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Botulinum toxin is an approved preventive treatment for chronic migraine and an established treatment for jaw clenching, teeth grinding and the pain of temporomandibular joint dysfunction. At Rejuvenation Dermatology Calgary South, Dr. Paul Kuzel, a board-certified dermatologist and physician injector, performs both protocols.
The same product used for facial lines is used at different sites and doses to prevent migraine and to relax the jaw. The two indications work by related but distinct mechanisms.
Botulinum toxin is not a first-line treatment for occasional headache or mild jaw discomfort. It is indicated for defined conditions, and the assessment confirms that the condition is present.
Headache on fifteen or more days per month, of which at least eight have migraine features, for more than three months. Botulinum toxin is approved in Canada for this indication and is typically used after oral preventive medication has been tried.
Grinding or clenching, often during sleep, producing jaw ache on waking, tooth wear, morning headache and enlargement of the masseter muscles. Frequently identified by a dentist.
Pain in the jaw joint and surrounding muscles, clicking or locking, limited opening, and referred pain to the ear and temple. Where the muscular component is significant, masseter and temporalis injection reduces load on the joint.
Patients treated for bruxism frequently note a slimming of the lower face over two to three months as the masseter muscles reduce in bulk. This is a cosmetic effect of the same injection and is discussed at consultation.
Both treatments depend on correct patient selection, correct dosing and precise placement. The muscles of the jaw and the nerves of the head and neck do not tolerate approximation.
Each treatment takes ten to twenty minutes. Both are performed in clinic without anaesthetic.
A total of 155 units delivered as 31 small injections across the forehead, temples, back of the head, neck and upper shoulders, with additional sites where pain is concentrated. Repeated every twelve weeks. Most patients notice fewer headache days by the second cycle; the full effect is assessed after three.
Twenty to forty units per side into the masseter, identified by asking the patient to clench, and additional units into the temporalis where it is tender. Clenching force reduces over one to two weeks. Repeated at three to six month intervals, with the interval lengthening over time.
Bruxism is a recognised contributor to headache, and patients with both are commonly treated at the same visit. The doses are planned together so that the total remains within safe limits.
Botulinum toxin does not replace the rest of migraine or TMJ care. A night guard, physiotherapy, trigger management and preventive medication continue where they are in use, and Dr. Kuzel communicates with the physician or dentist managing them.
Migraines and TMJThe consultation confirms the indication and the treatment is typically performed the same day.
Side effects are usually minor and temporary. Knowing what is expected, and what is not, avoids unnecessary concern.
For chronic migraine, a referral or diagnosis from your family physician or neurologist supports coverage of the product under many drug plans. Referrals can be faxed to (403) 225-2914. The injection fee is quoted at consultation.
Bruxism and TMJ treatment can be booked directly and is quoted at consultation. Call (403) 286-6888 for fees and to check what your plan covers.
For chronic migraine, clinical trials show a reduction of roughly eight to nine headache days per month after two treatment cycles, with about half of patients achieving a fifty percent or greater reduction. Response is assessed after three cycles; patients who respond continue on a twelve-week schedule, and many report reduced headache severity as well as frequency.
For bruxism and TMJ dysfunction, jaw pain and morning headache typically improve within two weeks and remain improved for three to six months. Tooth wear stops progressing while the muscles are treated. Masseter bulk reduces over two to three months in patients with enlarged muscles, which slims the lower face.
Neither treatment is a cure. Both are repeated on a schedule, and the interval between masseter treatments commonly lengthens as the clenching habit weakens.
Botulinum toxin for chronic migraine is an approved indication in Canada, and the product is covered by many private drug plans and by Alberta's public drug plans with special authorisation, usually after oral preventive medications have been tried. The injection fee is separate and is quoted at consultation. The team will confirm what your plan covers.
No. Treatment of bruxism and TMJ dysfunction is not covered by Alberta Health Care and is quoted at consultation. Some dental plans contribute with a letter from your dentist; the team can advise.
A referral is not required to be seen. For chronic migraine, a diagnosis from your family physician or neurologist supports the coverage application for the product, and a referral can be faxed to (403) 225-2914. Bruxism and TMJ treatment can be booked directly.
Patients with chronic migraine: headache on fifteen or more days per month, at least eight with migraine features, for more than three months. It is not indicated for episodic migraine or for tension-type headache alone. If your headache pattern does not meet these criteria, Dr. Kuzel will say so and suggest the appropriate route.
For migraine, headache days begin to fall within the first cycle and the effect builds over the second and third; response is formally assessed after three treatments. For jaw clenching, the muscles relax over ten to fourteen days and pain improves within two weeks.
Yes. The dose reduces the force of clenching, not the ability to chew. Some patients notice fatigue with very tough or chewy food for the first two to three weeks, which settles.
Masseter injection reduces the bulk of enlarged jaw muscles over two to three months, which slims the lower face in patients whose masseters are prominent. In patients with normal-sized masseters the change is minimal. The migraine protocol does not alter facial shape, though the forehead injections soften horizontal lines.
Both treatments have a long safety record. Temporary side effects include bruising, neck ache after the migraine protocol, and jaw fatigue after masseter injection. Uncommonly, product spreads to an adjacent muscle and causes temporary eyelid drooping or an asymmetric smile, which resolves over weeks. Serious reactions are rare. Treatment is avoided in pregnancy, breastfeeding and certain neuromuscular conditions.
Yes. Bruxism contributes to headache in many patients, and the two protocols are commonly combined. The doses are planned together so that the total remains within the established safe range.
Dr. Paul Kuzel, MD FRCPC, a board-certified dermatologist and the founder and Medical Director of Rejuvenation Dermatology Calgary South, performs all injections personally. He sees patients in English and Czech.
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Book a consultation with Dr. Kuzel. A referral supports coverage for chronic migraine but is not required to be seen.
Rejuvenation Dermatology Calgary South
10201 Southport Rd SW #102
Calgary, AB T2W 4X9
Two blocks west of the Delta Hotel
(403) 286-6888
Referrals by fax: (403) 225-2914
Open seven days a week, with early mornings and evenings on weekdays.
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