Recommended Botox Injector for TMJ?

Question

I saw a TMJ (Temporomandibular Joint) patient get her jaw muscles injected with Botox to help with tightness and pain. When I asked my plastic surgeon about it, he wasn't familiar with its use in that manner. Any suggestions on a specialist who can do these procedures?

Tanveer Janjua, MD · Answer

I use it for a few of my patients who have very strong jaw muscles. It works well.
However, what has really helped my patients is the injection of Kenalog (a mild steroid) directly into the jaw joint (TMJ).
If you are hurting in the joint get kenalog and ask your doctor to give you a muscle relaxant like Soma250mg for every night.
I typically inject 5mg of kenalog in each TMJ.
Here are some of the instructions that I give to my TMJ patients.
2345 Lamington Road, Ste 108Bedminster, NJ 07921Tel: (908) 470-2600 Fax: (908) 470-1660 www.janjuafacialsurgery.comTMJ (JAW JOINT) PAIN PREVENTION
&bull; DO NOT CHEW GUM&bull; EAT ONLY SOFT FOODS THAT DO NOT REQUIRE EXTENSIVE CHEWING. CHEWY FOODS TO AVOID INCLUDE BAGELS, RAISINS, GRANOLA BARS etc.&bull; DO NOT YAWN WITH A BIG MOUTH&bull; DO NOT EAT ANYTHING THAT REQUIRES OPENING A BIG MOUTH, SUCH AS AN APPLE OR A BURGER&bull; DO NOT MOVE YOUR JAW SIDEWAYS&bull; DO NOT USE YOUR TONGUE TO REMOVE FOOD PARTICLES STUCK BEHIND YOUR TEETH&bull; REMIND YOURSELF CONTINUOUSLY TO RELAX YOUR JAW MUSCLES ESPECIALLY AT WORK&bull; USE MOTRIN FOR PAIN (IF YOUR STOMACH CAN TOLERATE IT)&bull; APPLY WARM COMPRESSES TO THE JOINT&bull; SEE YOUR DENTIST/ORAL SURGEON/ORTHODONTIST TO DETERMINE IF YOU NEED A NIGHT GUARD &bull; TAKE THE MUSCLE RELAXANT (IF GIVEN BY DR. JANJUA)&bull; YOU MAY ALSO BENEFIT FROM BOTOX INJECTION INTO THE MUSCLES OF THE JAW JOINT.&bull; YOU MAY ALSO BENEFIT FROM INJECTION OF KENALOG INTO THE TMJ.&bull; VISIT WWW.TMJ.ORG TO GET MORE INFORMATION. 
You should look for an Otolaryngologist who does TMJ injections.

Otto Joseph Placik, MD · Answer

TMJ pain is difficult to diagnose and treat. There are multiple causes and muscle spasm or imbalance is only one cause. Most individuals suffer from loose ligaments or a disc which can get pinched and cause pain with locking or clicking. Relaxing the muscle will not necessarily correct the problem in these individuals.
Seek an expert in TMJ pain. Ask your dentist for a referral as they are the most common individuals to see this condition. As mentioned below, Maxillo-facial surgeons are the specialists who treat this problem and can recieve training in oral surgery, otolaryngology, or plastic surgery.

David Shafer, MD, FACS · Answer

Botox is a useful treatment for TMJ.  However, no everyone knows about it, as you have found out.  The best advice is to call around to ENT surgeons offices and possibly platic surgeons office to see if they offer the service.  Good luck.

Kris M. Reddy, MD, FACS · Answer

Oral maxillofacial surgeons tend to perform the treatment more frequently than plastic surgeons since they are more likely to treat TMJ patients.

Sirish Maddali, MD · Answer

Botox is a common tool used to treat TMJ tightness and pain. However, you will find that it is difficult to locate a plastic surgeon with a lot of experience with this procedure. Look into Oral Maxillofacial Surgeons (OMFS). They are the ones that most likely perform this procedure frequently. Good luck.

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