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What is Botox for TMJ Disorder and Does it Work?

Jan 22, 2021

You’ve heard of Botox® injections to smooth lines and wrinkles, but did you know it is also used as an alternative treatment for temporomandibular joint disorder (TMD)?


Patients suffering from TMD look for effective treatments to relieve pain in and around the temporomandibular joint (TMJ) and associated orofacial pain. Botox injections are one of the non-surgical ways to address TMD-related pain. Botox has been shown to reduce muscle activity, and injections into the TMJ muscles may reduce jaw joint stress and painful jaw-locking issues.

What Is Temporomandibular Joint Disorder (TMD)?

TMD is a group of symptoms involving a broad category of conditions linked to TMJ dysfunction of the TMJs and associated muscles. The TMJs are complex joints that connect your lower jaw to your skull on each side of the head just below the ear. Working like a sliding hinge, moving the jaw up and down, forward and backward, and from side to side, they allow you to chew, speak, yawn, and drink. 


A host of symptoms can arise when the TMJ is overused, suffers trauma, is afflicted with arthritis or disc derangement, or excessive strain is exerted on the jaw joint and the associated muscles. TMD symptoms include:


  • Pain or tenderness of your jaw - Jaw pain can be caused by inflammation of the TMJ and the surrounding muscles and tissues and by TMJ disc displacement or breakdown of the cartilage due to degenerative diseases such as osteoarthritis. 
  • Pain in one or both of the temporomandibular joints - Inflammation and swelling in the TMJs can spread to other areas of the orofacial region.
  • Pain around the eye area - Tightness and soreness around the TMJ can spread to the face and head, creating pressure and pain around the eyes.
  • Aching pain in and around your ear - The TMJs are just in front of your ears. Pain and inflammation from TMD may spread to the ears, causing a dull ache or even sharp, searing pain. 
  • Difficulty or pain while chewing - Swollen, inflamed jaw joints and surrounding tissues affect the ability to chew.
  • Aching facial pain - As mentioned, inflammation from the TMJ can spread to facial muscles and tissues, causing various facial aches and pains.
  • Locking of the jaw joint - Jaw lock with TMD is due to misalignment or damage to the cartilage, tendons, or ligaments that move the jaw, making it difficult to open or close your mouth. 
  • A clicking or popping sound - Sounds such as these are often symptoms of the disc inside the TMJ shifting as you open and close your mouth.
  • Tooth pain - Bite issues, teeth grinding, and problems with mastication muscles may create tooth pain.
  • Headaches and migraines - TMD pain spreading up the cheeks’ side and to the top of the head can result in headaches and migraines.

How to Treat TMD

Treatment of TMD typically depends on the underlying cause(s), symptom severity, and patient history. Some TMD symptoms can be relieved with self-managed care and non-surgical treatments. Mild cases may be effectively treated with exercises that stretch and strengthen the jaw, over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin, Naproxen, or Ibuprofen, and alternating hot and cold packs applied to the area. Stress management may also help reduce or eliminate TMD causes such as teeth grinding and clenching.


When these and other measures don’t work effectively, or in more chronic cases, symptoms can be treated with custom-made oral appliances for TMD to relieve muscle tension and pain. The most common type of dental treatment for TMD, dental splints, also known as bite plates, are used to treat the underlying cause of a TMJ disorder and provide long-term relief. 


Botox is a non-surgical option for patients suffering from TMD that can help relieve some painful symptoms. A 2012 study found that a significant decrease in pain and movement improvement is possible in patients treated with Botox. Since the positive effects of Botox injections typically last only three months before another injection is needed, Botox is best as a short-term adjunctive therapy used in combination with splint therapy that can provide long-term relief. 

What is Botox and How Does It Help with TMD?

There are several off-label uses for Botox, including treating TMD. Botox is a drug made from a toxin produced by the bacterium Clostridium botulinum that relaxes or paralyzes treated muscles. Botulinum toxin can also interfere with inflammatory substance release, which further helps create an effective way to lessen TMD symptoms.


Botox may provide short-term relief of some TMD symptoms previously mentioned, including: 


  • Jaw clicking or popping (or jaw pressure)
  • Pain when chewing
  • Locking of the jaw (jaw lock) 
  • Headaches and migraines 
  • Earaches (pain under the ears)
  • Toothaches 
  • Tenderness of the jaw
  • Facial pain and pain around the eyes

How Botox Injections Treat TMJ Symptoms

In medical use, small doses of purified botulinum toxin are injected into muscles to block the release of a neurotransmitter (acetylcholine) from motor neurons, preventing or minimizing muscle contractions during waking hours and inhibiting muscles from engaging in movement while asleep. Botox injections relieve tightness and tension in the muscles around the TMJ that create soreness and discomfort. It may also help with headaches associated with teeth grinding and minimize jaw lock.

How Botox Treatment is Administered

  • Each treatment session typically takes 10 to 30 minutes, and there is little to no downtime associated with Botox injections. Most patients can return to their daily routine within a few hours.
  • During the non-surgical, in-office procedure, Botox is injected directly into the masseter and temporalis muscles to relax them.
  • Your TMD doctor will determine how many injections are needed and where based on your symptoms and their severity.
  • Botox may be injected into the jaw muscles, the forehead, the temple, and possibly other areas.
  • Usually, three or more injection sessions are recommended over several months for optimal results. 


Check with your TMD specialist about what to avoid before getting Botox treatment and how to minimize post-treatment bruising and discomfort. 

How Long Does Botox for TMD Last?

You may feel beneficial effects within a few days or weeks, with peak results occurring four to six weeks after treatment. Just like Botox treatments for cosmetic uses, injections for TMD do not last forever. It varies from patient to patient, but generally, the effects last three to five months. Since injections must be repeated every few months to maintain their positive impact, Botox is usually combined with splint therapy to achieve long-term success.

Side Effects and Risks of Botox Injections

As with virtually all medical treatments, procedures, and medications, patients may experience side effects after Botox injections. Typically, they are relatively mild and short-lived. Of course, always talk with your treating doctor immediately about any side effects you’re experiencing, and seek emergency medical care if they are severe.



Botox side effects may include:


  • Headaches
  • Nausea
  • Flu-like symptoms 
  • Drooping eyelids
  • Drooling
  • Respiratory issues or infection
  • Locked smile due to relaxed muscles 


How Much Does Botox Cost?

Before recommending Botox, TMJ Disorder specialists will likely try more conservative measures to correct the underlying cause of your symptoms, which we covered earlier. Botox for TMD can cost around $500 to $1500 per session, depending on the number of areas treated and your geographic location. Check with your insurance provider to determine if Botox for TMJ-related conditions is covered.

What to Expect After Botox Injections

The injection itself may feel like an insect bite or pinprick. Some doctors use a topical numbing cream or a cold pack before administering Botox to relieve discomfort. Common post-treatment side effects include mild pain, bruising, redness around the injection site for a few days, muscle weakness, and relaxed muscles and facial expressions. Of course, you should also experience reduced pain and muscle stress caused by TMJ Disorder.

Next Steps

If you believe you suffer from TMJ disorder, it’s essential to get diagnosed and treated as soon as possible to relieve symptoms and prevent complications from occurring. Dr. Katherine Phillips specializes in diagnosing and treating the symptoms of TMD and, more importantly, the underlying cause. She holds a Master’s degree, is board-certified in orofacial pain treatment, and is a certified sleep dentist. Dr. Phllips has dedicated her practice to treating TMJ disorders and sleep disorders. She creates individualized treatment plans to meet each patient’s unique needs.

Contact Us Today For A Consultation!

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Dr. Kathrine Phillips
About The Author
Dr. Katherine Phillips, DDS, MS received her undergraduate degree from the University of Michigan and her dental degree from the University of Detroit Mercy School of Dentistry. She currently serves as the Secretary/Treasurer on the American Board of Dental Sleep Medicine (ABDSM) Board of Directors and treats TMD and sleep disordered breathing at Restore TMJ & Sleep Therapy in the Houston, TX area. 
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Teeth grinding is the most common cause of jaw pain. Grinding your teeth also results in fractured teeth and the destruction of dental work, which can even change how you look. People who grind their teeth during the day can make conscious changes to reduce their teeth grinding for those who grind their teeth at night . Fortunately, with a visit to Dr. Phillips, you can discover how to stop grinding your teeth. What is Teeth Grinding, and What Causes it? Grinding or clenching your teeth, or bruxism , is a common condition affecting millions of people and, if left untreated, can lead to broader health issues. According to the American Dental Association (ADA), a 2020 ADA Health Policy Institute report stated that half of the dentists saw a rise in clients with stress-related dental problems, primarily due to teeth grinding and jaw clenching. It can happen during the day or night and often goes unnoticed until the person is alerted by a partner or family member. Treating bruxism can prevent further damage to the teeth and relieve any symptoms associated with the condition, and there are several steps you can take to stop grinding your teeth and protect your oral health. People grind and clench their teeth for various reasons, including stress and anxiety, misalignment of the teeth and jaw, or an abnormal bite. In adults, teeth grinding is often caused by emotional tension and stress and can become a subconscious habit. In children, teeth grinding is usually due to an immature bite and can be triggered by new teeth erupting or the recent placement of braces. How Do You Know if You're Grinding or Clenching Your Teeth? Grinding or clenching your teeth can be challenging to identify since it usually happens when you are unconscious or sleeping. However, several signs could indicate you are grinding your teeth. Common symptoms of teeth grinding include: Waking up with a sore jaw Frequent headaches Increased sensitivity or pain in your teeth Tired or tight jaw muscles Pain that feels like an earache, but there is nothing wrong with your ear A locked jaw that is difficult to open or close completely Neck or face pain Noticing that your teeth feel different or worn down You or your sleep partner may also notice that you make clenching or grinding sounds during the night. At a dental appointment, your dentist may suspect teeth grinding if you have the following: Teeth that are chipped, loose, flattened, or fractured Worn enamel on your teeth Gum recession Possible Causes of Teeth Grinding Many people grind their teeth and tighten their jaws without realizing it, especially at night. Although stress and anxiety can lead to teeth grinding, other common causes are: Posture. Poor posture is not only horrible for your back; it's also bad for your teeth. When the body's joints aren't in proper alignment, it can result in jaw clenching and grinding. Misaligned teeth. If the upper and lower teeth don't fit together correctly, the misalignment may result in the tendency to grind teeth or clench jaw muscles. Sleep disorders. Sleep habits and sleep disorders can lead to teeth grinding at night. Chronic obstructive sleep disorder , also known as sleep apnea , is a known cause of sleep bruxism. Resolving sleep apnea can help stop teeth grinding. Sleep terrors and insomnia may also result in grinding teeth at night. Joint disorders. The temporomandibular region is around the jaw, mouth, and ears. This area contains the temporomandibular joints and jaw muscles, which allow the jaw to open and close. Disorders in this area can affect teeth grinding and a sore jaw. Stimulants. Stimulants like caffeine, nicotine, and alcohol can trigger teeth grinding. Avoiding these can help prevent teeth grinding. Stress. Stress is a common cause of teeth grinding and clenching. Finding ways to manage and reduce stress can help decrease teeth grinding. These can include relaxation techniques such as progressive muscle relaxation, yoga, deep breathing, meditation, and guided imagery can help relax the jaw muscles and stop teeth grinding. Chewing on Objects. Chewing on objects such as pencils or fingernails can trigger teeth grinding. You may also need to avoid chewing gum, which can exacerbate teeth grinding. Finding out how to stop grinding teeth at night takes getting to the root cause of grinding. Discovering the cause provides clues, pointing to the appropriate solutions. Prevent teeth grinding during the day. It is crucial to identify triggers that cause teeth grinding if you intend to stop grinding them during the day. Pay attention to your habits during the day and see if you notice when and if your grinding or clenching is worse. A TMJ specialist or dentist specializing in bruxism can provide you with exercises or relaxation techniques you can do throughout the day if you notice yourself clenching and, in some cases, offer medical treatment like muscle relaxants or Botox for bruxism. Prevent teeth grinding and clenching at night/in your sleep. You'll have to make changes during the day to stop grinding or clenching your teeth at night or in your sleep. Start by talking to your dentist or doctor to determine if you have underlying medical issues that could be causing the grinding. Additionally, your dentist may suggest you wear a mouthguard, splint, or other oral appliance. At the same time, you sleep to protect your teeth from further damage and keep your mouth in the proper alignment, helping your TMJ to relax. A custom-fitted mouthguard also helps lessen the impact of teeth grinding by covering the teeth to create a physical barrier that reduces damage. How To Stop Child/Baby Grinding Teeth Many children grind their teeth at night, but most grow out of it. If your child or baby grinds their teeth, the first thing to do is identify what might be causing the behavior. Stress, anxiety, or an underlying medical condition can cause your child to grind their teeth. If the grinding is stress-related, identifying and addressing the source of the stress, such as an overly demanding school schedule or peer pressure, may help. If a medical or dental condition causes the grinding, your child's dentist or doctor can help you determine the best action. If the grinding results from a habit, it can help redirect your child's attention when they start to grind and provide them with other activities that may help reduce their stress and anxiety. Side Effects of Teeth Grinding Grinding your teeth may seem like a harmless habit. After all, it's easier to notice this behavior if you're not on the lookout for it. And unless your significant other or family members complain about the noise from your nighttime teeth grinding, it's difficult to find proof of the act. However, long-term grinding of teeth at night can lead to significant side effects like: Pain in the jaw. The pressure and movement from teeth can lead to tenderness in the muscles, causing jaw pain . For some people, the pain may become chronic and severe. Headaches. The constant back-and-forth movement and clenching can impact the muscles around the neck and head, resulting in headaches due to muscle fatigue and tension. Wearing down teeth. Like sandpaper eventually smooths a surface, the repetitive motion from teeth grinding can flatten teeth and wear the enamel down over time. Teeth grinding can change the appearance of your teeth, causing them to look shorter and making chewing more difficult. Damage or fractured teeth. Grinding can destabilize teeth, making them shift and feel wobbly. The force from grinding may also crack teeth, causing pain and affecting oral health. Misalignment and cracked teeth can result in gum disease, cavities, and tooth loss — leading to poor overall health. Chronic ear pain. The temporomandibular area is closely connected. If the muscles around the ear become affected due to teeth grinding, chronic ear pain may occur. Facial muscle changes. Most people need to be aware that teeth grinding can change the shape of your face. Long-term bruxism can cause shorter teeth. Shorter teeth, in turn, change the structure of the face and jaw — leading to a sunken appearance. In addition, other muscles around the face can enlarge to compensate for dental changes. If you're concerned about your appearance, you may want to note that chronic teeth grinding can change the way you look. Remedies for Teeth Grinding The methods for how to stop teeth grinding at night versus teeth grinding when you are awake are typically the same. Although some treatments aren't quite possible when you're asleep, their benefits can last even after you've gone to bed. Reductive coronoplasty. Reductive coronoplasty directly involves changing or leveling the biting surface of teeth. This procedure reshapes crowded or crooked teeth, improving teeth alignment. Conversely, additive coronoplasty can add to the surface of teeth to help treat bruxism. Dental Appliances: Mouthguards, night guards, and splints. A mouthguard does just that — it guards teeth. Typically used for sports, a mouth guard keeps teeth from injuries sustained during activity. A night guard protects teeth from grinding at night. Lastly, a bit splint guides jaw movement, enabling the jaw to land in the appropriate position. These appliances protect teeth differently, and finding the right one for your situation is essential. Biofeedback. Biofeedback allows a person to train themselves by monitoring auditory and visual stimuli from the body. Although biofeedback needs a person to be alert, the technique can still help sleep bruxism by reducing overall stress. Stress reduction techniques. Though implementing stress reduction techniques such as yoga, exercise, and meditation requires a person to be awake, they can also help with nighttime teeth grinding. Allowing muscles to decompress and relieve tension alleviates stress-induced teeth grinding, even at night. Tongue and jaw muscle exercises. Most people don't stop to think about it, but their faces and mouth are a team of tissue, muscles, bones, and joints that closely affect each other. The tongue, for example, affects how the jaw moves. You reduce teeth grinding by exercising the right muscles — like the tongue and jaw. Behavior changes. Behavioral modifications like changing your posture and avoiding environments that cause stress can reduce instances of teeth grinding. Cognitive Behavioral Therapy (CBT) can help change behavior and thought patterns that lead to teeth grinding. Medications. A doctor can prescribe medication to help treat bruxism if all other treatments don't work. When used for short periods, muscle relaxants can relieve tension in the temporomandibular area. In severe cases of teeth grinding, botox injections can alleviate muscle tension. Antidepressants and anti-anxiety medications assist in decreasing anxiety, allowing jaw muscles to relax and reduce bruxism. How Can a TMJ Specialist Help with Teeth Grinding and Clenching? A TMJ specialist is a dentist board-certified in orofacial pain and conditions affecting the TMJ. TMJ specialists have extensive knowledge and experience regarding the structure, function, and pathology of TMJ. In addition to more thorough diagnostic evaluations, they can often provide more effective and long-term solutions for teeth grinding than your doctor or dentist alone. This is because TMJ specialists use a holistic approach to treatment, focusing on the underlying causes of the teeth grinding, such as stress, anxiety, or misaligned teeth, rather than just treating the symptoms. They often work with other medical experts like dentists or sleep physicians for more comprehensive care and treatment. Protecting Your Oral Health Protecting your teeth is critical to taking care of your overall health. Chronic teeth grinding can result in costly dental work, poor oral health, and chronic pain. If you're experiencing a sore jaw, headaches, or cracked teeth, seeking an expert diagnosis to find the cause is the first step to finding a solution. Get the answers you need on how to stop grinding your teeth at night or keep from grinding in the daytime to protect your oral health. As a TMJ and sleep apnea dentist, Dr. Katherine Phillips specializes in diagnosing and treating bruxism. With her Master of Science in Orofacial Pain From USC and extensive experience in TMJ therapy, Dr. Phillips utilizes proven and effective evidence-based medical interventions to identify bruxism and help find the right treatments to suit your needs. Get in touch today for more information.
By manager 16 Dec, 2022
The temporomandibular joint, or TMJ, is an anatomically complex joint, composed of muscles, joints, ligaments, bones, and discs. Proper jaw movement requires a high level of interaction and coordination among all these components, especially the articular disc (which absorbs stress), the adductors (jaw-closing muscles), the abductors (jaw-opening muscles), and jaw ligaments. This makes diagnosing problems or dysfunction with the TMJ extremely difficult. Properly diagnosing disorders of the TMJ—collectively referred to as TMD—requires both clinical examinations and medical imaging in order to develop an accurate assessment of the joint, its function, and its surrounding bone and tissue. If you are experiencing pain, discomfort, or dysfunction in your TMJ, you will first have a clinical evaluation. This is when your doctor or TMJ specialist will discuss your symptoms with you and examine your jaw, pressing on areas around it to identify any sensitivity. He or she will also observe the range of motion of your jaw and listen to and feel around your jaw while you open and close your mouth. In some cases, the doctor’s clinical findings are enough to diagnose a TMD and begin treatment. Other times, additional diagnostic imaging will be necessary to confirm the presence of a TMD.
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