To turn down Botox?

[lhastingsmua]

I suffer from severe jaw pain caused by TMJ disorder. I grind my teeth too. The pain is so severe that my jaw locks shut and I can’t open my mouth, I constantly get a sharp shooting pain in my ears and I wake up with a sore/painful jaw.

At a referral I was hoping for the consideration of oral surgery, but the consultant said my only options are to continue with my splint/painkillers, get Botox or a referral to physiotherapy

With Botox: it sounds worth a try to stop the pain but it is temporary, and I have concerns about my appearance. There is a significant chance I will end up with a lopsided face/smile. My current jaw appearance is normal, I don’t have a bulky masseter muscle; so my jawline will lose its current shape/definition and begin to round out from the side (imagine resting your chin on your chest).

With physiotherapy: I’m not sure how useful this will be as a lot of the exercises simply involve opening and closing the mouth, so a physiotherapist will have limited involvement.

AIBU to refuse to get Botox for vanity reasons? What would you do in my situation?

Won’t they make sure that you look ok and not lopsided? I would expect that.

I have Botox for wrinkles but I would turn this down due to apparent bone damage/ loss. Google it and you’ll maybe be able to decide that way. I too have terrible bruxism but won’t have it for that.

Mine isn't as bad as yours but I also said no to Botox

I've seen too many horror smiles, no idea what their Botox was for but even though I'm not stunning, I'm not doing that to my face, however low the risk.

But I was warned the opposite way, my cheekbones are high and I was told they might go higher and we all joked about me ending up with that sucked in face look.

I take amitryptaline which helps.

I have botox for wrinkles and think it is great in the hands of a skilled practitioner.

Can you ask to see examples of work done by whomever would do yours to see how it would look? I know you can get droopy face etc due to botox but surely it is quite rare? However if I had been told there was a 50% chance of it changing my face for the worst then yes like you I wouldn't be keen.

Actually thinking about it, they person who does mine really only does frown lines/crows feet with it as he said there was more chance of it going wrong around the mouth area. (I had asked about fine lines around my lips)

I turned it down too due to risk and just wear my bleaching trays at night now (no bleach in them). I spit the splints out while I sleep so theyre useless.

When having my mouthguard made I was told I may need botox in the jaw also. Fortunately I didn't. However my dentist said there were only 2 practitioners he would be happy to refer me to UK wide so I don't think your concerns are in any way unreasonable. I also briefly had low dosage Amitryptilene as part of the diagnosis process and it did dull the pain.

In your case with the severe locking I would take the botox. I know nothing about in the jaw though but see a lot of kids with cerebral palsy who have it to release tension in the leg muscles and it really does help. I think botox and specialist physio for your face while it's in effect would be the way to go

Is your jaw bad on both sides?

I had it on both sides twice, it was fine. The only reason I didn't carry on having it is because I have HMS and decided it was a bad idea. I would do it again in a heartbeat if they'd let me!

My smile wasn't quite as wide and I lost my dimples until it wore off after about 3 months. It was very painful when they injected it.

I had loads of physio too, along with countless other things. Botox was so so so much more effective.

There is more to the physio than you think though and you will probably be allowed to try both.

It doesn't go in the bone BTW, it goes in the masseter. No bone loss.

I have a similar problem and turned down the botox and surgery. I have a mouth guard from the dentist at night to keep my jaw openish, and also a weird exercise that I was given by my dentist that really helped me, and I always try it with patients with TMJ probs (I'm a physio - not a TMJ specialist though).

With your mouth closed, touch the tip of your tongue to the roof of your mouth, then slide it back as far as you can, keeping it in contact with the roof of your mouth. When you get as far back as you can, open your mouth as much as you can without letting your tongue lose contact with the back roof of your mouth. Hold open for 20 seconds. Repeat twice each morning and evening.

Don't go too hard at it at the start, or you will get a banging headache.

If you get a specialist TMJ physio, there are mobilisations they will do to the TMJ (like manipulations, but gentler) - or you could maybe try craniosacral therapy, which some physios do on the NHS or privately.

I hope you find something to help - it's frightening having to crack open your mouth when it seizes up, or waking up in agony

OP did you ask about the likelihood of side effects in your individual case? Could they be permanent or would they wear of as the Botox wears of?
If it went well medically how much difference would it make to life practically and longer term to your health overall? will you only get minimal extra movement in the jaw or slightly less pain or could it transform things?

It's very hard, but try to be honest with yourself about how your appearance affects your mood. If you would be badly affected mentally/emotionally by a side effect than acknowledging that is not vanity.

@Alienspaceship the thing is it will take a few weeks for the Botox to take effect so my consultant wouldn’t be able to tell if my face is asymmetrical until then. He’s a very experienced maxillofacial surgeon so I do trust his expertise - he really stressed the side effects and said many patients turn Botox down due to the risk

Thanks for all the replies, it’s very interesting to read about all your experiences.

@Bagadverts I believe the side effects would be temporary until the Botox wears off but I’ll definitely ask the consultant at my next appointment, thank you I’m sort of leaning towards trying it once and taking it day by day. At best, if my smile looks normal and my jaw looks off, I could look into jaw fillers to offset the aesthetics as the pain reduction would be worth it. If my smile is asymmetrical then I’d let it wear off and refuse further injections as I’d feel quite unconfident in myself then

Good to know that there’s more to physiotherapy than I first thought!

@ChristmasFluff thank you for the exercise. Can I ask why you turned down surgery? I know it can be experimental in terms of long term results but I would have loved the option honestly

I have had botox for this reason, there is no difference in my face to look at but it has helped with my teeth grinding SO much!

I would go for it, it lasts around 4-5 months so yes it doesn't last long but if you are worried about a wonky face it wouldn't last that long.

My muscles were huge, and they aren't now yet I still have the same chew and bite and I haven't seen a difference in my face. The pain caused is a lot less, and I noticed in 1 week. It doesn't take weeks.

@LighthouseSouth haha from looking online, a lot of people actually get masseter Botox to get that sunken in look! But I don’t necessarily think it looks good as they look lovely in selfies, but off in person as they end up with a weird jawline. I quite like my jaw/cheekbones so wouldn’t want to change it for the worse