Botox® Treatment for Jaw Tension and Pain (TMJ Disorder)
Temporo-mandibular joint disorder (TMJ disorder or TMJD) is an increasingly
common problem in our stressful, modern world.
Usually a result of teeth grinding or clenching in sleep, this sub-conscious muscle flexing generates a large force within this delicate joint, leading to a wide array of uncomfortable symptoms - most commonly headaches, ear pain and tightness or locking of the jaw.
With careful injections of Botox® into the major paired jaw muscles (called the masseter muscles), pain and discomfort related to TMJ disorder can be dramatically decreased or even eliminated.
Botox® is well-recognized for its ability to lessen wrinkling by downregulating the facial “expression” muscles. Using the very same mechanism within the masseter muscles, Botox® gently reduces their strength, thus reducing their ability to generate the large force that causes the symptoms of TMJ disorder.
Patients with TMJ disorder are frequently diagnosed by their dentists because of worn down teeth (from the force of clenching), and are subsequently prescribed a nightguard to protect the teeth from this pressure. These guards work well to protect the teeth but do little to reduce the force on the joint – thus, the jaw discomfort usually remains. Botox® serves to directly reduce the strength of the problematic muscles, reducing the discomfort they can cause in the joint.
Botox® generally takes at least 2-3 days to begin its effect. Most patients notice a reduction in their pain and discomfort starting 1-2 weeks after treatment, and a maximal reduction in discomfort at 4-6 weeks.
Botox® for TMJ disorder typically lasts between 4-6 months. Patients will know it is wearing off when discomfort starts to worsen, and are encouraged to get re-treated before their symptoms fully return.
As long as dosing remains the same, the wearing off period typically remains stable for each patient. So once a patient knows how long the Botox® lasts, they can get on a simple routine for injection frequency.
In the short-term, patients may note some soreness in the jaw for a few days, especially when chewing. This is normal and related to mild muscular inflammation from the injection sites. Rarely a small bruise may show up at one of the injection sites. If there is a bruise, it is typically small (the size of a pencil eraser) and diminishes in several days.
With the typical dose of Botox® for TMJ disorder, patients tend to have no functional side effects. Occasionally there will be a 1-2 week period where patients feel they have to apply some extra effort to chewing tough or hard foods, like beef jerky or hard crackers. This is unusual at the typical dosing but can become more common if a patient has particularly severe TMJ disorder and requires a higher dose of Botox® to get relief.
TMJ disorder involves overworking your masseter muscles which – like any workout – leads these muscles to enlarge. Because the masseter muscles sit on either side of the back portion of the jaw – and thus add to the structure of the jaw – their enlargement can cause the jaw to appear squarer or widened. Many people with TMJ disorder will thus also comment that the shape of their face has changed.
Because Botox® weakens the masseter muscles and leads them to reduce in size, it will typically also narrow the jaw. This is a desirable cosmetic benefit for most patients, as it reduces the square/widened jaw. In fact, many patients get this treatment to reduce discomfort and change the shape of their face.
Some patients without TMJ disorder will even get masseter Botox® to narrow their jawline and create a more heart-shaped face.
Patients are still cautioned that they may not like the potential cosmetic changes of their jaw. In patients with age-related changes along their jaw, the reduction of masseter muscle bulk can lead to the appearance of subtle jowling (excess tissue next to the chin) or the worsening of jowling already present. Other patients may personally prefer the “strength” of the jaw created by the masseter bulk and won’t like the aesthetic effect once the muscles shrink.
Dr. Cabin is a Board Certified, sub-specialized Facial Plastic & Reconstructive Surgeon who is an expert in the aesthetic and functional concerns of the head and neck. After a detailed consultation, Dr. Cabin will be able to review your unique, individual considerations and, if appropriate, design a customized Botox® treatment for your TMJ disorder.