Botox is a renowned brand of botulinum toxin that is manufactured by Allergan Pharmaceuticals and is classified as a neuromuscular paralytic agent. This prescription-only medicine contains therapeutic units of botulinum toxin type A that is extracted and extensively purified from Clostridium botulinum bacteria (Hall strain) fermented with casein hydrolysate, glucose, and yeast extract. Though this neurotoxin is notorious for its toxicity, in-depth research has found that the toxin possesses effective muscle relaxing properties. As such, this toxin is used to temporarily treat a number of disorders caused by abnormal and painful muscle contractions, such as limb spasticity caused by stroke, blepharospasm, and cervical dystonia. Its muscle relaxing activity is also vital for temporarily correcting chronic migraines, an overactive bladder, and excessive sweating. Nowadays, Botox is also used to non-permanently soften the appearance of dynamic facial wrinkles, such as crow’s feet and glabellar lines.
What are the common dental issues that can be treated using Botox injections?
Besides muscular disorders and aesthetic imperfections, Botox is also used in the field of dentistry. Some examples of dental issues that stem from abnormal muscle movements and can be treated using Botox include:
- Temporomandibular Joint Disorders: Temporomandibular joint disorders (TMD) refer to a group of diseases that affect the normal masticatory function and are caused masticatory muscle dysfunction. Patients diagnosed with TMD usually experience joint sound(s), facial pain, neck pain, peri-auricular pain, headaches, and decreased jaw excursion.
- Oromandibular Dystonia: Oromandibular dystonia (OMD) is caused by involuntary muscle spasms and abnormal muscle contractions and results in distorted oral position and chewing, swallowing, and speaking difficulties. Though it is caused by neurogenic dysfunction, this disorder is still classified under TMD since it involves the masticatory apparatus.
- Masseteric Hypertrophy: Masseteric hypertrophy refers to the abnormal enlargement of the masseter muscle, one of the four major muscles that are vital for mastication. This condition may stem from a habit of chewing gum, dietary habits, and bruxism (teeth grinding).
- Bruxism: Bruxism is a repetitive jaw muscle activity that is characterized by clenching or grinding of the teeth. This condition can even happen during sleep (sleep bruxism). If left untreated, bruxism can result in teeth damage, headache, increased teeth sensitivity, and sleep disruption.
- Gummy Smile: A gummy smile is diagnosed when a patient displays excessive gingival tissue in the maxilla upon smiling. It is usually attributed to over-contraction of the upper lip muscle. Patients with a gummy smile may be conscious of their appearance when they smile.
- Dental Implant and Surgery: Overloading of the masticatory muscles upon insertion of dental implants can actually obstruct the osseointegration of implants and/or healing of fractures.
How does Botox help with these dental issues?
Botox is an excellent choice for treating the above dental imperfections due to its potent muscle relaxing capabilities. Once injected into the affected muscles, botulinum toxin inhibits the release of acetylcholine, a type of neurotransmitter, from the neurons. This effectively relaxes the muscles, albeit non-permanently, and dental problems caused by muscular disorders can be alleviated via this relaxation.
How is Botox injected to correct these dental problems?
Botox comes in the form of a white powder that must be reconstituted with sterile, preservative-free saline solution, specifically 9mg/ml of 0.9% sodium chloride solution. The resulting toxin solution should appear transparent and colorless (or with a slight yellowish color) and free from any suspending particulates. The exact dosage depends on the type and severity of the dental problem(s) that patients are facing. Botox is usually administered via intramuscular injections so that the problematic muscles are adequately treated.
How long will the results last?
Patients should be able to notice early improvements to their oromandibular defects within the first to third day after the procedure; peak performance of the botulinum toxin should appear within the first to fourth week after the treatment session. However, these effects are not permanent because injected botulinum toxin is metabolized away by the tissues. On average, the improvements from Botox only last for about six months, with an average range of four to eight months; hence, it is recommended that patients undergo repeated injection sessions two to three times annually once the initial botulinum toxin effects dissipate.
What are the side effects of Botox injections?
Following treatment sessions involving the injection of botulinum toxin to treat oromandibular disorders, patients are at risk of developing common side effects that can include pain at injection sites, hematoma, flu-like symptoms, nontargeted muscle weakness, difficulty swallowing, and facial nerve palsy. These secondary reactions are usually transient in nature and will subside within a couple of weeks. It is imperative that physicians explain in detail the possible side effects that their patients may experience during or after the procedure before obtaining their informed consent. Patients must be taught to identify the symptoms of side effects so that they can get immediate medical treatment if required.