Living with TMJ: It's More Than Jaw Pain

The temporomandibular joint is a small joint, but when it gets out of alignment, the impact is gigantic. I've had patients characterize their TMJ symptoms as "a constant companion" – and not a friendly one:

• Jaw pain that fluctuates from dull ache to piercing stabbing
• That annoying clicking sensation when opening your mouth
• Morning headaches due to teeth grinding at night
• Chewing trouble with certain foods
• Jaw pain that refers to the ear and temple
• Painful locking of the jaw that can also be embarrassing

For many of my patients, these symptoms do more than physically bother – they disrupt confidence, sleep, and enjoyment of life. One patient recently told me, "I stopped going out to eat with friends because I felt self-conscious about not being able to eat normally." Moments like these speak to why effective treatments are so valuable.

How Botox Works for TMJ: The Science Behind the Relief

Whenever most people hear the term "Botox," they immediately associate it with cosmetics, but its medical applications are quite fascinating.

Unraveling the Mechanism

Botox (botulinum toxin) essentially silences hyperactive muscles and causes them to relax. In TMJ patients, the problem is typically excess tension in jaw muscles. When we inject the ailing jaw muscles with Botox:

• The neurotransmitters that carry the message of muscle contraction are blocked
• The injected muscles are relaxed and no longer work too hard
• This relaxation lessens pressure on the TMJ
• Pain and associated symptoms start to diminish

I prefer to describe it to patients as follows: "Think of your jaw muscles as a rubber band that has been stretched too far for too long. Botox allows the rubber band to relax back to its original tension."

What Studies Show About Effectiveness

The medical community has been studying Botox for TMJ disease for decades, and what they have discovered is heartening:

• A seminal study in the Journal of Oral and Maxillofacial Surgery published patients treated with Botox for TMJ pain. Patients complained post-treatment:
  • 45-50% less pain
  • Mouth opening increased
  • Improved quality of life scores
• My favorite is a 2019 systematic review of several clinical trials. The scientists concluded that Botox reliably beat out placebo injections for alleviating TMJ pain. One of our office patients, Sarah (her name has been changed to ensure her anonymity), saw the same: "After years of attempting night guards and pain medication with minimal results, Botox decreased my jaw pain by roughly 70% after a single session."

TMJ and Migraines: Two Conditions, One Solution

Do you ever find yourself wandering around, thinking, "How do my jaw pain and headaches seem to flip back and forth with one another?" There is a reason why the two go together.

The TMJ-Migraine Connection

A number of my TMJ patients have also had chronic migraines, and it was not coincidence. The trigeminal nerve used by the two conditions forms a neurology corridor through which pain signals move from the jaw into the head and from the head back out into the jaw.

A research published in Headache: The Journal of Head and Face Pain classified patients with TMJ disorder as twice as probable as the general population to have migraines. This association is also why curing one condition often makes the other better.

Botox's Double Benefit

Botox was approved for use in 2010 by the FDA to treat chronic migraines after the PREEMPT clinical studies, which found staggering results:

• Average decrease of 8-9 headache days a month
• Reduced frequency of persistent headaches
• Lasting improvement of 3+ months with every treatment

For my headache- and TMJ pain-stricken patients, Botox is the smart two-for-one bargain. As described by one patient, "I came in hoping to eliminate pain from my jaw, but the nice surprise was how much better my headaches were too."

What to Expect: Your Botox Treatment Experience

Your First Consultation

I start with a thorough assessment of your jaw, reviewing your history and symptoms. I always take the time to answer questions – the two most common being "Will it hurt?" and "How fast will it work?"

During the Procedure

The treatment itself is faster than you'd imagine – usually 15-20 minutes. We will:

• Identify exactly which muscles are responsible for your TMJ pain
• Use very fine needles to inject tiny amounts of Botox
• Inject primarily the masseter (chewing) muscles and sparingly the temporalis muscles

The feeling is usually described as mildly stinging by most people. We can apply a topical anesthetic cream prior to treating if you are concerned about discomfort.

After Your Treatment

In contrast to some of the medical therapies having significant downtime after treatment, Botox for TMJ allows you to return on with business as usual after treatment. A couple of things to remember:

• Don't rub the site that was treated for 24 hours
• Tender spots at points of injection for a day or two is a complaint for a few patients
• Effects will usually become evident around 3-7 days
• Maximum effects by the 2-week point

Is Botox The Right Solution For Your TMJ Pain?

Though the clinical trials on Botox to be used in TMJ have shown encouraging results, it's not the perfect option for everyone. In my clinic, I use it most for:

• Untreated patients who have not found relief with conservative therapy such as night guards
• TMJ pain due to tension over joint trauma patients
• Chronic headache and TMJ pain patients
• Those who desire a non-surgical, low-invasive procedure

At the time of your visit to Vellore Corners Dentistry, we will determine if your particular symptoms and history qualify you for Botox treatment.

Beyond Botox: Our Holistic Approach to TMJ Treatment

While Botox may be very helpful, I like to treat TMJ disorders from every angle. The best result in most patients is a combination treatment:

• Custom Oral Appliances: A properly fitting night guard will prevent grinding of the teeth and position your jaw correctly while you sleep. Our custom appliances are different from over-the-counter devices because they are designed to fit the anatomy of your mouth.
• Physical Therapy Techniques: Light jaw exercises can cause tightness in the muscles and enhance range of motion. We usually instruct patients to perform individual home stretches between their visits.
• Stress Management: Since stress often causes clenching of the jaw, treatments like mindfulness meditation can also be employed as adjuncts to medical therapy. A patient wrote that combining Botox injections with a daily practice of meditation "finally broke the cycle of pain" she had suffered for decades.

Looking to the Future: TMJ Treatment Advances

TMJ treatment continues to evolve, with researchers studying new uses and combinations of treatment. Researchers are now exploring whether combining Botox and hyaluronic acid injections could provide even more benefit for some patients.

We at Vellore Corners Dentistry stay up to date with the latest research so that we can offer the best solutions to our Woodbridge community.

Take the First Step Towards TMJ Relief

Don't have to live with the pain of TMJ. If you're tired of day-to-day discomfort, eating issues, or TMJ headaches, we can help you figure out if Botox might be the solution you've been searching for.

Call us today at 905-417-8111 to schedule an appointment at our Woodbridge clinic. We are open from Monday to Thursday from 8:00 AM until 8:00 PM and from Friday to Saturday from 8:00 AM until 3:00 PM to accommodate your busy lifestyle.

Start your path to a less tense jaw and fewer headaches by talking to us casually about how you can use Botox to calm TMJ.