Who should I go to for Botox TMJ? (photos)

Question

I am a 22 year old female and I have a strange looking jawline due to my constant grinding and clenching. I'm currently looking around for an expert at botox for TMJ but I am unsure if I should go with a plastic surgeon or dentist.

John Mesa, MD · Answer

Botox is a medication that in certain patients can be used to make the lower face/jaw line narrower then injected in the masseter muscles ( muscle on the side of the cheeks by the angle of the jaw close to the ear).Patients with TMJ probllems like pain, teeth surface wearing off, etc should seek a TMJ specialist ( an ENT doctor) for consutlation.Patients interested in narrowing the bulkiness of the jaw masseter  muscle, shoukd make a consultation with a Board Certified Plastic Surgeon specialist in Botox to determine if they are candidates.

Jonathan Kulbersh, MD · Answer

Botox is commonly
injected into the muscles that are responsible for clenching and grinding.
These muscles include the masseters and temporalis muscles.  In a patient
that has significant clenching, I would inject the masseters with a total of 50
units and that the temporalis with 20 units of Botox.  Commonly, this
treatment is effective in improving the pain and soreness associated with
grinding. It is also effective in preventing damage to the teeth.

I consider an effective treatment is that
patients either have complete resolution or a reduction of the symptoms
associated with grinding. There are some patients that will not have relief
with Botox injections.I would choose and injector that has experience and commonly do injections.  I am a facial plastic surgeon so I am biased that I would believe a plastic surgeon would be better.I hope this helps.

Matthew Elias, DO, FAAD · Answer

Thank you for your question.   Your search should take into account if the physician is an expert at that technique.  Typically Board Certified Dermatologists and Plastic Surgeons are the core specialists injecting Botox.  We inject masseters not just for the TMJ component but also to slim the jawline so there is an aesthetic component to it.  Regards, Dr. Matt Elias

Lawrence Osman, MD · Answer

Botox is a great treatment for reducing the size and intensity of contraction of the masseter muscles.  Your choice of physician should mostly depend on their familiarity with the anatomy of the area and how frequently they use Botox.

Suneel Chilukuri, MD · Answer

In Houston, many dentists refer their TMJ patients to me, a board certified dermatologist as I have significant experience treating this condition.  The dentist then looks for a more permanent cure by readjusting the patient's bite. The question you should ask a potential dentist, dermatologist, or plastic surgeon is how many TMJ patients they treat in a week with a neuromodulator such as Botox, Dysport, or Xeomin.  An experienced injector in your area is Dr. Jeffrey Rapaport. Best of luck,Suneel Chilukuri, M.D.Houston, TX

Masoud Saman, MD · Answer

Dear waffles23:Thank you for your question. The jaw line contour as you describe (as well as the grinding) can be improved with botox injection into the masseter muscle. This is something that any well trained facial plastic surgeon would feel comfortable with. TMJ (temporomandibular joint) itself does not get injected with Botox, however. There are times when injection of the masseter alone does not suffice and offers little improvement of the grinding. It those cases, injection of the temporalis muscle (the muscle by your temple area) can help. I hope this helps!

Who should I go to for Botox TMJ? (photos)

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