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Letter to the Editor| Volume 52, ISSUE 1, P97, January 01, 2014

Re: Sidebottom AJ, Patel AA, Amin J. Botulinum injection for the management of myofascial pain in the masticatory muscles. A prospective outcome study

Published:October 21, 2013DOI:https://doi.org/10.1016/j.bjoms.2013.09.015
Re: Sidebottom AJ, Patel AA, Amin J. Botulinum injection for the management of myofascial pain in the masticatory muscles. A prospective outcome study
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      We read with interest this paper which provides valuable evidence for the use of botulinum toxin as an alternative treatment for masticatory pain when conservative methods fail.
      • Sidebottom A.J.
      • Patel A.A.
      • Amin J.
      Botulinum injection for the management of myofascial pain in the masticatory muscles. A prospective outcome study.
      Br J Oral Maxillofac Surg. 2013; 51: 199-205
      However, we wish to draw clinicians’ attention to the fact that not all Primary Care Trusts (PCT) fund this treatment in the National Health Service (NHS). Our PCT views the paper as level C evidence
      • Centre for Evidence-Based Medicine (CEBM)
      Levels of evidence.
      Oxford University, 2009, March
      http://www.cebm.net/?o=1025
      and does not consider it adequate to overturn guidance from the National Institute of Dental and Craniofacial Research (NIDCR) in the United States of America, stating that more research is needed.

      US Department of Health and Human Services. National Institutes of Health. TMJ disorders. National Institute of Dental and Craniofacial Research. Available from: http://www.nidcr.nih.gov/NR/rdonlyres/39C75C9B-1795-4A87-8B46-8F77DDE639CA/0/TMJ_Disorders.pdf.

      It also notes that there is no reference to botulinum toxin treatment for temporomandibular joint (TMJ) pain in the relevant clinical knowledge summary of the National Institute for Health and Care Excellence (NICE CKS).

      The National Institute for Health and Care Excellence. Clinical knowledge summaries. TMJ disorders: secondary care treatment. Available from: http://cks.nice.org.uk/tmj-disorders#!scenariorecommendation:3.

      It is disappointing to note that this summary has not been revised since 2010.
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      References

        • Sidebottom A.J.
        • Patel A.A.
        • Amin J.
        Botulinum injection for the management of myofascial pain in the masticatory muscles. A prospective outcome study.
        Br J Oral Maxillofac Surg. 2013; 51: 199-205
        View in Article
        • Centre for Evidence-Based Medicine (CEBM)
        Levels of evidence.
        Oxford University, 2009, March (Available from:)
        http://www.cebm.net/?o=1025
        View in Article

      3. US Department of Health and Human Services. National Institutes of Health. TMJ disorders. National Institute of Dental and Craniofacial Research. Available from: http://www.nidcr.nih.gov/NR/rdonlyres/39C75C9B-1795-4A87-8B46-8F77DDE639CA/0/TMJ_Disorders.pdf.

        View in Article

      4. The National Institute for Health and Care Excellence. Clinical knowledge summaries. TMJ disorders: secondary care treatment. Available from: http://cks.nice.org.uk/tmj-disorders#!scenariorecommendation:3.

        View in Article

      Article Info

      Publication History

      Published online: October 21, 2013

      Identification

      DOI: https://doi.org/10.1016/j.bjoms.2013.09.015

      Copyright

      © 2013 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

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