Botox quickly gained an excellent reputation for its ability to fight fine lines and wrinkles. Now, the neuromodulator has been applauded for its ability to: help realign lazy eye (when injected into a key eye muscle); give the appearance of a more elongated face (when injected into the chin); alleviates hyperhidrosis (aka excessive underarm sweating); migraine relief; and even take the edge off an overactive bladder. Additionally, if you suffer from temporomandibular joint (TMJ) dysfunction, a group of facial bone disorders that can cause severe pain, tenderness, and decreased range of motion in the jaw, Botox can help with this as well.
What is TMJ?
Before revealing the correlation between Botox and TMJ, it helps to know what TMJ is from a holistic perspective. Short for temporomandibular joint, TMJ is a disorder that resides in the actual jaw joint. This is important to note as TMJ is often confused with TMD (temporomandibular joint disorder) which is actually the designated category for a small number of disorders that can affect the jaw joint. In layman’s terms, TMJ refers to the joint itself, while TMD refers to the disorders that can wreak havoc IN common.
“TMD/TMJ problems are orthopedic problems involving muscles, joints, ligaments, and tendons,” says orofacial pain specialist Donald R. Tanenbaum, DDS, MPH. “Common problems are joint sprains, tendon strains and muscle problems including pain, spasm, inflammation and tension.” The cause of these symptoms is simple: overuse.
“Behaviors and habits such as biting nails and cuticles, clenching or clenching teeth, overload the jaw muscles, potentially leading to muscle damage and pain symptoms, limited jaw movement, inability to bring the teeth and/or jaw together normally. locked”, he says. Dr. Tanenbaum. “Additionally, grinding and clenching your teeth during sleeping hours can also overwork and fatigue the jaw muscles leading to morning headaches, jaw muscle pain, toothache and limited jaw movement.
Does Botox Help TMJ Disorders?
Consider how Botox works: It’s designed to prevent muscle contraction. As such, injecting Botox into the masseter (the muscle that is primarily responsible for jaw movement) can actually alleviate the over-stimulation of certain daily habits that can lead to TMJ problems. But don’t worry! Getting botox will not make it impossible to open your mouth or impair your speech.
“Botox does not stop muscle contraction, but reduces the intensity of the contraction,” says Dr. Tanenbaum. “Since it works by reducing a muscle’s ability to contract and tighten as strongly as it normally would, it can help muscles that have been overworked begin to relax and regain their health.”
All this to say: Yes, indeed Botox for TMJ makes work. “Botox injections can help reduce common TMJ symptoms of pain, soreness, tightness, tension, and fatigue,” says Dr. Tanenbaum. (But remember: This is still a relatively new practice. Most studies of Botox for TMJ insist that more research is needed to definitively prove the treatment’s benefits.)
One thing to note: Botox is not the answer to every TMJ/TMD issue. According to Dr. Tanenbaum, is not regularly used to treat clicking and jaw locking problems.
Botox for TMJ Logistics
Although the masseter is the largest muscle in the jaw, Dr. Tanenbaum says that, for the most effective treatment, Botox should be injected into the temporalis to treat TMJ.
“[The masseter and temporalis] bring the teeth together from an open mouth position,” he explains. “These are called jaw lifts. Sometimes, the jaw opening muscles, called the lateral pterygoids, also need to be injected. [But] for the most part, the temporalis and massage are the focus of Botox injections.”
Given the size of the jaw muscles, more Botox units are needed to adequately relieve the tightness. “Typically, 25 to 30 units of Botox are needed in the right and left masseter muscles, and 20 units in the temporalis muscle,” says Dr. Tanenbaum. After the injection, he says most patients feel relief within five days, however, the most noticeable benefits appear around two to three weeks, with full benefits taking up to eight weeks. So, just like facial botox, it’s important to know that the results won’t last forever.
Side effects of Botox for TMJ
When botox is injected into the forehead, there is minimal discomfort of a paralyzed expression or a droopy eyelid. Although it is rare, it is possible. Similarly, Botox for TMJ has possible side effects, but they are rare. “Side effects only occur if Botox is not injected in the right places, leading to lip droop,” says Dr. Tanenbaum. “Otherwise, patients can chew, swallow and speak without worry.”
Downside of Botox for TMJ
When considering Botox for TMJ, Kate Zoumboukos, DMD of SW Austin Dental, points out the cost of Botox. Although the neuromodulator is thought to have a strong risk-benefit ratio (and Journal of Oral Maxillofacial Surgery agrees), the high cost of treatment may take it off the table for many.
Cost aside, Dr. Tanenbaum says that, as effective as Botox can be for TMJ, he doesn’t recommend it as a stand-alone therapy. “It should be supplemented with education, strategies to change excessive jaw use behaviors during the day, jaw stretching exercises, breathing exercises to keep jaw and neck muscles loose, oral appliances for sleep hours to reduce impact of bruxism and management of life stressors. “, he shares. “These treatments are often helpful on their own or make Botox treatments more helpful.”
Before modern medical advances, TMJ used to be relieved without the use of neuromodulators. Although it is possible, Dr. Tanenbaum says Botox is now a valid treatment that has helped countless patients.
“It has been a great advantage to use in patients who could not tolerate a bite device during sleep, or [who] it got worse when I use them,” says Dr. Tanenbaum. “It has also helped patients who used to clench their jaw muscles during the day, or live with their teeth together, to change these behaviors, resulting in comfortable jaw muscles and fewer facial/temporal headaches that would occur during the day .”
However, Dr. Tanenbaum says Botox shouldn’t be seen as a once-in-a-lifetime solution. Instead, Botox for TMJ should be used to first relax the jaw in a way that helps the patient easily work on reducing jaw clenching behaviors. After all, you don’t want to overuse Botox for TMJ. “Continuous injections over several years can weaken the jaw muscles excessively and cause facial sagging that may not be desired by the patient,” says Dr. Tanenbaum. “On the other hand, some patients come to see me just to reduce their square facial profile by slimming massagers.”