Lena D. Karkalas, DDS
Creating Beautiful Smiles
Call: (401)861-2140

Thereputic Botox for TMJ



TMJ and Oral Facial Pain Therapy

If you suffer from moderate to severe headaches on a regular basis and are unsuccessful in finding relief or do not like the side effects associated with prescription migraine medications, the cause of your headaches could be  temporomandibular joint dysfunction or TMD. TMD disorders are a family of problems related to your complex jaw joint. If you have had symptoms like pain or a “clicking” sound, you’ll be glad to know that these problems are more easily diagnosed and treated than they were in the past. These symptoms occur when the joints of the jaw and the chewing muscles (muscles of mastication) do not work together correctly. TMJ stands for temporomandibular joint, which is the name for each joint (right and left) that connects your jaw to your skull. Since some types of TMJ problems can lead to more serious conditions, early detection and treatment are important.

No one treatment can resolve TMJ disorders completely and treatment takes time to become effective. Dr. Karkalas can help you have a healthier and more comfortable jaw.

Trouble with your jaw?

TMJ disorders develop for many reasons. You might clench or grind your teeth, tightening your jaw muscles and stressing your TM joint. You may have a damaged jaw joint due to injury or disease. Injuries and arthritis can damage the joint directly or stretch or tear the muscle ligaments. As a result, the disk, which is made of cartilage and functions as the “cushion” of the jaw joint, can slip out of position. Whatever the cause, the results may include a misaligned bite, pain, clicking, or grating noise when you open your mouth or trouble opening your mouth wide.

Do you have a TMJ Disorder?

  • Are you aware of grinding or clenching your teeth?
  • Do you wake up with sore, stiff muscles around your jaws?
  • Do you have frequent headaches or neck aches?
  • Does the pain get worse when you clench your teeth?
  • Does stress make your clenching and pain worse?
  • Does your jaw click, pop, grate, catch, or lock when you open your mouth?
  • Is it difficult or painful to open your mouth, eat, or yawn?
  • Have you ever injured your neck, head, or jaws?
  • Have you had problems (such as arthritis) with other joints?
  • Do you have teeth that no longer touch when you bite?
  • Do your teeth meet differently from time to time?
  • Is it hard to use your front teeth to bite or tear food?
  • Are your teeth sensitive, loose, broken or worn?

The more times you answered “yes”, the more likely it is that you have a TMJ disorder. Understanding TMJ disorders will also help you understand how they are treated.


There are various treatment options that Dr. Karkalas  can utilize to improve the harmony and function of your jaw. Once an evaluation confirms a diagnosis of TMJ disorder, Dr. Karkalas  will determine the proper course of treatment. It is important to note that treatment always works best with a team approach of self-care joined with professional care.

The initial goals are to relieve the muscle spasm and joint pain.  Self-care treatments can often be effective as well and include:

  • Resting your jaw
  • Keeping your teeth apart when you are not swallowing or eating
  • Eating soft foods
  • Applying ice and heat
  • Avoiding chewy or tough to eat food and not chewing gum
  • Practicing good posture

Stress management techniques such as physical therapy, massage therapy or chiropractic therapy may also be recommended. There are different types of appliances used for different purposes.  A splint (or nightguard) fits over your top or bottom teeth and helps keep your teeth apart and helps you stop clenching or grinding your teeth and reduces muscle tension at night and helps to protect your teeth from wear.  An Orthotic or anterior positioning stabilization appliance moves your jaw forward, relieves pressure on parts of your jaw joints and aids in disc repositioning to reduce joint sounds and helps your jaw to open and close comfortably. An Orthotic utilizes neuromuscluar healing techniques to provide headache tension relief. It may be worn 24 hours/day to help your jaw heal. Both appliances will help to protect from tooth wear.

Is the BOTOX Treatment for You?

We are also excited to announce that Dr. Karkalas is now providing BOTOX treatment to her patients as a cutting-edge alternative for facial pain and TMJ therapy.  BOTOX injections have proven to be very effective in relieving pain with TMJ disorders, reducing bruxism (griding of the teeth) and reducing or even eliminating tension type migraines.  The procedures mentioned above if used alone may fail to give you the relief you need, but adding BOTOX may be the answer.

Call Dr. Karkalas to help determine which therapy will most effectively treat your specific concerns



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