Overnight grinding can lead to muscle buildup, major headaches, and overall tension.

Pia Velasco
August 31, 2020
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Welcome to Try Before You Buy, a monthly series where we talk about the pricey beauty products and in-office treatments that are getting major buzz and give our honest feedback. 

If you've ever woken up with a massive headache or jaw pain, you may have TMJ disorder—a condition that causes pain and discomfort in the jaw area. One surprising treatment? Botox. When you think about Botox, you probably think about it as an anti-aging treatment, and you're not wrong—but there's so much more to the popular injectable. To better understand how Botox can treat TMJ, we tapped Y. Claire Chang, M.D., a board-certified dermatologist in New York City.

What is TMJ?

TMJ, or the temporomandibular joint, is a joint that connects the jawbone to the temporal bone in your skull, and TMJ disorder causes pain and discomfort in that area. Dr. Chang says that symptoms of TMJ include pain or tenderness of the jaw, aching pain in or around the ears, clicking, popping, or grating sounds when opening and closing the mouth, locking of the joint, difficulty and pain with chewing, pain extending to the neck and shoulders, and headaches. "Some patients also complain of facial swelling, ear fullness, tinnitus (ringing sound in the ears), or eye pain," she adds. According to a 2017 study, it is estimated that 10 million Americans have TMJ disorders, and while the cause isn't always clear, factors that can contribute to TMJ are genetics, arthritis, jaw injuries, and teeth misalignment.

How does Botox help with TMJ?

Botox was originally created for medical purposes and has been used to treat crossed eyes, involuntary muscle contractions, excessive sweating, migraines, urinary incontinence, and wrinkle reduction. Because of its ability to reduce involuntary muscle contractions, it can also prevent teeth grinding and clenching. "Botox is used off-label to treat TMJ-related pain, headaches, grinding, and clenching," says Dr. Chang. "It's injected into the TMJ muscles which causes relaxation and shrinkage of these hyperactive muscles to relieve pain." Although it's not FDA-approved yet, Botox's effect on treating TMJ just recently passed phased two of its clinical trial, and for years, it's been widely used by doctors off-label for this and is considered safe.

What are the side effects of getting Botox for TMJ?

"It can cause injection-related discomfort, local tenderness, bruising, or swelling," Dr. Chang explains. "Difficulty chewing may occur from local muscle weakness and is usually dose-dependent and temporary." A cosmetic side effect could be face slimming around the jaw area—patients won't be grinding or clenching their teeth anymore, so all the muscle build-up will dissolve and will therefore slim the face. Dr. Chang notes, though, that these side effects are very uncommon and mild.

What should you take into account before getting Botox in your jaw?

While the price of Botox injections ranges depending on your location and practitioner, each unit can range anywhere between $10-$25, and the amount of units you need is determined by the severity of your TMJ and your doctor's advice. Also, while Botox is offered by many dentists off-label to treat TMJ, Dr. Chang recommends getting treatment from an experienced board-certified dermatologist or a general practitioner to avoid any adverse effects or complications.

How long do results last?

It depends on the patient's metabolism, but results typically last between four to six months. "In my experience, patients may go even longer than six-month intervals after receiving multiple treatments," says Dr. Chang. "However, patients who use their jaw muscles more, like gum chewers, may have a shorter duration of effect."

Is there anyone who should stay away from getting Botox?

According to Dr. Chang, people who are breastfeeding shouldn't get Botox since the toxin can transfer via breast milk to the baby. While there isn't any clinical evidence that proves that Botox is harmful to the fetus of a pregnant woman, Dr. Chang also suggests that those who are expecting stay away from the injectable just to be on the safe side.

First-person review:

I got Botox for my TMJ two years ago and was shocked by how much it helped reduce pain and tension. Teeth clenching and grinding has always been an issue for me, day or night. My dentist noticed that my teeth were wearing down and becoming shorter, and asked me about my teeth grinding. Honestly, I hadn't ever thought about it before, but once that question came up I realized that I was doing it all the time. When I'm stressed, I clench my teeth. When I sleep, I grind my teeth. When I concentrate, I clench my teeth. You see a pattern here?

I visited my dermatologist for a check-up, during which she recommended Botox as an off-label treatment, and I decided to go for it. The injections didn't hurt—they felt like a tiny pinch—and I started noticing results after about 10 days. My head didn't hurt as much before, my face felt less tense, and I didn't wake up with a sore jaw. The results lasted about six months. I didn't notice my face slim significantly, which for me hadn't been a concern and TBH, I'm also not that observant, so who knows,

Would I do it again? Probably! For me, the big factor to consider is the price, since Botox isn't exactly cheap, but if my TMJ-related pain got really bad, I wouldn't hesitate to do it again.