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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
      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.
      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.
      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
        • Centre for Evidence-Based Medicine (CEBM)
        Levels of evidence.
        Oxford University, 2009, March (Available from:)
      1. 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.

      2. 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.