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Hello. Two Part Question. Recently Had Botox Injection Into The

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Posted on Sun, 13 Sep 2020
Question: Hello. Two part question. Recently had botox injection into the face for a facial pain condition known as atypical odontalgia, done by a neuro surgeon. Lip on one side is hanging down now where I have to lift it to brush teeth, etc and wondering if that will abate in time. Real reason for my inquiry, though, is that my neuro surgeon said that for atypical odontalgia ( which is a constant dull ache between two teeth) - that the best injection site would be into the gums but an ENT would be most skilled to do this. Just wondering if u have ever heard of this. Thanks so much.
doctor
Answered by Dr. Dr. Rajat Basak (8 hours later)
Brief Answer:
Atypical odontalgia

Detailed Answer:
Hii. Welcome to the Ask A Doctor services.

Atypical odontalgia, also known as atypical facial pain, phantom tooth pain, or neuropathic orofacial pain, is characterized by chronic pain in a tooth or teeth, or in a site where teeth have been extracted or following endodontic treatment, without an identifiable cause. It is generally treated by a dental surgeon and not Ent surgeon. The most common treatment options are tricyclic antidepressants, gabapentin group of drugs. Botox can be a treatment but pain can recurr and may need repeated injection. So better to consult a dental surgeon and get an opinion and if needed to start tricyclic antidepressants and gabapentin prescribed by them

Please review if you have any queries.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Dr. Rajat Basak (8 hours later)
Hi, doctor. First, to preface, I am very glad u are so familiar with AO, describing it perfectly. I have had AO for close to 40 years now on the upper right side and have had every dental procedure done known to man (actually, too many) which has exacerbated the condition, not mitigated it. Have had RCanals, gum surgery of every kind, dental implants, you name it. Have seen two specialist dentists who are well versed in AO and have had various nerve blocks (Stellate ganglion), prescribed many meds over the years (Elavil, Neuontin, Cymbalta, Lyrica, Baclofen, Trileptal and a host of others), none of which really help and make me ill. The reason for my question to u is my neuro surgeon attempted botox injections into the face but no result and commented that botox may be yet an option but he does not inject into gums and that would need a skilled ENT for some reason. Just wondering if u have ever done this (into the gums) and any adverse effects? I believe he said an ENT since injections may affect tongue, sinus, swallowing reflex, etc so an ENT is needed.
doctor
Answered by Dr. Dr. Rajat Basak (2 hours later)
Brief Answer:
Hii. Ent surgeons generally use botox injection for vocal cord disorders. I

Detailed Answer:
Hii. Ent surgeons generally use botox injection for vocal cord disorders. In our practice we haven't seen too many ent surgeons using botox inj for a typical odontolagia. So dental surgeon will be the best to decide if you need botox injection or not. If he wants you to have botox inj then dental surgeon can get help from an ent surgeon while doing the procedure as botox injection can cause other complications like paralysis of vocal cords and others. So consult a dental surgeon and get a reference for ent surgeon while undergoing the procedure.
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.

Above answer was peer-reviewed by : Dr. Yogesh D
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Answered by
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Dr. Dr. Rajat Basak

ENT Specialist

Practicing since :2011

Answered : 801 Questions

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Hello. Two Part Question. Recently Had Botox Injection Into The

Brief Answer: Atypical odontalgia Detailed Answer: Hii. Welcome to the Ask A Doctor services. Atypical odontalgia, also known as atypical facial pain, phantom tooth pain, or neuropathic orofacial pain, is characterized by chronic pain in a tooth or teeth, or in a site where teeth have been extracted or following endodontic treatment, without an identifiable cause. It is generally treated by a dental surgeon and not Ent surgeon. The most common treatment options are tricyclic antidepressants, gabapentin group of drugs. Botox can be a treatment but pain can recurr and may need repeated injection. So better to consult a dental surgeon and get an opinion and if needed to start tricyclic antidepressants and gabapentin prescribed by them Please review if you have any queries.