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7 Things To Know If You’re Considering BOTOX® Injections For Your TMJ

Author: Donald Tanenbaum DDS MPH - Board-Certified Orofacial Pain Specialist at New York TMJ & Orofacial Pain

Date: October 28, 2020

As an orofacial pain specialist and an expert in the treatment of temporomandibular disorder (commonly referred to as “TMJ”), most patients who seek my care have been suffering from persistent jaw pain, tightness, and soreness due to overstressed muscles – often for years. Tension in the masseter (jaw) muscles are at the root of this disorder and can be caused by several factors, with bruxism being the most common.  

If you’re considering BOTOX® injections for your TMJ, there are a few things you should know.

Bruxism comes in two forms: awake bruxism and sleep bruxism. Awake bruxism is excessive contact of the teeth during the day. Your teeth should never be in frequent contact during waking hours. Consistently clenching or grinding your teeth while sleeping is called Sleep Bruxism. 

botox injection sites for TMJ, donald tanenbaum, tmj doctor nyc
Typical Masseter and Temporalis Injection sites (varies from person to person)

Orofacial pain specialists like myself have been carefully turning to BOTOX® injections for TMJ problems for the last few years. While BOTOX® injections were initially approved to reduce facial wrinkles and frown lines, the medical community has recognized its use to help patients who have migraines and other conditions, including TMJ. If you’re considering BOTOX® injections for your TMJ because nothing else has worked, here’s what you need to know and understand:

7 Things To Know If You’re Considering BOTOX® Injections For TMJ

1. BOTOX® Reduces Muscle Contraction

When injected into the masseter muscles, BOTOX® reduces their ability to contract fully. During the 3-4 months after you’ve had injections, your masseters will exert a lower amount of force than normal. While your brain may be telling your muscles to contract with a normal amount of force, as long as the BOTOX® is active, they simply can’t. 

2. BOTOX® Can Provide Some Pain Relief

When BOTOX® is injected into muscles, it causes the muscle to relax, and less lactic acid and other pain-producing chemicals accumulate. As a result, the nerve endings within the muscle tissue become less irritated and sends fewer pain signals to the brain. 

At the same time, BOTOX® also directly reduces the release of pain-producing chemicals (neuro-transmitters) by the nerve endings in the muscles. That’s one of the reasons why BOTOX® reduces pain in migraine sufferers. 

3. BOTOX® Stays Where It’s Put

When injected by a trained clinician, BOTOX® will not typically diffuse into neighboring tissues – as long as the proper volume and technique are used. 

To treat TMJ, BOTOX® injections typically go into your masseter and temporalis muscles, which are the muscles responsible for closing your jaw from an open position. BOTOX® is sometimes also injected into your lateral pterygoid muscles – the ones that allow you to open your mouth and move your jaw from side-to-side.

4. BOTOX® Is Not A Stand-Alone Treatment For TMJ

Symptoms such as jaw locking or clicking are usually caused by loose ligaments and changes in the position of your shock-absorbing disc. BOTOX® injections do not predictably help these problems. Nor can BOTOX® minimize inflammatory pain in your TMJs. 

Locking, clicking, and disc problems require a different level of care. Therefore, an accurate diagnosis is absolutely necessary before BOTOX® injections are considered. When chosen, BOTOX® is commonly complimentary to other TMJ treatments such as medication, oral appliances, exercises, meditation, and physical therapy. This is very important to understand if you’re considering BOTOX® injections for your TMJ.

5. BOTOX® Injections Should Be Administered By A Healthcare Provider Who Has A True Understanding of TMJ Problems

Knowing how to inject BOTOX® is only part of the equation. The practitioner doing the injecting must fully understand how the jaw works, the risk factors that lead to muscle pain and overdevelopment, and how a patient’s bite relationships relate to their jaw muscles. A trained dentist or dental specialist is likely best equipped to answer these questions and provide the education that is needed to assure treatment results. 

6. BOTOX® Injections For TMJ Are Not (Usually) A Once-And-Done Therapy 

Most people who end up having BOTOX® injections for TMJ have been suffering for many years. One series of injections alone will rarely if ever, solve the problem. Many patients who find relief after the first series of injections can see their symptoms return, particularly if the pertinent risk factors (what caused the problem in the first place) have not been identified and addressed. If you’re considering BOTOX® injections for your TMJ and plan for only one series of injections, you’ll likely be disappointed.

7. BOTOX® Injections Can Give You A Slimmer Jawline 

BOTOX® is becoming an accepted solution for people who are unhappy with the shape of their jaw. If your masseter muscles are enlarged due to bruxism or daily habits such as gum chewing, BOTOX® injections can be extremely helpful in slimming its appearance.

After a series of injections, BOTOX® will increase the amount of collagen and fat in your masseters and shrink the size of muscle fibers. This is why slimming occurs.  Along with muscle slimming, BOTOX® injections can also weaken the muscles making chewing more difficult. This is why a trained practitioner is advised.

BOTOX®: A Tool, Not A Cure 

BOTOX® injections for TMJ are not a cure. They are, however, a vital tool of orofacial practitioners like me. If your doctor or dentist has tried everything, and you’re still suffering, BOTOX® may be your next step. Make sure that the person who administers your injections is highly knowledgeable, skilled, and trained in using BOTOX® injections for TMJ. 

Choose carefully.

(Learn more here: All About BOTOX® For TMJ)

Live or work in New York City or on Long Island? You can schedule a consultation with me here or call 212-265-0110.


DISCLAIMER: The advice offered in response to your questions is intended to be informational only and generic in nature. Namely, we in no way offer a definitive diagnosis or specific treatment recommendation for your particular situation. Our intent is solely educational and our responses to your actual questions serve as a springboard to discussion of a variety of dental topics that come up in a day-to-day dental practice. Any advice offered is no substitute for proper evaluation and care by a qualified professional.

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