Teeth Grinding Treatment by Dr Rivkin (Los Angeles)

[spinceara]

interesting

[YoungalQeadaGeneral]

i started grinding when i was 18 by the time i was 22 my upper front teeth were pretty much all worn and visible at the bottom ,now when i eat i get cracking sound or when i lie down on my left side i can hear a grinding sound in my right ear.the worse thing is when you wake up you have a hard time opening your mouth and speaking from all the grinding.it sucks

[Barooze]

Clearly this is what Charice had done...

[cdsunwow]

have had TMJ for quite sometime now. also after 2 surgeries, very little to none relief. anybody know of any clinical studies in the LA Riverside area??? thanks

[connie59do]

Can this be cover by medical/dental insurances?

[arivkin9]

sometimes, it depends on the insurance. it is pretty rare, though

[dana102083]

Hmmm I have very severe TMD and have had excruciating pain over the last 2.5 years with no releif from non invasive procedures. I just saw a surgeon today and this was his advice, which he does himself-- I'm amazing with all my internet searches and talks with specialists that this has never come up!! I have pain from the top of my head to my shoulders mostly on my left side and have fatigue and chronic sleep problems... Its completely changed my life, and I want it back! I hope this helps...

[bronx43]

Hi, how long does it take for the Botox to decrease the hypertrophy caused by bruxism? Thanks.

[arivkin9]

hi

it takes several sessions of botox injections. usually you will see significant decrease in size within 2 sessions - i.e. 4 to 6 months.

[a217andy]

i think if you massage the masseter muscle this would help.

[ciararavenblaze]

@a217andy it does help, but it doesn't help nearly as much.

[DLPBurke]

@ciararavenblaze plus it has risks plus it isn't permanent. I have had a better idea recently and I am testing it out.

[ciararavenblaze]

@DLPBurke details, man! details!! fellow bruxism sufferers want to know!

[DLPBurke]

@ciararavenblaze It might not work, but the idea is to force your brain to change its habit based on pain. If you place your thumb in your mouth while you sleep, yes you feel like a dick head, but as soon as you sleep and grind, you wake up through the pain of biting the thumb.,

It may be possible over time that your brain is conditioned not to grind.

[DLPBurke]

@DLPBurke I made this idea up.... I do not know it it will work but I am trying everything. A thicker mouthguard would help me, this thing I have, I just grind instead.

[Seagee48]

Thanks Doctor. I just came across a Baylor trial recruiting participants where they will inject 60u in each masseter and 35u in each temporalis. I often have pain in my temporalis from my bruxism. Do you ever inject there as well?

[arivkin9]

yes, i do inject there commonly - it works. however, i usually inject alot less than 60 units per side. i start with 20 and put in more as needed. just be careful.

[themakeupfreak]

Are there any good doctors in NYC (Manhattan) who can help me with this?

[arivkin9]

unfortunately, i do not know any.

try looking on the allergan website for the biggest botox users and try calling their offices. if anyone does it, they should. the weather in LA is nice, though, so if you have to come out, you can make a mini-vacation out of it!

[Silv3rsail0r]

Can you use botox in the upper part of the masseter? My jaw muscles always been stronger(bulkier) in that area giving me a more roundish face that I don't like.

If you can use it in the upper part would the lower masseter still keep its bulk?

[arivkin9]

well, botox does spread about a centimeter from the point where it is injected. it is certainly worth a try.

[ceciliam23]

Hello. I live in DC. If you know of anyone in DC, Maryland or Virginia who could help me with this, I'd be grateful.

How do I know if I doctor has enough experience to do this procedure?

[arivkin9]

there's a doctor near you named dr george bitar who should be able to help.

[ceciliam23]

I talked to Dr. Bitar. He called me back personally and was very interested in botox as a treatment for TMJ but said he's never done it & he couldn't help me. He did say that I should let him know how it turns out if I get it done. Very nice man!

[arivkin9]

he is.

well, i'm happy to help you myself if there is no-one in your area.

[mikeasavage]

Who would you recommend for this procedure in the Chicago area? Both dentists that I have seen want to take a different approach.

[arivkin9]

the only guy i know in chicago is steve dayan. he is an experienced injector and should do a great job. otherwise, just look on the allergan website for the busiest botox injector in your area.

[mikeasavage]

Thank you! I have made an appointment to see him. Have you worked with using Marcaine and Kenalog along with the Botox injection to help with the immediate jaw pain?

[arivkin9]

sure, that sounds like a fine idea.

much of the time, the botox kicks in within a few days, but if it is acute, the marcane and kenalog will help.

[mikeasavage]

DR. - I went and saw Dr. Dayan and I have had about 70% reduction in pain except I still have quite a bit of swelling around the ears that still effects hearing/pain. He said he does not use Marcaine or Kenalog. He used 30 units per side - he said that was a moderate amount and that I may need more due to the size of the masseter muscle. Could more help the pain? It definately has improved but not all the way.... it has been 16 days since it ewas done.

[arivkin9]

it sounds like you had a great treatment.

he is rightly conservative.

yes, more botox will get you to the proper level of relief

it has been enough time for you to evaluate the results.

[HiTmAyKa87]

could I jus go to my normal doctor/ physician?

[arivkin9]

usually not - they don't have much experience with this procedure.its not rocket science, but the doc should have experience.

[HiTmAyKa87]

So where do I go to get the botox?

[arivkin9]

i would go to a doc experienced with botox injection in general and injecting the masseter muscle in specific.

[wingyluu]

i also grind teeth and have tmj

but do we have to do multiple sessions of botox or is it a one time thing?

so..doing this could help the tmj, teeth grinding, and a smaller jaw line??

[arivkin9]

its usually a couple of sessions of botox, separated by about 3 months. that usually breaks the habit of grinding and you don't need it nearly as often. it will help tmj and grinding, but will not augment the jawline. jawline augmentation needs filler like radiesse.

[peruvian31495]

Like what can you do if you chin goes to the left..for some people their chins just doEs that when they yawn..but my chin is 24/7 like that and it gets worse when i talk..i had TMJ since i was 12..now im 14..do i need surgery or what??

[arivkin9]

not necessarily. i would talk to your dentist to know for sure.

[HotSiracha]

too many bjs

[LJHaywood]

I was expecting an injection into the temporalis, not the masseter - I wonder if it depends on the patient?

[arivkin9]

it does depend. most people need just the masseter and do not need temporalis, but occasionally it is necessary to do both.

[down2marsAngel]

If it's for larger size masseter muscles, how many unit you supposed to inject?

How long does it take to see the result?

[arivkin9]

i start with 20 units per side and then see the patient back in 2 weeks or so to make sure that its enough.

if necessary, i then inject more. it should take a week to see the results, but its not always something you need to do regularly. after we do it a few times, you may not need it again for a long time because we have broken the habit of grinding.