Temporomandibular joint diseases and disorders, commonly called TMJ or TMD, are
a category of conditions that cause symptoms such as chronic headaches, migraines,
neck pain, pain behind the eyes, congested ears and popping of the jaw.
At the core, TMJ is usually caused by the misalignment of bones which form the jaw.
Many sufferers of this disease clench and grind their teeth at night and during
the day, which only aggravates the delicate muscle and bone structures in the jaw
and makes the symptoms worse. Some individuals also experience symptoms of TMJ while
exercising due to many muscles being affected at the same time.
Ocean View Dental has two innovative ways to help relieve the symptoms of TMJ. The
first is Dentox, a name given to Botox® when used by dentists. The second is
the NTI Tension Suppression System (NTI-tss), a dental appliance that helps eliminate
clenching and grinding, a major cause of TMJ symptoms.
A recent study confirmed that injection of purified Botulinum toxin (Botox®)
is effective in treating TMJ cases that do not respond to the most common forms
of treatment. Botox can relieve headaches, jaw pain, teeth clenching, TMJ, and other
symptoms of temporomandibular disorders.
The most common benefit of Dentox is the reduction in the number of clenching events
and their intensity. This will reduce the destruction of your teeth, gums and jaw
joint, reduce the discomfort and pain in your face and chewing muscles, and reduce
the intesity and frequency of headaches and migraine episodes. A beneficial side-effect
is the smoothing of lines between the brows and in the forehead. Other benefits
are that only the injected areas are effected and results are often seen within
What can I expect at the initial consultation?
At the initial consultation our trained dentist will first determine
if you are an appropriate candidate for Botox® and if indeed it is the best
treatment for the results you desire. You should also discuss your medical history
with your dentist. He/she will assess if you are allergic or hypersensitive to any
ingredient in Botox®. Furthermore, it is imperative that you disclose all medications,
vitamins, herbs, and supplements you currently take. These substances could hinder
or intensify the potency of the Dentox (Botox® for Dentistry) or cause bleeding
and bruising at the injection sites.
To schedule your initial consultation, please contact us
or request an appointment online.
What is the procedure for Botox® Injection?
Botox® is a simple, non-surgical procedure. We will have you contract the muscle
area to be treated in order to determine appropriate injection sites. Then, an electronic
mucle locating device (EMG) may be used to exactly locate the targeted muscle site.
Then targeted injected areas may be numbed with an ice pack or a topical numbing
agent. Anesthesia may or may not be used. Finally, the dentist will administer several
tiny injections of Botox® directly into the muscle. Only the injected areas will
be “paralyzed.” It will not affect any other muscles in your body.
How long is the procedure?
The length of the procedure depends on the number of injections needed as determined
by the dentist. It is reasonable for the procedure to be completed within 10-30
minutes at our practice.
Is there a hospital stay required?
Because the procedure is non-surgical and is done right in our office, there is
no hospital stay required.
Will I need a driver?
No. Botox® will not limit your driving ability.
How much pain is there?
The pain associated with this procedure is due to the injections, but it is generally
minimal and brief. Some patients have likened it unto a “bug bite” or “prick”. Pain
can be reduced by proper injection techniques and by numbing proposed injection
sites with a cold pack or anesthetic cream. If you are scared of needles, please
talk to us about sleep dentistry.
What can I expect afterwards?
Muscle tenderness will start to disappear almost immediately. There may be mild
temporary bruising, numbness, or redness around the injection sites. You will not
look 20 years younger, but you may find that the effect of the Dentox on your muscles
may cause you to look more natural and relaxed or less sad and angry. After a few
weeks, most patients see a marked decrease in clenching, headaches, and other TMJ
What is the recovery like?
Because the procedure is non-surgical and non-invasive, it is highly likely that
you can return to normal activities immediately. However, to avoid spreading the
toxin to other muscles, you should not rub or massage the area injected and remain
upright for many hours. Physical activity should also be limited for a time.
What is the long-term outcome?
Results of Botox® generally last up to six months. Patients should wait at least
three months between treatments. There is also the likely possibility that with
repeated treatments, the injected muscles will atrophy allowing the patient to go
longer and longer between sessions. Do not have Botox® treatments elsewhere because
they may weaken the affects of Botox® in your body. With more and more injections,
there is a chance of growing resistant to Botox®. Your body may develop antibodies
that would cause treatments to become less effective over time. This resistance
can be minimized by using the lowest dose possible and extending the intervals between
sessions. It is best to limit your Botox® injections to one office. Ocean View Dental
can take care of all your Botox® needs.
How long do the results last?
Your chewing muscle discomfort will disappear for up to six months. Results may
last longer with subsequent treatments due to muscle atrophy. If another round of
Botox® is not performed, facial or chewing muscle discomfort may return.
Who is an ideal candidate?
Botox® may or may not be the best treatment for the results you desire. An ideal
candidate meets the following conditions:
- Between the ages of 18-65
- Has a dento-facial problem caused by parafunctional muscle activity
- Is looking for a non-surgical solution
- Is looking for a temporary solution
- Is knowledgeable about the procedure
- Is realistic in expectations
- Is in good physical and psychological health
- Is not pregnant or nursing
The above criteria are not comprehensive. Please schedule
an appointment so that we can determine the best treatment plan for your
How much does the procedure cost?
Depending on the number of injections, treatment can cost anywhere from $500 to
What else should I know?
With the FDA’s approval of Botox®, it has become increasingly popular to administer
it in social settings and/or non-medical facilities, sometimes without trained personnel.
Although, this can help reduce the costs for patients, they should be aware of some
of the concerns. First of all, it is imperative to have a qualified, trained doctor
or dentist administer the injections. Next, the environment needs to be sterile
and equipped to handle any adverse effects. A physician’s office or clinical setting
is best. Finally, adherence to post-treatment instructions is key, and these may
be neglected in a social/party-like atmosphere. It goes without saying that alcohol
should not be a part of any medical procedure. Some other restrictions are that
Botox® injections cannot be performed if there is any infection at the injection
sites, if you are hypersensitive to any ingredient in the botulinum toxin type A,
or if you are pregnant or nursing. There is an increased risk with patients that
have any neuromuscular disorders.
As with any medical procedure there are possible risks and side effects. Since this
is a non-surgical procedure, the risks and possible complications are infrequent,
minimal and temporary. The most common reported side-effects are headaches, respiratory
infection, flu syndrome, temporary eye-lid droop, and nausea. Less commonly reported
effects are pain, redness at spot of injection, and muscle weakness. These symptoms
are thought to connected with the injection and occur within the first week. There
could also be bruising at the injection site. Another limitation to Botox® injections
is that there is a possibility of developing antibodies that would render the treatments
less and less effective over time. This resistance could be delayed by using the
lowest effective dose possible over the longest intervals of time.
Botox injections should be avoided during pregnancy and lactation.