Botox, Dysport and TMJ Part 1

December 2013

I contracted TMJ, (temporomandibular joint dysfunction) since 2001. This was a side effect after my braces in 1996. I had to seek pain relief with Botox for the last 2 years after failed remedies.

The dentist was Dr Vivien Tan.  Why I do not like her?

1. My original case file was with Singapore National Dental Centre in 1990s.  Weeks after going to this government dental centre, I received a call saying that Dr Viven Tan had privatized, set up her own private clinic and that my patient file would go with her.  The fees hence was increased from government rate to private patient rate.  I did not like the idea yet there was no option! I was told by the caller that I could not belong as a patient under Singapore National Dental Centre anymore.  Very ridiculous isnt it?  To date, I am suspicious if the call was indeed from Singapore National Dental Centre or if someone had stolen my records off the database to make me go to Vivien's private dental clinic. 

2. Dr Viven Tan hasten my entire orthondontic process. Heard most people took 2 years. Mine was 1 year plus only.  I even had to wear a X men head gear.  After my braces was taken out, whenever I go to various dentist for regularly 6 months check up, they would comment on how my teeth was over corrected.

3. God knows why she went into private practice, then now back to working in government hospital again. 

4. Subsequently I developed TMJ disorder where the left side of my jaw hurts so bad I cannot sleep at night. The pain would extend to the back of my ear and neck.  Have been to general practitioners, dentists, and ENT specialists.

The different specialists told me to try heat therapy, night splinters, mouth guards, painkillers, of which none worked. I  could understand why Mr Jim Rogers got so mad with Singapore Dentists.

http://www.businessinsider.com/report-jim-rogers-sues-a-cosmetic-dentistry-for-negligence-2012-6

http://nicolastang.com/2012/09/07/investment-guru-settles-out-of-court-with-dentist/

There are people who commented that "rich people like Mr Rogers have all the money to be nasty and go around suing people".   

Come on idiots, precisely, because he is rich, Mr Jim Rogers will know not to mince his words if he wants cosmetic dentistry instead of oral healthcare treatment. Jim's ailment was of his TMJ pain. Jim might have wanted pretty teeth too.  However, it would be weird for a dentist to recommend dental splints and ceramic bonding done at the same time.  It is even weirder if a dentist places cosmetic dentistry above the medical condition of TMJ, even if patient requests for it.

I have no idea why the SG dentist recommended ceramic bonding. Ceramic bonding or tooth shaving/recontouring might have been used to correct height or placement differences at the molars for TMJ disorder. But for Jim's case, it was reported as many 20 ceramic bondings were made?!  If a patient is suffering from TMJ, all dentists would know not to weaken the teeth with cosmetic procedures in consideration of future tooth recontouring???

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Back to my story.

I have been to various tests and X ray for my jaw. They tested me for cancer and thyroid, where all proved negative.

The ENT doctors at Singapore General Hospital finally recommended me an option which they do not perform. They told me I could consider botox to relax the masseter muscle.  I remember doing extensive research on botox after my consultation.  From knowing that Botox was used in military biochemical warfare, to the possible long term effects.

The pain outweight all consequences and I went ahead with the botox jab. It felt awesome.  For the period when the botox was effective, I was super happy and cheery. No pain, no soreness.

I hope Health Ministries from all over the world, especially Singapore, would read this.   TMJ patients are real patients with real health problems.  We NEED Botox not for vanity reasons.  Botox should be administered to TMJ patients at affordable rates and not at cosmetic enhancement procedure rate.  TMJ disorder can be so traumatising that one can get depression from it.    Please consider making botox cheap for TMJ patients like us.  

I understand Health ministries may have concerns that vain patients may lie that they have TMJ and go to various doctors for multiple botox shots.  This can be controlled with regulations -  Real TMJ patients can only obtain botox shots, twice a year, 2 shots each time, limited units, and must be accompanied with government ENT/dentist recomendation letter.

Read that there is another method call the TMJ flushing method.  Personally I am not a fan of this method as it assumes that you have inflammation at that area. Most of the time, TMJ pain has to do with the enlarged masseter muscles and joints irregularity and height of the molars.

Joint realignment surgery is a major surgery with plenty of risks. There is also the option of tooth recontouring where the molar is shaved down or heighten. The drawback is that outcome is by trial and error most of the time and the molar is weakened. Almost all dentists I have spoken with in Singapore have only HEARD about this method. Either dentists lack the expertise or such option is really is bad.   Which really leaves Botox as the only pain relieving solution.

Fellow TMJ sufferers, I am with you.  Please find the best doctors who can offer to you authentic botox at cheap rate.   For more information on Botox and fees, please refer to next blog.