Use of Botox/Xeomin in the Treatment of TMD

Dr. Zapatero has been at the forefront of treating temporomandibular clenching and bruxism linked to masseter muscle hyperactivity with therapeutic Botox/Xeomin in our Hampton Roads Communities. Patients, who didn't find conventional splint or night guard therapy effective, can experience significant relief through neurotoxins like Botox/Xeomin (BTX) treatment using our proven protocol.

Administering BTX into specific muscles of mastication temporarily reduces muscle activity and thus minimizes pressure exerted on the jaw and teeth. BTX Treatment does not impact chewing or smiling. It relieves muscle tension and stress, substantially diminishing pain within three to four days when the appropriate dose is placed. The effects of BTX typically last for 3-4 months, after which time you might find your symptoms slowly re-appearing. BXT works by temporarily blocking the acetylcholine receptors at the nerve-muscle interface.  Eventually, your body will produce new receptors, and the strong muscle contraction will return. Our proven protocol allows most patients to find relief for six months once a decrease in muscle mass has occurred due to BTX treatment. In general, injections are administered every 3-6 months over a period of one and a half years.

Gradually, if the muscle remains relaxed, it will diminish in size, leading to a less pronounced jawline and a gentler appearance. Patients often look younger as the jaw muscle prominence recedes because an oval facial shape appears more youthful and soft than the square, angular shape attributed to a large masseter muscle before treatment.

Symptoms and Causes

TMJ dysfunction and myofascial pain can cause chronic or recurring debilitating, frustrating issues. Many patients suffer from headaches, popping or clicking joints, ringing in the ears, neck pain, and limited mouth opening, among other problems. We offer services designed to remedy pain and correct the imbalance in the jaw joints. Dr. Dag Zapatero also treats the occlusion and bite relationships to achieve whole-mouth harmony.

TMJ disorders cause tenderness and pain in the temporomandibular joint (TMJ), the joint on each side of your head in front of your ears, where your lower jawbone meets your skull. This joint allows you to talk, chew and yawn.  Pain is present when the joint becomes misaligned or damaged.

Between 5 and 15 percent of people in the United States experience pain associated with TMJ disorders, according to the National Institute of Dental and Craniofacial Research, part of the National Institutes of Health. Women are more likely than men to develop TMJ disorders.

In most cases, pain and discomfort associated with TMJ disorders can be alleviated with self-managed care or nonsurgical treatments.

Symptoms associated with TMJ disorder include:

• Pain or tenderness of your jaw or around your ear
• Difficulty chewing or discomfort while chewing
• Aching facial pain, headaches, or migraines
• Difficulty opening or closing your mouth, or a limited lateral movement of the jaw
• An uncomfortable bite that may be an uneven bite because one or more teeth are making premature contact
• Neck or Shoulder pain
• Ringing in the ears

If you have persistent pain or tenderness in your TMJ, if you have facial pain and experience clicking or grating when you chew or move your jaw, or if you can’t open or close your jaw completely, contact us.  We have had a tremendous amount of success in working with people with TMJ issues.  We will discuss possible causes and treatments of TMJ disorders with you, including splint therapy, occlusal adjustments (selective grinding of the top surface of the teeth to remove known interferences), surgery, physical therapy, and medications.

Procedure for Botox Injections

After cleaning the treatment area and demarcating the borders of the muscles, Dr. Zapatero will palpate the muscles in both the open and closed positions and identify any pain or trigger points in the muscles.  He will then proceed with the determined intramuscular injections of Botox, the dosage of which depends on the severity of each case. A higher initial dose is often required in more aggravated cases to maximize the results and patient comfort once the BTX takes effect.