Botulinum Toxin Type A (brand names: BOTOX®, Xeomin®, Dysport®) is used as an alternative treatment for certain types of TMJ (temporo-mandibular joint) disorders and associated jaw tension and pain. When injected into the over active muscles afflicted with soreness and discomfort, BOTOX® relieves TMJ and jaw tension for many patients. The injections often eliminate migranes and other types of headaches resulting from teeth grinding and clenching which happen mostly at night during sleep. In some cases, BOTOX® can minimize lock jaw caused by muscle spasm. Although Botulinum Toxin Type A treatment for these conditions is presently an "off-label use"; evidence indicates that it can be extremely effective.
Mechanism of action of Botulinum Toxin Type A is through temporary weakening and partial paralysis of the overworked muscles that help close the jaw. When these muscles are over active, they can displace the TMJ and with excessive teeth grinding, a person may suffer severe tension headaches, as well as sharp pain in the jaw. Botulinum Toxin Type A relieves jaw tension by making muscles less prone to engage in the powerful and often unconscious para-functional movement of the jaw that produces headaches and pain. The Botulinum Toxin Type A alternative treatment for TMJ disorders and jaw tension is usually quick (10-20 minutes), straightforward, and effective. A non-surgical procedure, Botulinum Toxin Type A injections are administered in a doctor’s office. Treatment often requires a follow up visit in 10-14 days to evaluate the results and receive minor doses of enhancement injections if needed. Most patients experience noticeable improvement within one or two days of their first treatment, although relief can take up to a week.
After the Botulinum Toxin Type A TMJ Treatment muscle tenderness will start to disappear almost immediately. Wrinkles begin to disappear within one or two days after the injections, and you may continue to see the wrinkles diminish up to one week after the Botox treatment procedure. There may be mild temporary bruising, numbness, or redness around the injection sites. Botulinum Toxin Type A treatment is non-surgical and non-invasive procedure and you can return to normal activities immediately. However, to avoid spreading the toxin to other muscles, patients should not rub or massage the area injected with Botulinum Toxin and remain upright for many hours. Physical activity should also be limited for a time.
These are the most common symptoms of TMJ Disorder which tend to get worse over time.
A typical Botulinum Toxin Type A injection will result in 3 to 6 months of relief. The effects will wear out over timejust like any other medication andre-injection may be necessary.
The cause for gummy smiles can be of skeletal, dental or soft tissue (muscular) in origin. Botulinum Toxin injection may be used for correction of excessive showing of the gums or gummy smile caused by hyperactive upper lip elevator muscles.
In the lower face region, a very common area of concern for wrinkles is around the mouth. These are known medically as perioral lines and commonly are referred to as smokers lines or kissing lines. It is noteworthy to point out that while the deeply creased vertical lines in the lips can be caused by smoking, it is not the only cause of perioral lines. They also can result from excessive sun exposure over the years, habitual puckering of the mouth, excessive use of drinking straws and even as a hereditary predisposition. For less deep lines, Botox can be injected into the muscles around the lips to soften both upper and lower lip creases. For deeper lines, a combination of Botox treatment and dermal filler injections can be used.
Overactive muscles in the face specially the Masseter muscle which is the main muscle involved in closing the mouth can give the appearance of bulgy angular appearance to one. This is more noticeable in females. Botox injection directly into the masseter muscle can alleviate this problem. Botox slowly and gently reduces the size of the masseter muscle, which in turn reduces the appearance of a strong and square jawline. In about 4 weeks one can begin to see the results and the effects persist typically for around a year. Compared to traditional uses of cosmetic Botox treatments (ie between eyebrows, and forehead) the effects for the jawline last much longer. Most patients seem to need no more than 2-3 treatments over the span of several years to maintain the result and it is reasonable to consider this treatment very long lasting but not truly permanent. This treatment is ideal for patients who are looking for softer facial features, as it’s very effective at softening the appearance of what’s considered to be a more masculine jawline.
Angular Cheilits is the medical term for dropping of the corners of the mouth which is often associated with cracked corners of the mouth and gives one appearance of a constant frown or reverse smile. The condition can also make one susceptible to fungal infection that tends to manifest itself as cracked, bleeding and itching of the corners of the mouth where upper and lower lips meet. This creates an aged look regardless of actual age. The reason for fungal infections is that drooping corners of the mouth are prone to saliva accumulation which creates a moist fold in the skin where fungi will thrive. Minuscule amounts of Botox injections on the bottom lip which pulls the corner of the mouth downward, will weaken that muscle, thereby helping the muscles of the upper lip to pull the corners of the mouth upwards to alleviate the problem.
Typical Angular Cheilitis presentation with cracked and bleeding corners of the mouth
Notice reverse (upside down) smile line with many vertical lines and wrinkles
Also notice drastic reduction in vertical
Smokers or Bottle Drinkers lines
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