Tempromandibular Joint Pain

Putney Dental Surgery on Charles (behind florist)

TMJ is an abbreviation for Tempromandibular Joint Pain, or more commonly known as jaw joint(s). TMD stands for Tempromandibular Disorders, which is a collective term for the muscle and/or joint. Symptoms that commonly arise when there is TMJ pain and dysfunction are chronic headaches and jaw pain.

At Putney Dental Surgery we prefer a conservative, less invasive approach to treating this complex disorder( Tempromandibular Joint Pain) rather than irreversible treatments which are reserved as a last resort

Tempromandibular Joint Pain treatment  options include:

  • Changes to your eating habits
  • Stretching the jaw muscle with set exercises
  • Medication such as Botulinum to relax the muscle
  • A plastic appliance such as a dental splint that is worn at night
  • Orthodontic (braces) adjustment to change the way your teeth bite together


Related to TMD, is excessive clenching or grinding of the teeth, known as bruxism, is often caused by physical or psychological stress or a sleep disorder. If untreated, bruxism can lead to excessive wear on the teeth and may cause permanent damage to the teeth and jaw joints.

Treatment involves repairing damaged teeth (such as restorations, crowns, or inlays to replace the damaged tooth surface) and subsequently creating an occlusal splint (night guard) made from hard plastic that fits over the upper or lower teeth, and is worn at night to prevent further wear of the tooth surfaces.

Tempromandibular Joint Pain

TMJ disorders are not uncommon and have a variety of symptoms. Patients may complain of earaches, headaches and limited ability to open their mouth. They may also complain of clicking or grating sounds in the joint and feel pain when opening and closing their mouth. What must be determined, of course, is the cause. We work with you to determine the cause and offer a range of options in order to reduce and deal with the issue before it damages your teeth.

Clenching and grinding teeth causes a variety of problems such as tooth wear, damage to dental restorations, dental sensitivity, migraines and tension headaches. Traditionally, a patient would be given a bite guard but, many have continued symptoms. Those patients eventually move on to medications and other therapies.

There are several options, such as Botulinum that can be used to immediately cease the clenching and subsequent headaches and jaw pain.

Dr Patel is trained in providing Botulinum treatment for  tempromandibular joint pain, TMD and associated issues.

Botulinum (Known commonly as Botox ®) can lessen the destructive effects of grinding and cease headaches associated with TMDs.

An extremely dilute form of Botulinum is injected to partially weaken muscles and has been used extensively in cosmetic procedures to relax the muscles of the face.

Bruxism can be regarded as a disorder of repetitive, unconscious contraction of the masseter muscle (the large muscle that moves the jaw). You can find this muscle if you place your hands on your face and clench firmly; you will feel them contracting. In the treatment of bruxism, Botulinum weakens the muscle enough to reduce the effects of grinding and clenching, but not so much as to prevent proper use of the jaw muscle for eating.

The optimal dose of Botulinum must be determined for each person as some people have stronger muscles that need more Botulinum. This is why you should always see someone specifically trained in the application of Botulinum for treatment of clenching.

Therapeutic Botulinum allows pain to be treated much more effectively and simply. Botulinum is used in dentistry to treat:

  • Myofascial pain
  • Headaches originating from chewing muscles
  • Bruxism
  • Masseter muscle hypertrophy
  • Trismus (inability to open jaw)
  • Gummy/asymmetric smiles

What is Botulinum

Botulinum is a prescription medicine which contains 100 units of botulinum toxin type A and is a natural, purified protein that is used therapeutically in dentistry to relax facial muscles to treat overactive masseter muscles or gummy smiles.

It has been widely used for medical conditions such as cross-eye, spasticity due to cerebral palsy, severe underarm sweating and more commonly for use in facial enhancement

How does Botulinum work?

Headaches are related to muscle contraction. Since Botulinum relaxes part of the facial muscles, they cannot be contracted fully therefore the pain is minimized.

What does the treatment involve?

Botulinum is administered by a very fine needle into the muscles that are causing the pain (eg. Masseters, temporalis, frontalis) with selected appropriate dose so that only part of the muscle is treated. The rest of the muscles still can function normally therefore chewing is mostly unaffected.. It takes a few minutes per side, and you can start to expect feeling the in 3-4 days and up to 7 days for the full effect to be felt.

No anesthetic is required since the procedure has minimal discomfort (a slight sting at the injection site). The treatment generally takes around 15 minutes for a full treatment.

Treating the Masseter muscle for Bruxism

Treating the Masseter muscle for Bruxism

How long does it last?

This varies from individual to individual but the effects last for about three months. Over time it is usually possible either to decrease the dose or increase the interval between treatments.

What are the Side Effects?

The amounts are carefully measured appropriately for your case and the injection site is very localized therefore the side effects are minimized.

Possible side effects include but are not limited to:

  • Headaches,
  • pain,
  • burning/stinging,
  • swelling,
  • redness,
  • bruising around the injection site.

Always use a trained professional.

Contraindications to using Botulinum:

  • Pregnancy or breastfeeding
  • If you have had Botulinum in the last 2-3 months
  • Allergy to albumin
  • Immunization to Botulinum
  • Have an infection, skin condition or muscle weakness at the site of injection
  • Have Eaton-Lambert syndrome, Lou Gehrig’s disease or myasthenia gravis[/expand]