toxin could be effective if injected in a precise place.
Potential Complications of BOTOX ® Injections
Overall, BOTOX ® injections are highly safe, especially when used for cosmetic purposes, but some studies show that using BOTOX ® injections to paralyze some of the muscles may have long-lasting or even permanent consequences.
As neuromuscular dentists know, your muscles and your bones have a complex interrelationship. It’s not just that your muscles anchor on your bones–this anchorage stimulates the bone to grow, similar to what your teeth do in your jaw. When the muscle is paralyzed for long periods of time, the bone can lose density, which may expose you to serious risks of facial bone fractures.
It may even affect the structure of the temporomandibular joint.
Researchers have observed this phenomenon, but we’re not sure how serious it is. There’s currently a study ongoing at the University of Connecticut to determine how much bone is lost because of BOTOX ® injections. They will measure bones with cone beam computed tomography (CBCT, the same tool we use to measure bone density for dental implants) and come up with a reliable figure.
Relaxing Muscles without Paralysis
But there are other ways that we can relax tense muscles that are responsible for TMJ pain. Neuromuscular dentistry allows us to analyze your bite and determine whether we can reduce muscle tension by repositioning your jaw.
Once we find the position of maximum rest for your jaw, you’ll see a reduction in pain–some patients see it eliminated entirely. There are no injections, just a mouthguard-like bite splint that you wear, maybe just at night. And because we aren’t paralyzing your muscles, the bones will continue to be stimulated, so they’ll maintain their density. And if you want the results without a bite splint, we can alter your teeth to hold your jaw in this position.
If you want to learn how we can get you relief from TMJ pain in Rochester, MI without injections and without drugs, please call (248) 656-2020 for an appointment with a neuromuscular dentist at Rochester Advanced Dentistry.
