Articles about Botox for TMJ Don’t Talk about Complications

During the first decades of the 21st century, no medical treatment has been more prominent than Botox ®. As a cosmetic treatment, it revolutionized our approach to treating wrinkles, and, with injectable fillers, it has created an entirely new industry of nonsurgical facelifts.

It has also extended from its original medical intervention as a treatment for spasms to be used in many different medical conditions, including psychological conditions like depression. Recently, it’s been employed as a treatment for migraines and bruxism (teeth grinding). Although it can be an effective treatment for the right people, it’s important to keep in mind that the procedure has drawbacks we don’t fully understand yet, which might give us pause in using it as a frontline treatment.

Botulinum toxin is a very potent paralyzer. It induces what is known as a “flaccid paralysis” by blocking the ability of nerves to signal muscles that they should contract. Not told to contract, the muscles relax.

Bruxism–teeth clenching and grinding–occurs when overactive muscles clamp the jaw down and cause destructive motions of the jaw. By limiting muscle function, Botox reduces these destructive motions. The jaw is too weak to clench in this way.

The treatment for migraines is the same. Essentially, Botox is used to treat the tension that can lead to migraines. Injection in many different muscles groups of the head cause these muscles to relax so they can’t hold tension and therefore can’t trigger migraines.

Articles that focus on the effectiveness of Botox treatment for migraines and bruxism often talk about how the procedure comes with few side effects or complications. Consider this recent article in the Chicago Tribune which talks about Botox treatment for bruxism and claims, “the Botox treatments produced no serious side effects.” It lists lopsided smiles as the only side effect while other articles outline many side effects of Botox.

But there’s a much more serious complication related to the use of Botox that isn’t even mentioned in the article. Some studies have shown that the use of Botox in jaw or head muscles can lead to bone atrophy.

Muscles and bones develop in concert. As the muscles strengthen, the body builds the bone to support the action of muscles. When the muscles are paralyzed, the bone isn’t stimulated, and, as a result, it can diminish.

To be fair to the Tribune writer, these complications don’t show up right away, so they don’t show up right away. They take time to develop, and as a result, we’re still not sure about the ultimate consequence of this diminishing bone.