BOTOX,

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Botox® is the trade name for Botulinum Toxin, a neurotoxin in the form of a purified protein. The mechanism of action for Botox is really quite simple; it is injected into facial muscles but really doesn’t affect the muscle at all. Botox works by blocking the transmitters between the motor nerves that innervate the muscle.

The areas typically treated with Botox to reduce the appearance of facial wrinkles on the forehead, between the eyes (glabellar region), around the corners of the eyes (crow’s feet), around the lips (smoker's lines or gummy smile), and can also be used to reduce the muscle tension in the masseters (jaw line). There is no loss of sensory feeling in the muscles. Once the motor nerve endings are interrupted, the muscle cannot contract, causing wrinkles in the skin to smooth. 

Botox has important clinical uses as an adjunct in facial pain and bruxism cases for patients with chronic Temporal Mandibular Joint Syndrome (TMJ) and orofacial pain. Botox is also used to complement esthetic dentistry as a minimally invasive alternative to surgery to treat conditions related to the TMJ, may also help prevent nighttime teeth grinding, patients that clench, and relieve chronic migraines. Botox takes between 2-10 days from injection to exert its clinical effect. 

Most common, re-treatment is between 3-4 months with a small percentage going considerably longer. Cumulative effect of long-term, regular use of botulinum toxin obtains best results and often patients will note longer duration of action in part of mild atrophy of the hyper-dynamic muscles and skin regeneration. As the effects wear off, strength gradually returns (along with the wrinkles caused by movement) but wrinkles are not any worse than baseline. 

To reduce the possibility of bruising/swelling, it is recommended to avoid alcohol for at least 24 hours and aspirin/anti-inflammatory medications for a period of two weeks prior to the procedure. As always, consult your physician before stopping any medications.

The most common side effects of Botulinum Toxin injections are bruising, redness, and swelling. Other, rare side effects are possible and will be reviewed by the treating doctor. To avoid adverse reactions/results, do not manipulate the treated area for 2 hours after injections and maintain an upright position.

The effects of Botulinum Toxin typically last three to four months. As the treated muscles regain movement, lines and wrinkles will begin to reappear and require retreatment. Over time, these lines and wrinkles should appear less noticeable due to training the treated muscles to relax.