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Botulinum toxin (BoNT-A), 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. It has been reported that approximately 16% of dentists in North America now use BoNT-A in their offices for cosmetic and therapeutic applications.

Botox acts by inhibiting the release of acetylcholine. Acetylcholine depolarizes the motor end plate of the muscle and will cause a muscle contraction. By inhibiting the release of acetylcholine, Botox effectively will either reduce the intensity of the contraction of the muscle or will eliminate the contraction altogether, depending on the amount of Botox used. Essentially, BoNT-A neurotoxin causes a temporary muscle paralysis. Each treatment can usually last between 3-6 months as the muscle initiates new acetylcholine receptors and the growth of branches from the neurons to form new synaptic contacts. Gradually the muscle returns to its full function and with no side effects at all.

Botox And Dental 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 varied and complex. The goal of treatment in TMD has been to provide non -invasive, reversible treatment options. Surgery is an option, although rarely used, due to limited success. Botox gives the dentist the ability to relieve TMD and facial pain symptoms for a short period of time (from weeks – months for each 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. For trigger point injections, it makes much more sense to use Botox because the effects will last for three months and you are actually helping relieve the intensity of the contraction of the muscle, which is usually in spasm.This temporary muscle paralysis makes Botox a great tool in the treatment and management of TMD and facial pain disorders. The use of Botox products in TMD and facial pain management therapy can give us a totally new insight as to helping these patients who have had trouble getting relief previously.

-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. Using the right amount of Botox will decrease the intensity of contractions of the muscles of mastication as well as give you full ability for chewing, eating properly, and speaking. The relief afforded to patients by Botox can help eliminate facial pain, greatly reduce their TMD symptoms and can significantly help the other associated treatments of periodontal disease by removing bruxism from the equation of treatment.

-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.

Botox and Dentistry Conclusion

As with any botox application, training is critical. The dentist placing the injections 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 dentists new possible treatments that can lead to better lives for all of us.

Cosmetic surgery is a very popular specialty of medicine that has been growing steadily for decades. Youth is associated with vitality and beauty. For many of us, aging is not an easy thing to do and we seek out help to keep us looking and feeling younger and more vibrant. When seeking out cosmetic surgery, many often overlook the role our teeth play in our appearance. As we age, our teeth become darker, get worn down, and may even change alignment. This can create not only cosmetic issues but functional ones as well. These functional issues can lead to Temperomandibular Joint (TMJ) issues, headaches, and muscle pain.

How Can My Dentist Make Me Look Younger?

As our teeth wear over time, it can result in a shorter looking face, longer looking teeth, and darker teeth. The resulting appearance may make some of appear to age prematurely. The breakdown can be caused by tooth erosion (high acid wear), attrition (flattening and fracturing due to grinding and oral habits), and abrasion (overly aggresive brushing), recession (loss of gum tissue making teeth appear longer) . The length and shape of our faces and teeth, as well as the position of the jaw are determined by the teeth, skeletal bones, and a person’s bite. So, when a person’s teeth wear down it will give the appearance of a shorter face. Pain and discomfort are often associated with wearing down of teeth and gums, as they become more sensitive, prone to increased fractures, and to development of TMJ and headache pain.

Your dentist can give you the ability to change all of this, allowing the patient to look more youthful while correcting dental issues.  The patients oral hygiene must be good and the mouth should be in a healthy state before any work can be completed.  This should include control of periodontal disease, removal of any loose teeth, addressing gum loss issues, ascertaining desired whiteness, and correcting dangerous oral habits, .  Great care must be taken while returning someone to their proper tooth height (vertical dimension) as it can create even more TMJ and headache issues if not done properly.

Some of the procedures involved in making you look younger include:

-Porcelain Crowns. These crowns will give the cosmetic appearance most patients are seeking but also give the strength and stability to open one’s bite .  One type of strong porcelain which is used where teeth grinding has been a problem is a Bruxzir crown. When placed properly, a patient will begin to see an immediate improvement in their bite and in the cosmetic appearance in the skin around the face as wrinkles will lessen.

-Porcelain Veneers. A staple of cosmetic dentistry but used in conjunction with porcelain crowns to lengthen and restore the length of front teeth. Porcelain veneers are less invasive and more conservative than porcelain crowns. For teeth that do not require a full coverage crown, porcelain veneers can adequately lengthen and reshape, and change the color of your smile.

-Orthodontics. Limited or full orthodontics may be necessary to remove any bite issues that can cause undue stress or trauma to the teeth before new restorations are placed.

-Dental Bonding. Used to restore any teeth that have been damaged by tooth decay, staining or slight wear. Dental bonding is a cosmetically pleasing option that will look very natural when completed.

-Crown Lengthening. A surgical process to expose more tooth structure so that there is enough room to properly place a crown. This is often necessary in severe grinding cases.

-Gum and Bone Grafting and Recontouring. Lost bone and gum tissue can often times be grafted to help regrow them. They can also be reshaped surgically to be healthier, easier to work with, and more cosmetically appealing.

-Teeth Whitening. Many of our worn teeth are also dark and discolored. The color you desire to reach may require a dental whitening process, or simply a whiter color bonding restoration or a whiter colored porcelain restoration.

Conclusion

Cosmetic dentistry will change not only how your teeth function but how you feel about yourself. Many dentists often overlook the relationship between our teeth and our bite. If the bite is not in alignment, your teeth and face will never look and feel their best.

There was a time when it was expected to lose your smile as you got older. With advancements in dental education and dental technology over the last few decades, many of us now expect to have our smiles for a lifetime. Unfortunately, our dental health is constantly under attack from trauma, tooth decay, periodontal disease, and our own daily habits. A few simple tips can go a long way to keeping your smile intact for decades to come.

How To Keep Your Full Smile?

-Floss Regularly. This is such a simple task, but for many, seems to be a real chore. Regular flossing will help prevent the development of periodontal disease as well as ward off tooth decay. It is recommended to floss at least once per day, generally before bedtime.

-Brush Regularly. Another simple tip but many people rush through their brushing or do not do it often enough. It is recommended to brush at least twice a day for a minimum of 2 minutes each time. Use a soft toothbrush, preferably an electric toothbrush which is more efficient.

-Maintain Regular Dental Visits. A 6 month dental examination and professional cleanings every 3-6 months are highly recommended. This will not only help keep your teeth clean and decrease risks of periodontal issues but it can also catch developing issues before they arise into something bigger. These visits are also a great time for dental education if you have any questions or the dental team notices you are not doing something properly.

-Be Proactive. It is important to note when you have a dental issue between dental visits. If something has changed or there is discomfort or sensitivity, contact your dentist. Having a problem evaluated in its earliest stages will usually save you time, money, and discomfort down the road.

-Check Your Diet. Our diet (including both food and drink) have a significant impact on our dental health. Drinks high in in sugar or acids should be avoided as they can lead to tooth decay and tooth enamel erosion.

-Rinse Or Chew Gum After Meals. If you are unable to brush after eating, a good habit is to rinse with water or chew sugar free gum. The water can wash away loose debris as well as neutralize any acid build up in the mouth. The gum chewing will increase salivary flow which will naturally wash away harmful oral bacteria and neutralize acid.

-Protect Your Smile. Participating in sports like football or skateboarding can be hazardous to our teeth due to possible trauma. A well fitting mouthguard can protect our teeth from damage during these activities. You should also protect your teeth and TMJ from the damages of clenching and grinding. Your dentist can fabricate the appropriate appliance for you.

Conclusion

A smile can last a lifetime with proper care. A few minutes a day and a change in habits is all it takes to stay healthy as long as possible.

Living with chronic facial pain can be very difficult for the sufferers and their loved ones. Often, diagnosis and treatment of chronic pain can be elusive. Since the pain can radiate outward in an area, it can be difficult to pin down the source of the pain. The source of the pain may be related to infection, nerve, or muscle tissue.  Botox may be the answer for many muscular issues. Botox can cause an overactive, painful muscle to become more flaccid and therefore relieve pain from muscle spasms allowing sufferers to be pain free.

What Can Botox Do?

Botox (a brand name of Botulinum Toxin for injection) is injected directly into a targeted muscle group. Once botox enters the muscle it prevents the muscle from recieving nerve commands. Without this command the muscles will not contract thus leaving them temporarily paralyzed. The most popular use of Botox is to relax facial muscles, removing wrinkles to give a more youthful appearance. Botox can be used throughout the facial muscles to paralyze the painful, spasming muscles related to grinding, clenching, headaches, etc. This paralysis can give much needed pain relief from overactive muscles for as long as 3 months at a time.

What Types Of Dental Pain Can Botox Treat?

-Temperomandibular Joint (TMJ) Pain. The temperomandibular joint is susceptible to disorders, as it consists of delicate moving parts. When any of these moving parts are not in proper alignment pain can be the result. The major reason for damage is due to chronic bruxism (teeth grinding) or teeth clenching. With Botox use in the TMJ area, the muscles of the jaw are allowed to relax and prevent it from contracting, decreasing the grinding or clenching, and in turn decreasing pain.

-Myofacial Pain Syndrome. This is considered a chronic pain disorder. This syndrome occurs when pressure is placed on sensitive points in your muscles. These are called trigger points. When this “trigger point” pressure occurs, the pain can does not always occur at the source, but may begin at a different location from the source of the pressure. This is called referred pain and may be very difficult to accurately diagnose. Myofacial pain syndrome typically occurs after a muscle has been contracted repetitively. This can be caused by repetitive motions used in jobs or hobbies or by stress. Myofacial pain can stem from problems with your TMJ / jaw muscles, or forehead muscles. Myofacial pain can be sudden and debilitating.

-Arthritis. Early studies have shown that Botox injections appear to reduce arthritis pain in the shoulder, knee and hip. These results are promising, and may be helpful in patients with arthritis along with TMJ pain, but further research is needed.

Botox Conclusion

When it comes to chronic pain it is difficult to predict how each patient will respond. It is important to note that an infection should always be ruled out, and diagnosis by your dentist or medical doctor should be conclusive before trying  Botox treatment. Botox may just be the answer to many to relieve them of their chronic pain in the short term. While still being studied, it could be a key component in relieving the symptoms of those suffering from chronic pain.