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Jaw tension caused by teeth grinding, over-active masseter muscles, or jaw clenching due to stress, can lead to serious pain and discomfort along the jaw, called the temporomandibular joint, or TMJ, and beyond. So many of us have bitten into something sticky, chewed gum, or chatted with a friend when suddenly we feel a clicking, popping, or painful sensation along the joint of the jaw. Our jaw muscles are some of the most active muscles in our body, operating regularly during the day and often storing tension at night. Unfortunately, this amount of activity can lead to misalignment, stress and, ultimately, pain along the temporomandibular joint. Characterized by tenderness along the jaw line, aches around your ear, pain in the joints of the jaw, chronic migraines and jaw dysfunction that can lead to difficulty chewing and opening or closing the mouth, TMJ disorders can feel like they are keeping you from your highest quality of life.  While pain or soreness around the jaw joint and lower jaw do not suggest serious issues for everyone, patients may develop more serious Temporomandibular disorders, abbreviated as TMDs, which can suggest chronic facial pain. Luckily, TMD treatment options are available, including the use of Botox.

Botulinum toxin type A, known colloquially as Botox, is an injectable treatment that works to essentially “freeze” the muscle at and near the injection site. While many patients may hear “Botox” and think about cosmetic treatments to eliminate fine lines and wrinkles, Botox has also been FDA approved to treat many medical conditions, including chronic migraines, blepharospasm, and cervical dystonia. As TMJ disorders are caused by overuse or pain in the masseter muscle of the jaw, the use of Botox acts as a muscle relaxant, which elevates the tension along the jawline to eliminate symptoms of TMD, including headaches, lockjaw, and jaw pain. Botox for TMJ is a common off-label use of Botox that can be administered by an experienced dermatologist.

If you have been suffering with jaw pain, TMJ treatment can give you the relief you have been looking for. New York-based, board-certified dermatologist Dr. Michele Green is an expert in the use of Botox, including Botox to relieve symptoms of TMJ and treat the masseter muscle for facial slimming. Dr. Michele Green is a platinum level Botox physician, and utilizes Botox extensively to treat fine lines around the forehead, neck, crow’s feet, lips, and glabella area. Dr. Green will help determine if Botox for your TMJ is the best treatment option for you. Contact the office today to learn how Dr. Green can help treat your TMJ and finally experience the pain relief you’ve been looking for.

What is TMJ?

The Temporomandibular joint, or TMJ, is where the jaw bone (mandible) connects to the skull (temporal bone), essentially operating like a sliding hinge on either side of the face. The connecting parts of the bones have a cartilage covering, and are separated by a small disk, designed to be shock-absorbent and keep jaw movements as smooth as possible.

Many patients feel jaw pain or discomfort along this joint. Years of clenching your teeth, both in waking hours and while you sleep, induce an overactive masseter muscle which grows larger and induces more discomfort. This jaw tension is most noticeable while you sleep, as it causes teeth grinding that can ultimately damage them. Research by the National Institute of Dental and Craniofacial Research has estimated that more than 10 million Americans suffer from TMJ issues and have associated tension headaches, pain, tension, clicking and grinding. Botox treatment in the masseter muscle to relieve TMJ has fast become a simple, fast, and effective way to treat bruxism (teeth grinding).

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TMJ Disorder (TMD) Causes

Due to the strength of the muscles along the Temporomandibular joint, temporomandibular joint disorder, known as TMD, is quite common. TMD/TMJ is largely caused by jaw clenching, though many people who clench their jaws will never experience the burning pain and swelling that can occur with TMD. TMJ disorders can also be prompted by injury to the muscles of the jaw, head or neck, such as from a heavy blow or impact from the body. Additionally, pain from TMJ can be due to genetic factors or arthritis, as well as when the disk of the joint erodes or shifts from its proper alignment.

TMD/TMJ Symptoms

Symptoms of temporomandibular joint disease (TMD)/TMJ include:

  • Discomfort or soreness along the jaw
  • Jaw clicking or popping
  • Pain behind the eyes, neck, or shoulders
  • Ringing in the ears
  • Headaches, ranging from mild, dull aches to chronic migraines

Typically, those who experience symptoms of TMD experience symptoms cyclically and the pain can go away on its own or with minimal treatments (such as anti-inflammatories or alternating heating pads and cold packs along the jaw). However, returning symptoms or longer-term symptoms often cause enough pain to seek medical or dental treatment.

In the past, those suffering from TMJ pain have looked to mouth guards, bite guards or stabilization splints to improve jaw tension while sleeping. Sometimes, pain is so severe–varying from swollen jaw muscles to chronic migraines–that patients will experiment with “no-chew” diets, cognitive behavioral therapy, physical therapy, or even surgical intervention. Oftentimes, these treatments can lead to inconsistent results, which has led to the development of alternative treatments. Botox injections along the jaw are an innovative way to limit, reduce and, in some cases, eliminate TMJ/TMD symptoms.

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Botox masseter, 1 session, 3 months before and after

What is Botox?

Botulinum Toxin Type A, also known by the trade name Botox, is a product produced by the company Allergan. Botox has been FDA approved for cosmetic purposes to reduce the appearance of fine lines and wrinkles around the eyes and across the forehead, as well as to treat certain medical conditions, including chronic migraines and muscle spasms. Botox is an injectable treatment that leads to controlled muscle paralysis where the treatment is injected. Freezing the muscles causes them to relax, which smooths out fine lines and wrinkles and can relieve pain or spasms caused by over active muscles. For that reason, Botox is an effective treatment for TMJ disorders.

How does Botox work for TMJ?

Botox treatment involves the injection of the neurotoxin botulinum toxin type A into the target muscle in order to freeze and relax the muscle. TMJ disorders are frequently caused by strain or overuse of the masseter muscles in the jaw. Jaw clenching, teeth grinding, and overworking with jaw muscles can lead to tension and pain throughout the jawline and around the face. When treating TMD, the Botox is injected directly into the masseter muscles. When injected, the botulinum toxin blocks the neurotransmitters responsible for telling the masseter muscles to contract. This causes the muscle to relax thereby relieving the tension along the jawline. Further, the Botox prevents the muscle from contracting, which eliminates involuntary clenching of the jaw from stress or grinding teeth in your sleep.

While Botox injections for TMD are still an off-label use for Botox, meaning that Botox is not specifically approved to treat TMJ disorders, several studies have demonstrated that Botox is very safe and effective at treating TMD. According to a study performed in 2012, when treating TMD, Botox was shown to alleviate pain and increase movement capacity of the jaw for up to three months after the injectable treatment was performed. In 2003, a study demonstrated that 90 percent of patients who had not responded to other treatments showed improvement after receiving Botox treatment. While there is more research that needs to be done before Botox can be FDA approved to treat TMD, the studies demonstrate that the treatment is very effective and can be easily performed by a board-certified dermatologist, such as Dr. Green, for amazing results.

Can Botox help TMJ?

Botox (botulinum toxin) is a neurotoxin-based injectable cosmetic treatment that freezes muscles on and around an injection site, designed to relax the muscles and alleviate overuse. Though it’s more commonly used in the United States to treat crow’s feet and forehead wrinkles, Botox has been used in Asia for years to slim the face and facial muscles by injecting it directly into the masseter muscle. Many patients seek injections of the masseter muscle to have a more elongated, slimmer, face.  It turns out that this treatment has an incredibly positive side effect: by injecting Botox directly into this hypertrophic (overactive) muscle, its function decreases, which then diminishes the symptoms of common TMJ disorders.  Over time, with repeat Botox injections at 3 to 5 month intervals, the masseter muscle decreases in size, allowing the TMJ joint to relax and the symptoms to resolve.

Botox for TMJ is generally injected directly into the masseter muscle and, occasionally, other jaw muscles, such as the temporalis and frontalis muscles. There is no pain, bruising or down time associated with these TMJ injections. Dr. Green recommends that these Botox injections be repeated periodically for continued relief of TMJ symptoms. In time, with the continued weakening of the muscle through these Botox injections, your symptoms will resolve.

SC Before and after 1 treatment botox masseter MGWatermark

Before and after 1 treatment of Botox to the Masseter muscle area

Relieving TMJ pain

In addition to Botox, Dr. Michele Green recommends limiting the amount of chewing gum or sticky candy you chew. Since the masseter muscle is one of the muscles activated during chewing, limiting excess chewing can help to relieve jaw tension, thus alleviating TMJ pain. Dr. Green also recommends dental night guards, as continual use prevents the unintentional teeth grinding and clenching of your jaw at night, thus limiting TMJ/TMD symptoms and damage to your teeth.

Many patients have functional impairment, pain, spams, lockjaw, headaches, or difficulty chewing and don’t realize that it is from TMJ, which can be easily and successfully treated with Botox. Dr. Green can help you work through these symptoms and arrive at a solution to your pain through Botox injections and other TMJ treatments.

The Botox treatment Process for TMJ

The process for treating TMJ with Dr. Green is very straightforward. During the consultation. Dr. Green will examine your jaw, masseter muscles, and dental configuration. She will determine if Botox is the proper treatment to relieve your TMJ or for facial slimming. When you arrive at the office for the treatment, photographs are taken before the procedure for your private medical records. Then, Dr. Green will mark the area of injection in a grid to indicate where the injections will take place. The number of injections will vary from patient to patient and will depend on the size of the masseter muscle and the areas of the face that are most affected by the pain. Most patients feel little to no discomfort during the injection process with Dr. Green’s practiced hand.

Two weeks later, you will return to the office for examination and additional photography to ensure complete treatment of the area. Additional suggestions such as night guards and other modifications may be added at that time.

Where is Botox injected for TMJ treatment?

The number of injections as well as the treatment area depends on several factors including the size of the masseter muscle and the areas of pain. Typically, in order to treat TMD, Botox injections are done in the forehead, temple, and masseter muscles. When you have your initial consultation with Dr. Green, she will assess the treatment area and you will discuss the nature of the pain you are experiencing in order to make a determination about where and how many injections are needed to properly treat your condition.

Does Botox help jaw clenching?

As jaw clenching is a common cause of TMJ/TMD pain, it follows that Botox can be used to treat pain from jaw clenching. Botox for TMJ is able to target the muscles responsible for jaw clenching, such as the larger masseter muscle along the jaw, thus reducing the overactivity of the muscle over time.

Can Botox Cause Jaw Pain?

In extremely rare cases (less than 1% of reported symptoms), Botox injections can cause mild jaw pain and discomfort, however research is not conclusive if injections are the root cause of this reported jaw pain. While some may experience a mild pinch or soreness upon application of Botox to the jaw, a simple cold pack should resolve any discomfort post-procedure.

Does Botox Slim the Face?

If you’re wondering, can Botox lift the jawline?, or does Botox jaw reduction really work?, the answer is a confident yes. Botox is designed to relax the muscles centered around the injection site and, when applied to the masseter muscle, it can actively reduce the strength and size of the muscle, thus slimming the jawline over time. For more information on this process, you can look at our information on Non-Surgical Jaw Reduction.

Does Botox for TMJ change face shape?

Botox, a form a facial esthetics treatment, is a non-surgical option for treating TMJ that also has face slimming properties. Overworked masseter muscles can cause the face to develop a boxy appearance, known as a square jawline. When Botox is injected into the masseter muscle, it causes the muscle to become smaller, which reduces the square jaw appearance of the face. The result is a slimmer face shape and less square jawline.

Is Botox Jaw Reduction Permanent?

The effects of Botox jaw reduction and Botox for TMJ are generally long-lasting, and effects of the treatment are usually apparent 2 weeks after treatment. Botox jaw reduction is incredibly effective, though it is not permanent. Supplementary injections may be needed at regular intervals, depending on your medical and aesthetic goals. Dr. Green will happily work with you to find the best treatment plan for your specific needs. Botox jaw reduction and botox for TMJ can last for several months but, depending on the severity of symptoms, multiple sessions may be needed. With each subsequent treatment of Botox injections in the masseter muscle, the muscle gets smaller, TMJ relief lasts longer, and the cosmetic results of facial slimming continue to improve.

How Much Botox is needed for Jaw Reduction?

In order to determine how much jaw Botox is, either for jawline reduction or for TMJ, it’s important to consider how much Botox is needed for the jawline. Generally 50 units of Botox are injected (25 units on each side) as the preliminary dosage. All patients are brought back two weeks after an initial Botox for TMJ treatment to make sure that the muscle is frozen and to determine if additional Botox is needed in the area.

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Botox to masseter area – 3 months

How much is Botox for TMJ?

Botox is priced per area or by unit. The price of Botox for jaw reduction is generally $1,000. An experience cosmetic, board certified dermatologist, like Dr. Green, may be more expensive than a med spa or clinic with a nurse injector.

Will insurance cover Botox for TMJ?

When patients ask, is Botox for TMJ covered by insurance, the answer is, no. Botox for TMJ is still an off-label use of the treatment, which means it is unlikely that insurance companies will recognize it as a medical treatment that is covered. If you are wondering about whether your insurance covers the treatment, it is best to reach out to your insurance company directly.

Does Dental Insurance such as Delta Dental cover Botox for TMJ?

If you have Delta Dental insurance and are wondering about coverage for Botox to treat TMJ disorders, it is best to reach out to Delta Dental directly. They will be able to give you the information about what your plan does and does not cover, including Botox treatment options. Dr. Green’s office advices that you determine whether your insurance company covers the procedure first before making the appointment.

Does Kaiser cover Botox for TMJ?

Similarly to Delta Dental, it is best to reach out to Kaiser directly to ask if they cover Botox for TMJ disorders. Typically, Botox for TMJ is not covered by insurance as the treatment is an off-label use of Botox.

Are there any side effects associated with Botox for TMJ?

Some minimal side effects can occur after treatment, including redness around the injection site, as well as muscle weakness. The procedure is painless as Botox injections do not cause any discomfort in this area.

It is important to note that, though research on Botox treatments for TMJ has been positive, this alternative treatment has not yet been approved by the food and drug administration (FDA), meaning that it’s an “off-label use” for Botox injections. Due to this, it’s important that anyone committing to TMJ treatments via Botox be seen by an experienced medical professional, such as a plastic surgeon or a dermatologist, to ensure the safety of the procedure. Dr. Green is a master Botox cosmetic injector, including the use of Botox for TMJ treatment and facial slimming.

Can Botox make TMJ worse?

Botox can have some mild, common side effects, which include redness, bruising, or swelling at and around the injection site and some muscle weakness. In rare cases, there may be jaw pain following the injections but there is not sufficient evidence to support that Botox was the root cause of the pain. Botox is a very safe and effective treatment for TMJ disorders and your risk of developing any more serious side effects is greatly reduced if you seek treatment from an expert, board-certified dermatologist, such as Dr. Green.

How long does TMJ Botox last?

Botox jaw reduction and botox for TMJ can last for several months but, depending on the severity of symptoms, multiple sessions may be needed. Botox is a non-permanent injectable and can last 3 to 4 months, depending on a patient’s natural metabolic process.

How does Botox help TMJ?

TMJ disorders can be caused by overuse of the masseter muscles from excessive chewing, stress clenching your jaw, or grinding your teeth at night. Botox is effective in eliminating pain from TMJ by essentially freezing the masseter muscle. When this occurs, the muscle will no longer contract, which reduces the tension and prevents further involuntary clenching of the jaw.

masseter jaw

What are other treatment options for TMJ

Botox is one of many potential treatment options for TMJ disorders and in order for the treatment to be most effective, Dr. Green may recommend pairing Botox with other treatments. Within the realm of dentistry the accessibility of products such as orals pints, mouth guards, or Invisalign, are very appealing and can help if TMJ pain is caused from teeth grinding, or bruxism, at night, however these help to alleviate the symptoms but do not address the cause of the pain. If TMJ disorders are stemming from stress and anxiety, muscle relaxants, physical therapy, acupuncture, or relaxation techniques may be helpful in addressing the issue. If these procedures do not do enough to reduce the pain, there are surgical procedures such as arthroscopy or arthrocentesis, which are minimally invasive surgical procedures.

How do I choose where to get Botox for TMJ?

You may see many options for places at which to receive Botox treatment for TMJ, such as MedSpas and Facial Esthetic facilities. However, due to the precision required for Botox injections, it is best to seek treatment from a board-certified dermatologist, such as Dr. Green. The risk of developing severe side effects from the treatment is greatly reduced if you seek treatment from an expert dermatologist.

Who does Botox for TMJ?

Dr. Green is an experienced, board-certified dermatologist who has been expertly performing Botox treatments at her Upper East Side NYC office for 25 years. She has been consistently voted as one of the best dermatologists in NYC by Castle Connolly, the New York Times, Super Doctors, and New York Magazine. Dr. Green is an expert in minimally invasive cosmetic dermatologic procedures, such as Botox injections, lip fillers, skin tightening lasers, and chemical peels. To find out more about Dr. Michele Green’s expertise in Botox for TMJ and facial slimming, in her private boutique NYC office, contact us online today, or call 212-535-3088 to learn more about how Botox injections for TMJ can be the best treatment for you.

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