BOTOX and other botulinum toxin injections have not been approved as a TMJ treatment, but it’s often used off-label to reduce the jaw pain, headaches, and other symptoms of TMJ. We’ve talked about both the good and the bad aspects of this treatment.
Now a new study coordinated by New York University (NYU) professor Karen Raphael is going to attempt to determine whether using botulinum toxin to treat TMJ is worth the potential risks.
Pain Relief Today, Pathological Fractures Tomorrow?
The concern at issue in the study is whether using Botox to treat TMJ leads to reduced bone density in the mandible. Remember, our bones aren’t static, they respond to stimuli from our muscles, gravity, and other pressures to determine how much bone material is needed in any particular place. When Botox is used to treat TMJ, it partly paralyzes the jaw muscles. When the jaw muscles stop pulling so hard on the jawbone, the body might believe that not as much bone is required in the jaw. This could result in less bone being built up in the jawbone, making it vulnerable to fractures. Previous work by Dr. Raphael and others indicates that bone density could be lost by people receiving botulinum toxin injections for TMJ.
The new study, which has received a $4 million grant, will take five years to complete. The study will be run out of NYU, but recruitment will be performed at intake centers coast to coast to ensure a large enough sample size for authoritative results.
Bone density changes will be measured over the course of the study using cone beam computed tomography (CBCT), which will be analyzed at the University of Connecticut (UConn). Researchers hope to recruit at least 100 participants.
What Is the Tradeoff?
This study will answer an important question that we have to ask about any medical treatment: whether the side effects cause more harm than the treatment provides benefits. If Botox really does lead to jaw fractures, it’s likely that it’s not a good TMJ treatment, and should be reserved only for people who can’t get benefits from other treatments.
Fortunately, there are many other TMJ treatments that can be used first to help people get relief from common TMJ symptoms. If you would like to learn what options can help you, please call (803) 781-9090 for an appointment with a Columbia, SC TMJ dentist at Smile Columbia Dentistry.
UPDATE: Thanks to input from Dr. Raphael, this blog was updated to better reflect the structure of the study. Aug 11, 2017