Based on your clinical experience, is Botox effective in relieving TMJ pain and/or tinnitus? There are not many studies.

Question

I have developed tinnitus in one ear from my TMJ (clenching). It is not responding to the traditional treatments. (ice, heat, occlusal guard, muscle relaxers) I am just wondering if the doctors who routinely use botox for TMD could give me any specifics on the clinical response from it, how many units I would initially need, and what is the time frame for the onset of relief? What is the maintenance dose? What type of doctor is best qualified to administer this type of treatment? Thank you.

Martin Jugenburg, MD · Answer

Thank you for your question. Botox is a wonderful product to use for TMJ and can provide great results if administered correctly. Any expert injector is able to inject this area. After your assessment the injector will discuss the amount of Botox required, depending on the size and bulk of the muscle. The amount of Botox can vary from 30-60 units. Best,

Steven F. Weiner, MD · Answer

I've been doing this since 1994. Here's the scoop. It works by relieving the tension in the muscles which might cause TMJ. It doesn't help with internal problems with the joint. Tinnitus is probably not going to be improved with Botox. There are more muscles to inject than the masseters. Temporalis and pterygoids can be injected as well. It is just one piece to the treatment regime and shouldn't be considered a panacea.

Melvin Elson, MD · Answer

Botox works very well for TMJ but may not relieve your tinnitus. You need to see a board certified dermatologist or plastic surgeon but I have found that dentists (if they are licensed in TX to do this) do a very good job

William Marshall Guy, MD · Answer

Hello Txmom808,Your question really asks about two different issues.  Botox can be quite effective at relieving TMJ pain.  It does this my treating one of the largest muscles that closes the jaw, so you can't clench as easily.  Since you aren't always contracting that muscle, the joint (TMJ) is not under so much force so the inflammation and pain starts to go away.  The pain does not go away immediately because the joint is inflamed.  You would likely start to see improvement in the pain in a few weeks after the Botox is working (which also takes about a week to reach its maximum effect).  It's kind of like having a swollen knee from running too long.  If you stop running, you aren't doing further damage, but it still takes some time for the pain to go away from the arthritis.  As far as using Botox to treat tinnitus, I don't believe in it.  The TMJ has nothing to do with tinnitus (although if you are hearing a crackling noise in your ear from the arthritis in the TMJ then it may help).  Tinnitus is the perception of sound created in the ear in the absence of a real sound.  Unfortunately, there is no perfect treatment for this.  If you do choose a treatment, don't spend a lot because there are many sham treatments out there taking advantage of people.  Studies have shown the masking the noise and biofeedback can help.  The less you think about the tinnitus the better it gets, and the more you think about it the worse it gets.  As far as the type of doctor there will be several.  Facial plastic surgeons and dentists would most likely have the most experience, but not everyone in either of those specialties is necessarily trained in it.  I hope this helps and good luck.

Based on your clinical experience, is Botox effective in relieving TMJ pain and/or tinnitus? There are not many studies.

Answers (4)

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