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Repeated Injections of Botox into the Masseter Muscle... A Longitudinal Study

The authors of this study examined mandibular bone before and after subjects received Botox injections into each masseter muscle. These volunteers were healthy adults (22-48 years old), both male and female, who wanted injections to slim their faces.

Washington Post Article on TMD

The Washington Post recently featured an article on Temporomandibular Disorders. Below is an excerpt from that article and a link to the full story.

Partnering to Improve Chronic Pain Care

The National Institutes of Health (NIH) held three meetings this summer with the goal of developing the first public-private partnership (PPP) to develop safe and effective treatments for chronic pain, as well as new treatments for opioid addiction and overdose.

TMJ Patient RoundTable Project: Status Update

The TMJ Association is acting as the catalyst to develop the TMJ Patient RoundTable, a broad initiative to advance the interests of patients with temporomandibular disorders (TMD). It encompasses collaborations with all stakeholders and

Educational Brochures on Chronic Overlapping Pain Conditions

This brochure addresses what are Chronic Overlapping Pain Conditions (COPCs), how COPCs are diagnosed, the complexity of the chronic pain experience, and how to work with your health care provider to develop a treatment plan. It is available by postal ma

Janelle's Story

  • May 13, 2015

I had probably been dealing with TMD for two years before I first took action in the Fall of 2008. It started out as severe ear pain that I noticed most when I ran outside. I thought it might be caused by the wind, so I would wrap my ears with an athletic band and wear headphones. Finally, the pain was so intense and persistent that I decided to visit an Ear, Nose, and Throat (ENT) specialist. When the ENT reported nothing abnormal in my ears, I think he could tell how confused and disappointed I was. Fortunately, he did something different. He pressed two gloved fingers firmly on the insides of my cheeks. When I yelped out in pain, he explained that the issue was actually my temporomandibular joint, or TMJ, and that TMJ pain often presents as ear pain. He then informed me that he could not treat me and referred me to my dentist.

The Long, Winding Road of Information and Treatment

My dentist suggested applying heat to my face, and when I explained that I had already been doing so, he advised alternating hot and cold packs. He also told me to relax and that the condition, which he called bruxism, was due to stress. He advised me to take the maximum dosages of over-the-counter (OTC) pain relievers—something I would hear repeatedly for the next several years.

After about a month, my pain greatly diminished even though I wasn’t taking OTC drugs; heat only alleviated the pain for about an hour, and cold was ineffective. Two more years passed before my next painful episode, but this time it came with hives as well as foot pain and discoloration. I was referred to a rheumatologist who told me that my symptoms were caused by stress. He recommended anti-anxiety pills (which I couldn’t afford) and told me to take any and every OTC I could buy.

Traveling with TMD

Summer came and I tried to relax as much as possible. In June, my new husband and I were traveling to Romania for a second wedding ceremony with his family. It was all I could do to find a wedding dress as my pain progressed to the point that I could not chew anything at all. Though my husband’s family was gracious and understanding, we quickly discovered that Romania does not have many pureed or chew-free foods. During the wedding, everyone seemed touched that tears streamed down my face. Little did they know that it was pain that was causing them.

My first glimmer of hope occurred the following day. One of the wedding guests worked for a dentist and gave me an arthritis medication called Piroxicam. The pain and swelling went down, and for short periods I was able to eat semi-solid food.

Back to the Dentist

My pain returned and I began to lose weight, so I visited my dentist again after returning home. He suggested Botox. Putting aside the expense of the procedure, my dentist seemed more focused on improving my appearance, rather than reducing my pain. I decided against it after my research concluded that Botox has no known efficacy for relieving bruxism or TMD. He did prescribe a muscle relaxant, which gave me some relief, and made me a nighttime bite guard. I was able to perform well on my final exams in school; however, these treatments were not a long-term solution.

Rays of Hope

A few weeks before midterms, my pain returned. My dentist suggested taking X-rays to see if I had a bad tooth. There was no way it was a bad tooth after all this time, so I knew he had run out of ideas.

My husband and mom, unable to see me in so much pain, spent an entire day calling different dentists, orthodontists, and oral surgeons. Finally, we reached a dentist self-described as a TMJ specialist. At the consultation, he explained that my TMJ socket was probably dislocated. He planned to do X-rays and put in a daytime appliance. While I was still very skeptical, I realized that this dentist was my last hope to graduate on time, or at all. I had X-rays, which concluded that my left jaw joint was compressed. Though I had read on The TMJ Association’s website (as well as in other resources) that TMJ splints rarely work long term, I decided to try the daytime oral appliance. My top and bottom teeth have not touched one another since.

I finished the semester strong, graduating Summa cum Laude. During my last year of school, I had become increasingly involved with the TMJA. The complexity of my TMD led me to the TMJA first for information. As part of a final project for school, I had to partner with and file a grant application for a small non-profit organization. I chose the TMJA. Though it has taken longer than expected, I am anticipating submitting a final grant proposal on behalf of the TMJA by the end of this year.

Though I am not pain-free and remain nervous for the future, finding a cure has become a critical goal for me. To this end, I'm committed to helping The TMJ Association. With the new job I started, I am eligible for gift-matching from my company; so if I make a donation, it'll be doubled. Since maintaining a healthy diet is difficult for many TMD sufferers (myself included!), I have also been working with TMJA and a dietician at Froedert Hospital in Milwaukee to produce a nutrition brochure. I have felt empowered working towards more understanding of TMJ disorders and encourage other patients to take control of their condition in a way that makes the most sense for them.

©2015 The TMJ Association, Ltd. All rights


In Treating TMJ

To view or order a free booklet about TMJ Disorders, visit the National Institutes of Health website.

U.S. DEPARTMENT OF HEALTH & HUMAN SERVICES
National Institutes of Health
National Institute of Dental and Craniofacial Research
Office of Research on Women's Health