As TMJ patients search for alternative treatments to manage their pain, a doctor may have suggested the possibility of trying Botox injections directly into the chewing (masseter and temporalis) muscles to relax these muscles. In addition to its well-publicized cosmetic uses, Botox has been approved by the FDA for painful conditions potentially related to TMJ, such as cervical dystonia and migraine.  When injected into facial muscles afflicted with soreness and discomfort, BOTOX® relieves TMJ and jaw tension for many patients. The injections often eliminate headaches resulting from teeth grinding, and, in cases of severe stress, BOTOX® can even minimize lock jaw. Although BOTOX® treatment for these conditions is presently in its early stages; evidence indicates that it can be extremely effective.

BOTOX AND FILLER ADMINISTRATION GUIDELINES – RCDSO REGULATIONS

Direct excerpt from RCDSO Dispatch November/December 2013

“Members who wish to use botulinum toxin and dermal fillers may do so, but only for procedures that are within the scope of practice of dentistry. Members may inject botulinum toxin and/or dermal fillers intra-orally for either therapeutic or cosmetic purposes, or botulinum toxin extra- orally for therapeutic purposes, but in either case only if they are appropriately trained and competent to perform the procedures. It is not within the scope of practice of dentistry and members are not authorized in Ontario to inject botulinum toxin or dermal fillers extra- orally for cosmetic purposes.”

Direct excerpt from RCDSO Dispatch November/December 2013

Members who wish to use these substances as described are expected to successfully complete a course of instruction that adheres closely to the following criteria. The course should:

• be conducted by persons who have had recognized education and training, preferably university-based, and significant experience in the parenteral administration of these substances;
• include a didactic component with formal evaluation that addresses:
  • pharmacology of these substances;
  • physiological activity of these substances;
  • diagnosis of relevant conditions;
  • indications for the use of these substances, as well as other first-line treatment modalities;
  • contraindications for the use of these substances;
  • related head and neck anatomy;
  • adverse reactions and their management;
  • include a hands-on clinical or clinical simulation component with formal evaluation;
  • promote the critical evaluation of research and literature on related topics.