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What should I do about crooked smile after Botox to treat bruxism and TMJ?

Jane000Jan 19, 2014
To treat bruxism & TMJ I had 50 units injected on each side to the masseter muscle and jaw joint. Immediately after, right cheek of my face was completely frozen and I couldnt smile on that side. The surgeon said its because he mixed it with numbing injection and it will go away in 3 hours, which did. On Jan 17th, I noticed the right side is slightly frozen again and I cant smile fully on that side. I can also feel the muscle on that side when I clench. Will it get worse like the day of injection?

Answers (2)

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Steven F. Weiner, MD profile photo
Dr. Steven F. Weiner, MD
Board Certified Otolaryngologist
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Answered on May 21, 2014
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Dr. Somyos Kunachak, MD - Account Suspended
Facial Plastic Surgeon
Answered on Sep 3, 2014
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Steven F. Weiner, MD

This is yet another person on realself.com that has been injected in the masseter improperly.  If the Botox is injected too anteriorly, you hit the risorius muscle, which will affect your smile.  I'm sorry you have this side effect but emphasizes that Botox in this area needs to be...

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Ira Shapira, DDS (in memoriam)

I have heard many stories of adverse effects from botox.  You may have had an intravascular injection or having over response or allergic reaction.You need additional evaluation ideally with neuropsych doctor.There are better treatment methods for TMJ disorders.  See patient videos on the web re...

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Ryan M Clancy, DMD, MAGD, LVIF

While Botox can be used effectively to temporarily treat TMJ symptoms, it doesn't fix the root cause of your TMJ and doesn't always work for everyone. I would suggest visiting a dentist who specializes in TMJ to explore other treatment options and find out why your jaw and neck have gotten worse...

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Anshul Gambhir, MD

Thank you for your message! There are plenty of providers who are able to inject Botox in general and for TMJ. Physicians, Physician Assistants, Nurse Practitioners, Dentists, etc. are able to inject. I would recommend consulting with a few providers and find one you feel comfortable with! 

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Otto Joseph Placik, MD

I would obtain a second opinion as this is a highly specialized and off-label use of Botox. There are several muscles of mastication and they work in a highly coordinated fashion. Weakening of one set of muscles could cause and imbalance resulting in pain.

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Ira Shapira, DDS (in memoriam)

THERE ARE FAR BETTER TREATMENTS THAN BOTOX FOR TMJ DISORDERS.LOOK INTO A NEUROMUSCULAR DIAGNOSTIC ORTHOTIC, LOW FREQUENCY TENS, TRIGGER POINT INJECTIONS, PROLOTHERAPIES, SPHENOPALATINE GANGLION BLOCKS ETC.  NEUROTOXIN IS NOT A FIRST LINE APPROACH TO A FUNCTIONAL ISSUE.CHECK THE WEB REFERENCE TO ...

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