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DENTISTRY By: Pedro J. Cuartas, DDS A dental office is probably the last place you would expect to find Botox used, especially because the most well known use for Botox in the last decade has been for its cosmetic benefits. However, there are many applications for Botox in dentistry. Ask yourself if either you or someone you know clenches or grinds their teeth, has headaches, or migraines. One of the mostfrequentlyencounteredproblemsseenindentalpatients today is excessive clenching, grinding, and recurring headaches/migraines. Much of this is probably due to the fast pace, high stress lives led by so many. As stress levels rise, alongwithotherpossiblefactors,apersoncanfindthemselves clenching or grinding their teeth with enormous amounts of force. These forces can be extremely damaging to the teeth, gums, jaw joints and related muscles. Some of the signs and symptoms of these excessive forces are cracked or chipping teeth, sensitive teeth, receding gums, unexplainable tooth aches,sorecheek,temporal,and/orneckmuscles,headaches or migraines. What options exist for people suffering with these symptoms? Most people are not aware that there are treatmentsavailable.Ifyoudoexperiencefrequentheadaches ormigraines,youshouldruleoutotherpossiblecausessuchas visionproblems,sinusinfections,orcertainneurologicaland vascularissues. If,however,youarenotdiagnosedwithanyof these other conditions, then you may consider the following options. The first option for patients is to reduce stress as much as possible. Finding the time to unwind is difficult for most people, but it would be extremely beneficial. Exercising and a healthy diet have been shown to go a long way in reducing stress.Regularexerciseandpropernutritionusuallycontribute tobettersleepaswell.Therapeuticmassagetherapymayalso offer great benefits. 4

The second option is to have some type of dental splint made. There are many types of dental splints available for clenching, grinding and headaches. The kind of splint made woulddependonthepatient’sparticularsignsandsymptoms and the dentist’s level of experience with these issues. Costs vary with these splints and can be worn on the upper or lower jaw. Most dental splints are very effective in reducing the damage excessive forces can place on the teeth, gums, jaw joints, and muscles. One of the most commonly stated drawbacks to the dental splint is in terms of comfort. Often times, patients find them to be bulky and take some getting usedto. Otherpatientshaveasensitivegag reflex and cannot tolerateasplint.So,althoughsplinttherapyisagreattreatment option, some people would simply choose not to wear them. The third option is employing therapeutic Botox. Botox is a naturalproteinandisthemostpowerfulmusclerelaxantwith the least side-effects. One desirable side effect, however, is thesmoothingoflinesbetweenthebrowsandintheforehead whentreatedinthisarea. Itaffectsonlythearea being treated and has no effect at all on the rest of the body. So, you may be

askingyourself,“HowdoesBotoxhelpwithexcessclenching/ teeth grinding, headaches and migraines?” Basically, Botox reduces the number of clenching/grinding events and their intensity. Asaresult,therearelessdamagingforcesappliedto the teeth, gums, joints, and muscles. There is a reduction of discomfort and pain in the face. Another benefit is the reductionoreliminationoftensionheadachesandmigraines that are the result of clenching/teeth grinding. The desired goal of reducing or eliminating pain is accomplished by relaxing the muscles responsible for generating the excessive, damaging forces. There are several commonly asked questions regarding the safety of Botox, the procedure, and the duration of treatment benefits.Asmentionedearlier,Botoxisextremelyeffectiveand safe. It only affects the treated area and if there is an adverse effect it is only temporary because Botox does not stay in the body indefinitely. Therapeutic Botox treatment is a simple, non-surgicalprocedure.Thedoctorwillhaveyoucontractthe muscleareatobetreatedsohe/shecandetermineappropriate injectionsite.Thetargetedinjectedareasmaybenumbedwith an ice pack or topical numbing agent. The doctor will

administer several tiny injections of Botox directly in the muscle. Only the injected areas will be“Botoxed”. It will not affect anywhere else in the body.The length of the procedure dependsonthenumberofinjectionsneededasdeterminedby thedoctor. Itisreasonablefortheproceduretobecompleted within 10-30 minutes. Muscle tenderness will start to disappear almost immediately. Pain and wrinkles begin to disappear within 24-48 hours after the injections. Results of Botoxgenerallylastuptofourmonths. Resultsmaylastlonger with subsequent treatments. For some people in this fast pace, high stress world, the combinationofallthreeoptionsmayofferthebestsolutionfor excessive clenching, headaches, migraines, and facial pain. If youhavebeensufferingwithanyofthesymptomsmentioned earlier, consult a Botox certified dentist and see if you are an ideal candidate for therapeutic Botox. In addition to the treatmentdescribedearlier,otherusesoftherapeuticBotoxin thedentalofficeincluderelaxingmusclesthatpreventmouth opening,relaxingupperlipmusclestoreduce“gummy”smiles, and reducing excessive and uncontrolled salivary flow.