Alexander Rivkin, MD
Expert Profile

User Photo For: AlexanderRivkinM.D.
Alexander Rivkin, MD
Plastic surgeon | Views: 243885

Friendname: AlexanderRivkinM.D.
Business Name: Westside Aesthetics
Website: www.westsideaesthetics.com
Location: 1033 Gayley Ave #104
los angeles, CA 90024
United States
Telephone: 310 443 5273
Languages Spoken: English

Post a reply Ask Alexander Rivkin a question Return to Alexander Rivkin's homepage

Ask An Expert > Alexander Rivkin Message Board > Botox for TMJ/Bruxism
Default User Photo
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?




Welcome to the Ask An Expert section of our website! Our network of board certified physicians can answer any questions that you may have regarding plastic surgery, skin care, dermatology and other conditions. Popular topics include tummy tuck, liposuction, rhinoplasty, acne scars, facelift, breast augmentation and more. This frequently asked questions section is opened to everyone and you need to set up an account with Makemeheal before you can ask your own question. This service is absolutely free and is available to those who are interested in learning more about a particular cosmetic procedure, treatment or product.

Before asking a question, we recommend you to browse through our existing collection of questions and answers to ensure that the question you want to ask have not already been answered by our highly experienced experts. This will help you save time and get an answer more quickly. When asking a new question, we recommend you to be very detailed so that our experts could formulate a more precise & professional answer.

Of course, this service is not a substitute for a doctor visit or a consultation with a plastic surgeon or cosmetic dermatologist. The answer you will find here only serve as initial directions of thoughts and not as specific instructions. You should remember that it is utterly important to consult a skilled specialist prior to scheduling any type of treatment in order to get acquainted with possible contraindications. Only a one-on-one meeting will enable your cosmetic surgeon to properly evaluate your condition, conduct examinations and explain their results.