Most people associate Botox* with smoothing out facial wrinkles. Its use and popularity has grown at an amazing rate in recent years, boosted by the publicity it has received from Hollywood celebrities, for whom image is everything.
But who has ever heard of Botox being used in the field of dentistry?
Rene Piedra DMD offers Botox in his Florida practice, and is one of a select group of dentists who use Botox for a number of procedures as an alternative or supplement to more traditional methods of treatment.
Dr. Piedra asserts that some dentists are unaware that Botox can provide a substantial benefit as an adjunctive therapy in certain dental treatments. One example is in the case of a condition known as TMJD.
TMJD, short for Temporomandibular Joint Dysfunction, is a condition affecting jaw muscles and the joints which connect the mandible to the skull. The most distressing symptom is the pain associated with the movement of the jaw and muscles when chewing, for example. This pain is usually followed by restricted mandibular movement, and noises from the temporomandibular joints. The condition, while not life threatening, is uncomfortable and can become chronic. Surprisingly, it is the second most frequent cause of orofacial pain after toothache, and so cannot be ignored.
Botox relieves jaw tension by preventing the muscles from engaging in the powerful movement of the jaw that produces headaches and pain. As an alternative treatment, Botox is quick, straightforward, and effective. The injections are administered in the dentist’s office, and most patients experience a notable improvement in a couple of days; the maximum relief is usually felt within a week.
A second condition which lends itself to Botox therapy is known as bruxism. This is the excessive grinding of the teeth and/or excessive clenching of the jaw. Bruxism symptoms can include hypersensitive teeth, aching jaw muscles, and headaches. Bruxism causes wear on the teeth and can even damage or break teeth and crowns or fillings.
The theory behind the use of Botox to treat bruxism is that a diluted solution of the toxin will partially paralyze the muscles and lessen their ability to forcefully clench and grind the jaw. However, it is important that sufficient muscular function be retained to enable normal activities such as talking and eating. This treatment typically involves five or six injections, but the dose of toxin used depends upon the person; a higher dose may be needed for some people with stronger muscles of mastication.
A third, but less frequently used application for Botox, is when it is used together with standard dermal filler therapy as a non-surgical alternative to high lip line cases. This procedure is required following a particular form of crown and bridge therapy in order to improve the final esthetic external appearance of the mouth. The effect of the Botox is to weaken the muscles surrounding the lip while retaining the ability to speak, smile, chew, and, of course, kiss.
Another application of Botox is for the retraining of muscles during orthodontic therapy. It reduces the intensity of the muscle after treatment; over time, the muscle may be retrained to a more physiological movement. This can be a good option for patients who are suffering from a significant orthodontic relapse due to a hyperactive muscle.
Botox is also useful for those who no longer have their original teeth, but have to rely on dentures to do the work. New dentures may fit perfectly in the mouth, but strong irregular muscle contractions make it difficult for some people to get used to them. Botox simply eases the transition and acceptance of the new replacement teeth.
Rene Piedra DMD is one of a number of dentists who view their work in a wider perspective than simply maintaining tooth or gum health. They want their patients to be able to smile, and feel comfortable about doing so. The problem is that as people get older, the corners of the mouth begin to turn down due to normal muscle development over the years. It is possible to inject Botox to relax those muscles, which then results in the corners turning up.
The question which then arises is this. Does this form of treatment still come within the area of dentistry, or does it really belong to the field of cosmetic surgery? What about the use of Botox to cure the wrinkles around the lips – often called “smokers’ wrinkles” – which interfere with a full smile?
The U.S. has entered an era in which a whole host of unqualified people are administering Botox, including beauticians and hairdressers, among others. It could certainly be argued that dentists, as oral and maxillofacial specialists, are far better qualified to administer Botox to this area than anyone else.
What can’t be argued, according to Rene Piedra DMD, is that Botox is a valuable addition in the sphere of dental treatments for those dentists who are trained and willing to use it.
(* BOTOX® is the brand name for a preparation of the Botulinum toxin manufactured by Allergan, Inc. The use of the name is for journalistic clarity, and does not imply any endorsement or recommendation for this specific brand.)