What is the Scientific Reason That Botox Treatments Help Ease the Symptoms of TMJ?

Will the botox treatments give lasting or temporary relief? How often are botox treatments needed before experiencing improvement in my symptoms?

Doctor Answers 5

TMJ can be relieved by Botox in some patients

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Botox can relax muscles that are overactive and put undue stress on one side, or both sides, of the jawbone where it pivots in its socket. This joint pain can radiate out to different areas and significantly affect the quality of life in individuals.  The clenching of the jaw and grinding of the teeth, that can occur at night during sleep as well, continues to make the problems worse.  The muscles of mastication (chewing) can then be relaxed with botox, but it does  have to be repeated. See a board certified ENT, plastic surgeon or dermatologist that has a great deal of experience with TMJ as the treatment does have risks and can further unbalance the situation.

Manhattan Dermatologic Surgeon
4.9 out of 5 stars 39 reviews

Science of TMJ treatment with Botox.

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Some (but not all) TMJ symptoms are caused by hyperactivity or spasm of the masseter muscle, which is the chewing muscle that bulges in your cheek when you bite down with your teeth. Grinding of the teeth while sleeping (dreaming) is termed bruxism, and is also associated with TMJ symptoms in some patients. Damage or destruction of the TMJ articular cartilages can also cause pain, "cracking" sounds, and "locking" of the jaw movement, but this can be associated with excessive masseter activity, or independent of it.

When excessive masseter activity causes TMJ pain and/or bruxism, a dental guard can help protect the teeth, and Botox can help reduce the strength and/or spasm in the masseter muscles, thereby improving TMJ pain.

I like Dr. Smith's inclusion of substance P as another potential cause of TMJ symptoms, as it is implicated in other pain syndromes as well. Capsaicin (used tropically in some arthritis creams) is a substance P depleter, causing release of substance P (may cause transient worsening of symptoms) and then once depleted, any substance P-mediated pain is reduced.

You should note improvement in symptoms within several days to a week or two after receiving your first Botox treatment--IF masseter muscle spasm and excessive muscular activity is the (main) cause of your TMJ symptoms. Also, realize that long-standing untreated masseter hyperactivity or spasm can cause TMJ cartilage damage and arthritis, which will cause additional symptoms unimproved by Botox. Good Luck!

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 263 reviews

What is the Scientific Reason That Botox Treatments Help Ease the Symptoms of TMJ?

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Best of luck. Dr Smith's answer is truly the way to learn the pathophysiology of Botox to masseter therapy. I recommend seeing an expert injector to have it done. 

It relaxes the chewing muscle

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The masseter muscle is the one that closes the jaw and helps us grind down on our food - as well as grind down on our teeth, so by relaxing the muscle, there is not as much force generated when using the muscle.  This reduces the friction and wear on the TM joint, thereby reducing pain.  One treatment may be very helpful by breaking the cycle for a period of time, but often best results are obtained by keeping the masseter muscle relaxed for long periods of time.  The longer you use the treatment, the weaker the muscles will become, so your problem should definitely improve with time.  You should also be wearing a night guard for your teeth to prevent grinding them.  The duration depends on what dose is used and where it is placed.  On another note, other anti-inflammatory agents can help as well - 4 grams per day of the omega-3-fatty acids DHA  and EPA (taken with food for best absorption) as well as NSAID's such as Rapiprofen. 

Laura E. Skellchock, MD (in memoriam)
Boca Raton Dermatologic Surgeon

BOTOX® helps TMJ pain and bruxism [grinding teeth by relaxing the masseter, and perhaps also blocking the release of Substance P

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BOTOX® helps TMJ pain and also bruxism [grinding teeth] by relaxing the masseter muscle [above the jawline and in front of the ear], and perhaps also by blocking the release of Substance P [a neurotransmitter which is involved in some chronic pain syndromes].

When used for TMJ pain and/or bruxism, I usually inject the masseter with 3 or 4 ten unit doses of BOTOX® at a depth of about 8 mm. Treatment is usually repeated every 3-6 months, depending on the patient's needs.

Kevin C. Smith, MD
Niagara Falls Dermatologic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.