Beyond Wrinkles: What you should know about using Botox to manage TMJ-Related Pain

When most people think of ‘Botox’ the first thing that comes to mind relates to its cosmetic application to treat forehead wrinkles and ‘crow’s feet’. What many people don’t know about Botox is that it can also be used quite predictably to manage TMJ-related pain and muscle dysfunction. Indeed, over the past few years I have had a lot of success using Botox to treat patients with TMJ problems, large jaw muscles and/or facial pain. Like any treatment, it cannot be used for everyone; but I can attest that it is quite effective in helping to manage many different TMJ-related problems. If you are considering getting Botox to manage TMJ pain, or are a dentist or physician considering administering it to your TMD patients, here are some things to keep in mind:

First, more-conservative treatment options should be explored before considering Botox. Despite being a surgeon, I always try to render conservative, non-surgical treatment before considering injections or invasive surgery. The core value of our profession, primum non nocere or ‘first, do not harm’, guides me here: I would never risk harming a patient with injections or surgery who could otherwise be treated less-aggressively. Non-surgical therapy for TMJ typically involves making a special night guard that fits on the teeth, prescribing medication therapy, adjusting the bite or making a referral for jaw physiotherapy. If done right, these therapies work great to alleviate pain in the majority of patients. I only consider Botox to treat the small percentage patients who have tried these treatments yet still have pain, including those patients who cannot tolerate a night guard.

A caveat to above principle is when Botox is used as a first-line therapy to treat big, over-worked, over-built, unaesthetic jaw muscles. Your jaw muscles are like any other muscle in your body – they grow bigger with use and over-use; however, unlike a desirable ‘6-pack’ or ‘buns of steel’, excessive jaw muscle growth is not aesthetic and can be quite uncomfortable. In these cases, Botox can be used quite predictably to reduce muscle bulk and produce a flatter, more-natural jaw line. Bear in mind, though, that if the cause of the muscle growth is not addressed, the muscles will continue to grow despite repeated injections. Also know that may take multiple injections over the course of a year to produce the desired aesthetic result.

Finally, be sure of your diagnosis before getting (or giving) Botox. Certain types of muscle pain will not respond to Botox as predictably as others. Botox works really well to treat muscles that hurt and have been over-worked as opposed to muscles that hurt and have not been over-worked. If your muscles hurt and have not been over-worked you may want to speak to your doctor or surgeon about treatment options that do not involve the administration of Botox.

As you can see, Botox can be used for more than just smoothing wrinkles and making people look younger. Indeed it has many applications related to the management of TMJ-related facial pain and excessive jaw muscle use and growth. That being said, it is not a universal cure. Professional evaluation and diagnosis is the key to solving most TMJ- and facial pain-related conditions. Talk to a specialist about if Botox is the right treatment for you.