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A toxin not toxic? Botox in dentistry and a factual evaluation of its merits and demerits

Pooja Vasudevan, Swati Setty


Background: Botulinum toxin has been known to humankind for ages but has not been gaining enough popularity until recent times. Initially, it was known to be nothing but threatening to its host, but through time, it has evolved and changed ones perception toward it by a breakthrough in medicine signifying some of the types of the known forms of toxin to be valuable assets. Although now very regularly used by people, it is most commonly known for its cosmetic value, little is the value for its clinical essence. Aim: The aim of this article is to throw light on the therapeutic aspect of this toxin and how if carefully used can result as a boon or ban subjective to case selection and individual variation post-close filtering by the clinician. Conclusion: This article will help one see this material through a new aspect, and it will give a perspective of its positive future usage but with great care attached to the thought of it being nonetheless a toxin if not handled rightly. Clinical Significance: The mention of its use for temporomandibular joint pain, bruxism, sialorrhea, and a host of other conditions from a more palliative and surgically adjunct nature through previous reports by various clinicians worldwide helps one think in the lines of its usage in the therapeutic aspect but also alerted to be used in caution.


Botox; botulinum toxin; cosmetic; dentistry; therapeutic

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Erbguth EJ, Naumann M. Historical aspects of botulinum toxin: Justinus Kerner (1786-1862) and the “sausage poison.” Neurology 1999;53:1850-3.

Segel HB. Travel Shadows by Justinus Kerner. Newcastle upon Tyne. Cambridge: Cambridge Scholars Publishing; 2014.

American Society of Health-System Pharmacists. Botulinum Toxin Type A. Available from: http// [Last accessed on 2018 Mar 06].

Srivastava S, Kharbanda S, Pal US, Shah V. Applications of botulinum toxin in dentistry: A comprehensive review. Natl J Maxillofac Surg 2015;6:152-9.

Göbel H, Jost WH, Arbeitsgruppe Schmerz im Arbeitskreis Botulinumtoxin der Deutschen Gesellschaft für Neurologie. [Botulinum toxin in specific pain therapy]. Schmerz 2003;17:149-65.

Sunil Dutt C, Ramnani P, Thakur D, Pandit M. Botulinum toxin in the treatment of muscle specific oro-facial pain: A literature review. J Maxillofac Oral Surg 2015;14:171-5.

American Academy of Facial Aesthetics. What is Bruxism: BOTOX® Treatment for Bruxism (n.d.). Available from: [Last retrieved on 2018 Mar 20].

Monroy PG, da Fonseca MA. The use of botulinum toxin-a in the treatment of severe bruxism in a patient with autism: A case report. Spec Care Dentist 2006;26:37-9.

Lee HJ, Kim SJ, Lee KJ, Yu HS, Baik HS. Repeated injections of botulinum toxin into the masseter muscle induce bony changes in human adults: A longitudinal study. Korean J Orthod 2017;47:222-8.

Nigam PK, Nigam A. Botulinum toxin. Indian J Dermatol 2010;55:8-14.

Rafferty KL, Liu ZJ, Ye W, Navarrete AL, Nguyen TT, Salamati A, et al. Botulinum toxin in masticatory muscles: Short- and long-term effects on muscle, bone, and craniofacial function in adult rabbits. Bone 2012;50:651-62.

Crowner BE, Torres-Russotto D, Carter AR, Racette BA. Systemic weakness after therapeutic injections of botulinum toxin a: A case series and review of the literature. Clin Neuropharmacol 2010;33:243-7.

Lakraj AA, Moghimi N, Jabbari B. Sialorrhea: Anatomy, pathophysiology and treatment with emphasis on the role of botulinum toxins. Toxins (Basel) 2013;5:1010-31.

Jeung IS, Lee S, Kim HS, Yeo CK. Effect of botulinum toxin a injection into the salivary glands for sialorrhea in children with neurologic disorders. Ann Rehabil Med 2012;36:340-6.

Layton TB. An unusual complication of botox treatment for sialorrhoea. Int J Surg Case Rep 2014;5:1072-3.

Chan KH, Liang C, Wilson P, Higgins D, Allen GC. Long-term safety and efficacy data on botulinum toxin type A: An injection for sialorrhea. JAMA Otolaryngol Head Neck Surg 2013;139:134-8.

Rao BL, Mohan TM, Punia V, Punia S. Role of botulinum toxin Type a in dental implantology: A review.annals and essences of dentistry. Ann Essen Dent 2010;2:136-9.

Kumar P, Khattar A, Goel R, Kumar A. Role of botox in efficient muscle relaxation and treatment outcome: An overview. Ann Med Health Sci Res 2013;3:131.

Kelly PE. Injectable success: From fillers to botox. Facial Plast Surg 2007;23:7-18.

Botox and Dermal Fillers for Every Dental Practice. Available from: [Last accessed on 2014 Jul 10]

Dinker S, Anitha A, Sorake A, Kumar K. Management of gummy smile with botulinum toxin type-A: A case report. J Int Oral Health 2014;6:111-5.

Al-Fouzan AF, Mokeem LS, Al-Saqat RT, Alfalah MA, Alharbi MA, Al-Samary AE, et al. Botulinum toxin for the treatment of gummv smile. J Contemp Dent Pract 2017;18:474-8.

Sandler PJ, Alsayer F, Davies SJ. Botox: A possible new treatment for gummy smile. Virtual J Orthod 2007;7:30-4.

Laser Therapy Spa. The Advantages and Disadvantages of Using Botox. Available from: treatment/the-advantages-and-disadvantages-of-using-botox. [Last accessed on 2015 Apr 08].

FDA Gives Update on Botulinum Toxin Safety Warnings; Established Names of Drugs Changed. FDA Press Announcement; 2009.

Rosenfield LK, Kardassakis DG, Tsia KA, Stayner G. The first case report of a systemic allergy to onabotulinumtoxinA (Botox) in a healthy patient. Aesthet Surg J 2014;34:766-8.

Article 2: What Happens if the Toxin Spreads. Available from: [Last accessed on 2011 Nov 27].


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