• Home
  • Pain Management Services
  • Esthetic Services
  • More
    • Home
    • Pain Management Services
    • Esthetic Services
  • Home
  • Pain Management Services
  • Esthetic Services

Pain Management Services

  Dr. Damon Spencer, DDS is a recognized leader and over his career he has received patient referrals from more than 4000 physicians, dentists, ENTs and physical therapists. 

Thanks to extensive experience and study in the realm of orofacial pain, Dr. Spencer is able to provide a level of care and expertise you simply won’t find anywhere else.

Click to call and schedule an appointment

Botox

Botox® has been approved by the FDA since 1989 and has a long-established record as a very safe medication. It is used for a variety of temporomandibular joint disorders, muscle disorders and nerve pain. Botox® is very useful in the treatment of:


  • Headaches
  • Chewing pain
  • Tooth grinding and clenching 
  • Muscle pain or spasm
  • Ear pain
  • Orthodontic pain
  • Trigeminal neuralgia
  • Diabetic neuropathy 
  • Cosmetic and wound healing issues 
  • “Gummy” smile


How It Works:

Botox® temporarily blocks nerve signals to overactive muscles, preventing them from fully contracting. This reduces muscle tension and pain. Dr. Damon Spencer is a highly trained and experienced provider of Botox®. His extensive knowledge of facial and neck anatomy combined with judicious dosing is the key to success.

Dr. Damon Spencer is an expert at diagnosing and treating different types of headaches.

Migraine Headache

  • Three times more common in females, usually 15-40 years of age. 
  • One side of the head is involved. 
  • Often starts with an “aura” such as seeing stars or swirling vision. 
  • Pulsing pain 
  • Moderate to severe pain. 
  • GETS WORSE WITH ACTIVITY. 
  • Comes on slow and lasts 4-72 hours. 
  • There are numerous variations in how a patient experiences a migraine. 


Common triggers for migraine:

  • Estrogen fluctuations
  • Stress 
  • Neck muscle pain
  • Certain foods
  • Certain aromas
  • Alcohol
  • Caffeine

 

Treatment should include addressing possible triggers listed above. There are several medications available to treat migraine. Several classic medications have a long history of success. They are usually more economical. 


Botox® is often an excellent treatment choice. Many migraine patients wish they had tried Botox® ten years earlier. There are several new medications that are migraine-specific that are often very effective when other medications have failed. They are not considered to be first-line treatment as they are significantly more expensive. Contact Dr. Damon Spencer for an examination to discuss your headache history, symptoms and a variety of treatment options. 

Tension Headache

This is the most common headache

  1. Usually affect people 15-40 years of age.
  2. Affects women and men nearly equally. 
  3. 30 minutes to several days in duration. 
  4. Involve both sides of the head, and often feel to be squeezing the head similar to wearing a hat that is too tight.  
  5. DOES NOT GET WORSE WITH ACTIVITY. 
  6. Triggered by stress, alcohol, caffeine and lack of sleep. 
  7. Triggered by painful muscles from clenching of the teeth or poor posture.  


Dr. Spencer is an expert at treating tension headaches. 

Successful treatment begins with a thorough examination and diagnosis. Treatment involves addressing possible causes for the headache as listed above. Physical therapy, either at-home or in-office, can be very helpful. 


Prescription and non-prescription medications can be beneficial. Trigger point therapy for involved muscles is a special skill of Dr. Damon Spencer. Botox or a dental appliance may be helpful. Make an examination appointment with Dr. Spencer to discuss your symptoms and treatment options. 

Cluster Headache

Cluster headache is considered the worst pain known to man. It is the least common type of headache, and the one type which is more common in men. 

 

  • It affects up to 4 in 1000 people, similar to the incidence of multiple sclerosis and Parkinson’s disease.
  • It affects more men than women, making it unusual among headache disorders.
  • A family history of cluster headache is rare (only 3–5% of cases are hereditary).
  • The  word ‘cluster’ refers to a period of time (weeks or months) during  which the individual suffers repeated attacks (cluster periods or  bouts). The start of bouts often coincides with changes of the season and recurs at the same time each year.

 

Attacks consist of a severe stabbing pain rapidly rising to an unbearable intensity, usually lasting between 15 and 180 minutes. It typically affects one side of the head near the eye or temple. The pain is often likened to a ‘hot poker’ penetrating one eye.


 Out of a number of symptoms at least one will also occur during an attack:

  • Eyes may become red and watery.
  • Nasal congestion.
  • Running from the nostril.
  • Forehead and facial sweating.
  • Constriction of the pupil.
  • Drooping or swelling of the eyelid.
  • Physical agitation and tendency to move around.


The exact cause of cluster headache is unknown. One of the main differences between migraine and cluster headache is that the person with cluster headache, becomes agitated during an attack and is unable to sit or lie down.

 

A migraine patient is typically looking for a darkened room and wants to lay down. 

Where a migraine can last up to 72 hours, a cluster headache lasts less than 3 hours with the intensity of the pain peaking within a few minutes and reducing quickly at the end of the attack.

  

Diagnosis: There is no special test to diagnose cluster headache so Dr Spencer will need to take a very detailed history of all your symptoms in order to make  the correct diagnosis. You may be referred for an MRI or CT scan to rule out other causes of the sudden onset of pain. Thankfully, this is an infrequent condition and is not life threatening. 


Triggers: Alcohol. Nearly all cluster headache sufferers are heavy smokers. 


Treatment: There is currently no cure for cluster headache, but available treatment has become much more effective in recent years. There are several medications that can be effective in treating cluster  headache and preventive medications are showing promise. Contact Dr. Damon Spencer if you suspect cluster headache. 

TMJ

“TMJ”  is actually a collection of numerous conditions called  temporomandibular disorders (TMD). The most common problems are discussed throughout this website. 

TMDs generally involve:

  1. Pain in muscles of the face and neck
  2. Pain within the jaw joint (noise or locking)
  3. Nerve pain. 
  4. Any combination of the above


Approximately 40% of the population have muscle pain.

Approximately 30% of the population have abnormal noise or locking in their jaw joint. 

A significantly smaller percentage of the population have nerve pain. 


The patient will receive a thorough examination from Dr. Spencer.  He will spend a minimum of 45 minutes on your examination. A good exam yields good information and directed treatment. Treatment should be conservative in nature. Less than 5% of temporomandibular disorders require surgery. 

Conservative treatments include:

  • No treatment 
  • Physical therapy
  • Medications, including Botox
  • Trigger point injections 
  • Steroid injections 
  • Occlusal appliances (nightguards)


A specifically designed “nightguard” can be very effective in reducing joint or muscle pain. One size does not fit all. Dr. Spencer utilizes several styles of nightguards depending upon the need of each individual. Relief begins with thorough examination and thorough discussion with Dr. Damon Spencer. Help is only a phone call away. 

Trigeminal Neuralgia

Trigeminal neuralgia usually occurs on just one side of the face, typically in people over 50 years of age. It is somewhat more common in women than men. It most often occurs in the lower jaw followed by the upper jaw and very occasionally in the temple. There are variations of neuralgia that can occur within the tongue or at the back of the head. Most patients report that their pain begins spontaneously and seemingly out of nowhere. Other patients say their pain follows a car accident, a blow to the face or dental surgery. 


Two types of neuralgia:

Most common: Episodes of intense, stabbing, electric shock along a nerve which lasts a few seconds to a few minutes. After a brief recharge period, the shock can come again. This is often confused with a toothache and might result in unhelpful dental procedures. Symptoms are more common during the daytime and less common at night. 

Less common: Constant burning (or prickling) pain that is less severe. 


A tumor or multiple sclerosis must be ruled out as they can have similar symptoms. An MRI is always needed and the patient should be tested for MS if they are significantly younger than 50. 


Neuralgia is most often successfully treated with medication, but intractable cases might require surgical intervention. Dr. Damon Spencer is skilled at identifying neuralgia and navigating the various treatment options available. Please make an appointment for an examination if you suspect neuralgia.

Tinnitus

Tinnitus (ear ringing) is a condition most often treated by an orofacial pain specialist like Dr. Damon Spencer. Relief starts with a thorough examination and accurate diagnosis. 


Tinnitus is most often a PERCEIVED ringing in the ears and not really an audible sound. 

It occurs in 10-15% of the population.  Prevalence increases with age. IT IS NOT USUALLY A SIGN OF SOMETHING SERIOUS.  It is overwhelmingly associated with hearing loss. Dr. Damon Spencer will perform an extensive examination to determine cause, and discuss treatment options.

 

There are NO FDA approved medications specifically for the treatment of tinnitus, but used “off label”, several medications have shown to be helpful. 


Danger signs involving tinnitus are:

  • Tinnitus that occurs suddenly, especially in one ear. 
  • You have hearing loss or dizziness with the tinnitus


Two General Types of Tinnitus 


OBJECTIVE: MUCH MORE RARE, could be caused by:

  1. Atherosclerosis: measurable, turbulent, blood flow (an actual sound) a.k.a, pulsatile (pulsing) tinnitus. 
  2. damage to hair cells of the inner ear propagating false impulses
  3. Acoustic neuroma- a benign tumor that grows on the nerve responsible for hearing. 


SUBJECTIVE: not an actual sound, and this is by far the MOST COMMON.  

It is often caused by:

  1. age-related hearing loss 
  2. noise trauma
  3. Otosclerosis (middle ear bone stiffening)
  4. muscle spasms in the inner ear 
  5. ear wax build-up
  6. Eustachian tube is stuck open (a “patulous” ET is quite RARE)


Medications known to cause or worsen tinnitus include:

  • Antibiotics
  • Cancer medications 
  • Diuretics 
  • Quinine medications
  • Certain antidepressants
  • Aspirin (usually 12 or more a day)
  • Nicotine
  • Caffeine 


Tinnitus was found to be 8x more common in patients with TMJ symptoms. 

Self treatment: Distracting  sounds such as a fan, low-volume radio static, or soft music may make tinnitus more tolerable. Relaxation, biofeedback, and exercise may also help you tolerate the ringing. 

Clinical Treatment: Medications used “off label” that have proven effective. 

  • Botox®
  • Smooth thread therapy for involved muscles. 
  • Trigger point therapy for facial and upper quadrant muscles. 


Come see Dr. Damon Spencer for a complete examination. After gathering good information, together we will discuss what treatment is most likely to help you.   

Trigger Point Injections / Botox® Injections

In short, trigger point injections or Botox® injections can both be very effective for muscle pain and headaches. Dr. Damon Spencer is skilled at providing both of these treatments. Often, a combination of these therapies is most effective. 


A trigger point injection consists of an anesthetic and is often combined with a steroid. Dr. Spencer will take time to precisely locate painful knots in your facial, neck or shoulder muscles.  Precise placement can often relieve pain immediately. Trigger point injections have been proven safe and effective with over 60 years of widespread clinical use. The key advantages of trigger point injections are cost and speed of relief. These injections are significantly less expensive than Botox® and can often provide relief in a matter of minutes. 


Botox® is botulinum toxin which in injected judiciously into musculature. Botox® works by paralyzing some, but not all, contraction in targeted  muscles. The effects of Botox® last for several months. It can be effective in relief of pain and headaches, but is not necessarily the  first or only choice. Botox® will typically work longer than trigger point therapy, but might take a week or two to reach peak  effectiveness. 


Either trigger point injection or Botox® injection works best when combined with other modalities such as massage, physical therapy or muscle relaxants. Talk with Dr. Damon Spencer to decide which approach might be best for your pain.

Burning Mouth Syndrome

(or ear, tongue, etcetera). Most common in peri- or post-menopausal women, 50+. 

Sources/Causes:

  1. Damage to nerves that control pain or taste
  2. Dental procedure 
  3. Xerostomia (dry mouth) 
  4. Vitamin deficiency 
  5. Sjögren’s syndrome 
  6. Certain blood pressure medications 
  7. An inflammatory reaction 
  8. Menopause
  9. Diabetes 
  10. Hypothyroidism
  11. Lichen planus


TREATMENT FOR BURNING MOUTH:  

There is no definitive treatment. 

Common initial treatments are ice chips, cold water, avoid alcohol. 

If initial treatments are ineffective, there are several medications that can be helpful. 

Dr. Damon Spencer is specifically trained and experienced with these types of issues. Please make an appointment to see Dr. Spencer for help in managing these troublesome conditions. 

Click to call and schedule an appointment

Copyright © 2026 BOTOXOLOGY - All Rights Reserved.

Powered by

This website uses cookies.

We use cookies to analyze website traffic and optimize your website experience. By accepting our use of cookies, your data will be aggregated with all other user data.

Accept