TMD and Misinformation: Botox is a valid treatment for TMD #10

This is the second article in a series addressing misinformation regarding TMD/TMJ. Botox is an injectable pharmaceutical derived from Clostridium Botulinum Type A Neurotoxin.  Clostridium Botulinum is a bacteria which produces its neurotoxin primarily in environments without oxygen. (Anaerobic).  This neurotoxin when ingested, even in small quantities, can cause respiratory failure, body paralysis, and death. When injected directly into muscle in small and diluted quantities make the muscle incapable of contraction.  Botox and similar Botulinum neurotoxins with trade names of Dysport, Xeomin, and Jeuveau have been approved by the FDA for cosmetic purposes.  These pharmaceuticals are used commonly for removing wrinkles or lines around facial structures.  Over the past 10 years Botulinum toxin has been used and recommended widely for the treatment of TMD/TMJ, primarily because of the millions of advertising dollars available to pharmaceutical companies to promote to providers. There is no argument that Botulinum neurotoxin can be used safely and effectively for the removal of facial lines and wrinkles in the hands of a qualified experienced provider. However, for those considering the use of Botulinum neurotoxin for the treatment of TMD/TMJ, be aware of the following facts.

Botulinum neurotoxin has not been approved by the FDA for treating TMD/TMJ.

Botulinum neurotoxin when injected near or around the facial nerve can cause facial paralysis that may continue for months until the toxin wears off. Many cases of this complication have been reported.

Injection of Botulinum neurotoxin for TMD/TMJ need to be repeated every 3- 4 months with significant cost increases over time.

Tight muscles which cause headache, neck pain, and shoulder pain are created by signals from the brain to tighten up muscles and immobilize the joint when it sees inflammation within the jaw joint (TMJ)

Injection of Botulinum neurotoxin into a specific tight muscle and paralyze it in an attempt to relieve the pain of that particular muscle does not address any of the other various muscles which receive signals to tighten up and certainly has no effect on the BASIC CAUSE of all the symptoms in the first place, which is inflammation within the jaw joint.

Most dentists, nurse practitioners, physician assistants, and physicians who inject Botulinum neurotoxin for TMD do not have a thorough understanding of the anatomy of the maxillofacial region and open the possibility of unintended consequences and complications.

Relieving inflammation of the jaw joint (TMJ) avoids the use of Botulinum neurotoxin completely. The best and simplest method to decrease inflammation of the TMJ is to unload the joint, rather than paralyze a specific muscle.

Therefore, (Botox) Botulinum neurotoxin is not a valid treatment for TMD/TMJ.