Hi Everyone! I'm Priya Mistry, the TMJ doc. This video is about Botox and TMJD.
A viewer requested that I make this video, so here it is and enjoy! Do you have headaches, jaw pain,
temple pain, or occipital pain? If so, watch this video until the end to see how my usual treatment
modalities can usually take care of this and then how Botox can fit into all of this. For those of
you who don't know me, my name is Priya Mistry and I'm a General Dentist with a practice in Portland,
Oregon where we are dedicated to taking care of patients with TMJ Disorders.
iI you haven't already, please check out my Instagram handle. I post here quite frequently;
there's a lot of little tips, tidbits, trivia, etc.. if you want to geek out on TMJ stuff like
i like to do. All right, so let's get right into it! What is Botox actually? A lot of
people just start with that question. It is a drug that's prepared from botulinum toxin.
Botulinum toxin is a neurotoxic protein that is produced by a bacteria called Clostridium
Botulinum - so that kind of sounds like a Harry Potter spell, doesn't it? Clostridium Botulinum!!
All right, enough of that - so what this protein does, is it prevents the release
of the neurotransmitter acetylcholine at axon endings at the neuromuscular junction,
which then leads to flaccid paralysis. Basically, it temporarily messes up nerve communication which
then messes up muscle function by freezing it. That's in plain old English. The way that this
can be used in TMJ Disorders is that Botox can be injected into certain muscles. When this is done,
the muscles cannot function the same way. So these big muscles of mastication - the masseter,
the temporalis, etc - cannot be used or overused by clenching and grinding activity, and when
these big muscles can't be overused it leads to a decrease in headaches, jaw pain, temple pain, and
occipital - the back of the head, the base of the head - pain for TMJ Disorders. Botox is typically
injected into the masseter - this muscle, the big one right here - the temporalis muscle,
and the occipital area. it takes about 14 days to kick in and the relief that patients get from it
lasts typically about three months, and then they need to get injected again so it's a temporary
fix. Pros about Botox - it can help a lot with pain in the short term and it's it's easy and
not really painful. Cons about Botox - and I would say there are actually more cons than pros - it's
temporary, it's expensive and the cost kind of keeps going up (or at least hasn't gone down since
it's come out), it cannot be injected into the smaller muscles (like the lateral pterygoid that
is a key player in a lot of TMJ problems and we cannot inject that muscle with Botox), and lastly
of course a big con is that it is a neurotoxin. Ultimately you're injecting a toxin into your
body. Many will refer to it as a neuromodulator to make it sound prettier, but it is a neurotoxin.
When botox is injected into the masseter three or four times a year - so every three to four
months or so - it can have a slimming effect in the masseter, which is a phenomenon that women
love but men don't like so much because it takes away from that sort of chiseled jawline look that
most men want. Botox can also atrophy or weaken this masseter muscle so much over time, that
it'll actually make it so the mandible drops back farther when we're sleeping. When the mandible
drops back farther, it makes the airway smaller so Botox over time, into the masseter, can actually
potentiate sleep apnea which is never a good thing. That means we're getting less oxygen when
we're sleeping. I am not anti-Botox by any means. I'm simply trying to lay out the pros and the cons
in a very simple manner. Having said that, my practice is in Portland, Oregon and many of my
patients have a very holistic mindset, and they would never get Botox for cosmetic purposes or for
therapeutic purposes. For that reason, we don't even carry Botox in my office. We're able to get
really good results without having to depend upon it. I kind of view Botox as a band-aid that can be
extremely helpful in the short term if you're in a lot of pain. Having said that, there are one or
two patients every single year that we cannot in good faith release from active treatment because
they're still having jaw pain. Their joints are healthy, but the clenching and bruxing activity
is proving to be so prevalent that we can't really get them the pain relief that they desire.
These patients are the ones that we refer to providers that do have Botox ready and available,
and we send them with the pros and the cons of Botox. Typically they are happy that they end up
getting it because it's kind of the last step to get them out of pain. I hope you find this video
helpful. If you like what you heard or you learned something new, click "Like" below, SUBSCRIBE to my
channel, do all the things. Feel free to reach out with questions, comments, etc. I always
make a point to answer everybody, and remember - you can never have TMI about TMJ! Thank you!