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San DIego, CA
Botox for TMJ/Bruxism
I've been dealing with TMJ issues for about 8 months and have some questions regarding Botox injections. I have tried numerous treatments so far including 2 mouthguards, an NTI device, prednisone, and Valium. So far nothing has helped much (Valium actually helped a bit).
I have had xrays which don't show anything unusual in the joint. I'm fairly confident my problem is due to severe nocturnal bruxism. It feels like my muscles aren't relaxing during sleep like they should. Sometimes I have trouble sleeping because shortly after drifting to sleep, my teeth will clench together and wake me up.
I've read a bit about jaw physiology and I think my problem may possibly be more related to the temporalis and pterygoids than to the masseter. I say this because during the day I can feel my temporalis spasming, which leads me to believe that it is massively overworked from nocturnal clenching. This also generally leads to restricted lateral and protrusive movements (which is why I think the pterygoids are being affected).
So here are my questions:
1) Is it likely that the clenching is causing the tight temporalis...or is the tight temporalis causing the clenching? Or might it be both?
2) Would you recommend botox injects in the temporalis for a situation like mine in addition to the masseter injections?
3) Are injections ever indicated for the pterygoids, or does temporalis weakening usually lead to healing of those muscles?
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