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Botulinum toxin, or “Botox“, has been used for quite some time as a cosmetic aid in physicians and dentists offices. It can be utilized to make us look and feel younger. Did you know that botox has many other medical uses? It turns out that botox can be used to aid in therapy for many dental, facial pain disorders.

Botox As A Medicine

Botox can be used for the following disorders:

-Temperomandibular Joint Disorder (TMD) and Facial Pain Management – TMD is a very difficult disorder to treat since its symptoms are so varied. The goal of treatment in TMD has been to provide non -invasive, reversible treatment options. Surgery is an option, although rarely utilized, due to it’s limited success. Botox gives the dentist the ability to relieve TMD and facial pain symptoms for a short period of time (weeks to months per treatment). In TMD and facial pain disorder, there are muscular trigger points that radiate outward through the nerve bundles. The  injection of Botox into these trigger point areas, “freezes ” the ability of the muscle  by paralyzing it for a while, can help relieve the intensity of the TMJ muscle contractions. The relief can last up to three months. This temporary muscle paralysis makes Botox a great tool in the treatment and management of TMD and facial pain disorders.

-Teeth Clenching (Bruxism) – This treatment becomes somewhat tricky as the dose is very important here. Too much botox into the area of the mastication muscles can paralyze these muscles and disrupt a person’s ability to chew and speak. Too small a dose and it has little to no effect. The proper dose will reduce the intensity of the muscles contraction, allowing the patient to still be able to chew and speak properly. When done correctly, the patient will see relief from facial pain and limit the damage done by the teeth clenching, as the force is no longer there to do damage to oral tissues.

-Orthodontics – Our muscles play a huge role in where our teeth line up. Following orthodontic therapy some patients teeth will relapse and this may be due to placement of that individual’s musculature. Many patients have an over active mentalis muscle that often causes relapse of the teeth and may cause spasm of the muscles. Botox gives us the ability to reduce these spasms and contractions allowing for limited relapse following orthodontic treatment.

-Treatment of Migraine, and other Headaches – Generally, migraines have been a source of the unknown for many patients. Migraines have multiple symptoms beyond just headaches. These can include nausea, dizziness, and even light sensitivity. The use of Botox can relieve these symptoms. The placement of a few well placed injections around the temples, forehead, and neck/shoulder area can ease these symptoms by preventing the pain signals to reach the nerve bundles on the head and neck. This can also relieve severe headaches in the forehead region, if you suffer from them frequently. This can get quite expensive but for those suffering it can be well worth the cost to feel pain free again.

-Controlling Excess Saliva Production (also called sialorrhea) – The more common term for this is drooling. While there are other treatments for this, botox gives the ability to stop the excessive salivary production by injecting into the parotid and submaxillary glands. Again, this treatment is very dose specific. Too high a dose can disrupt a person’s chewing ability and also lead to dry mouth (xerostomia).

-Facial Asymmetry – In many of us, the muscles of the face may be asymmetrical leading to an imbalanced look to the face. Botox can restore that symmetry by balancing the facial muscles. Eyebrow lift, or depression of the brow can be enhanced with properly placed botox.

-Gummy Smile – This is shown as a smile that shows too much gum tissue. This usually is the result of the lip rising too high when smiling. Injecting Botox into the upper lip weakens the retractor muscles of the upper lip so that it won’t raise as high and your smile will seem better-balanced.

-Trigeminal Neuralgia- This extremely painful condition can be brought about by something as simple as air blowing on your face. Freezing a few select muscles on the affected side of the face can bring relief from extreme pain, and piece of mind. Not having to worry about accidentally setting off the facial pain can give you your life back.

Conclusion

As with any botox application, training is critical. The injector should be well versed in not only a person’s anatomy but also in the use of the right dosing of the botox. Too little and there will be no relief from symptoms while too much botox can lead to disabling effects. Botox gives patients and doctors a new world of possible treatments that can lead to better lives for all of us.

We, as a society have become more acutely aware of the ingredients in many products used for our health. This includes food, medications, and children’s products. Now we

Cosmetic Dentist Marielaina Perrone DDS

Educate Yourself On The Hazards Of Mercury, BPA, and Triclosan.

can include dental materials to the list. Controversies have developed recently surrounding the use of Bisphenol-A (commonly referred to as BPA) as well as mercury use in dentistry. What are the truths regarding dental materials and what can you do to keep you and your family healthy at the dentist?

Controversial Dental Materials

-Mercury – This has long been used to restore tooth decay in something called a dental amalgam. A dental amalgam is a metal based restorative dental material that is a mixture of liquid mercury and a powdered alloy (composed of silver, tin, and copper). A dental amalgam is the cheapest of all dental materials used for restoring tooth decay and was developed over 150 years ago. While controversial in it’s use, It has been and will continue to be utilized around the world as an economical choice in dental restoration.

The controversy that surrounds dental amalgam is the incorporation of mercury. There are some who are allergic to dental amalgams. This allergy could be due to the mercury or one of the other components. The main concern is the inhalation of mercury vapors into the lungs. The NIH, and FDA have been conducting and comparing dental mercury research for quite some time. The general rule of thumb for mercury exposure is, low levels have no statistically significant or reproducible harmful effects whereas much higher levels can cause issues like, fatigue, memory loss, irritability, and headaches. Most research addresses levels released in the mouth following placement. Studies have concluded that, as these dental amalgams wear in the mouth, mercury is released mainly while chewing. While the research concluded that the level of mercury release was low, it can still be a cause for concern for many patients.

The FDA has released a final study on this stating that, “the levels released by dental amalgam restorations are not high enough to cause harm in patients.” The bottom line for the use of dental amalgam should be a dental materials choice between patient and dentist. It is an effective dental material (both in cost and function) and will continue to be an option for most dental offices in the near future.

-Triclosan – This ingredient is found in many everyday products including soap, toothpaste, and many mouthwashes. It’s main use is to reduce or prevent bacterial contamination.  Since its main use is as an anti-bacterial, many wonder if its overuse in soaps and mouthwashes will cause new bacterial strains to develop that are able to resist triclosan’s effects. Other concerns are its effect on our immune and muscular systems. There have been small studies done that have shown an increased incidence of hay fever and allergies in general from over exposure to anti bacterial soaps.

The jury is still out on triclosan as the FDA has not given it a full vote of confidence. It has approved it for use in toothpastes as an effective aid in preventing the development of gingivitis. As of this writing, triclosan has not been determined to harm humans but studies are ongoing.

Dental Materials Marielaina Perrone DDS

Make Informed Decisions on Mercury, BPA, and Triclosan For Your Entire Family.

-Bisphenol-A (BPA) – BPA is used in a variety of products mainly for the use in production of polycarbonate plastics and epoxy type resins. Commonly household items include water bottles, baby bottles, and even compact discs. BPA is also found in many dental materials including dental sealants and dental composites.

The controversy surrounding BPA is the fact that BPA has been characterized as an endocrine disruptor. Studies have linked BPA to numerous diseases in humans including heart disease, diabetes, and fertility issues. One study followed almost 1,500 adult patients in the U.S. and associated higher levels of BPA in the urine to lead to a greater probability of being diagnosed with heart disease, diabetes, and liver enzyme abnormalities. Another concern is the effect it has on children, as dental sealants are predominantly placed on children. The jury is still out as there has been no definitive relationship to this point.  Ask your dentist if they know if they are BPA free?

Dental Materials Conclusion

There is continuing research looking into the effects of BPA use by the FDA. Nothing definitive has been stated yet but ask your dentist regarding products they use. Many dental companies in response have developed “BPA free” alternatives. Many products claim to be BPA free because they do not technically add BPA. However, all sealants and composite resins have Bis-GMA and/or Bis-DMA which are made from BPA and release BPA into the mouth as a by-product. Bis-DMA releases far more BPA, and some brands of composite or sealant release substantially higher amounts of BPA at normal ph levels.

There is countless information available on all of these products. The internet is full of truths and lies. It is important to look at these ingredients, and research studies objectively and make the right choices for you and your family. If there are any concerns about any dental materials, ask your dentist for more information to make an educated choice. An educated patient is an empowered patient who can make informed choices about their dental care.