Botox for TMJ: What you need to know about it's effectiveness for treating TMJ dysfunction

Temporomandibular joint (TMJ) disorders can cause pain, jaw stiffness, headaches, and even difficulty chewing or speaking. While physiotherapy, splints, and lifestyle changes are the first line of care, Botox is emerging as an option for some people. Here’s a quick look at when it may be used, the potential benefits, and the downsides to consider.

Indications

Botox may be recommended for TMJ when:

• Jaw pain or muscle tightness has not improved with conservative treatments

• Teeth grinding (bruxism) causes significant discomfort or damage

• Muscle overactivity is a major contributor to symptoms

• Chronic headaches or facial pain are linked to TMJ dysfunction (TMD)

Benefits

• Pain relief: Botox can reduce muscle tension, which in turn can ease jaw pain and headaches.

• Reduced Bruxism: Relaxing the jaw muscles may protect teeth from further wear.

• Quick procedure: Treatment usually takes only minutes, with results appearing in days to weeks.

A Window of Opportunity

In most cases, once any inflammation at the TMJ is managed with rest, lifestyle changes, improved alignment and control and the majority of our patients do not need to go as far as Botox to successfully treat their TMJ dysfunction.

For some patients, particularly those with chronic issues that stem from years ago, Botox can provide a valuable “window of opportunity” where pain is reduced enough to allow them to address the underlying cause of their TMJ issues. During this time, patients can focus on their physiotherapy exercises, retrain jaw mechanics, and improve control and alignment. This approach can lead to lasting improvements in pain and function by the time the effects of Botox wear off, helping to avoid long-term use on injections. When used in this way, Botox can be a beneficial part of a broader treatment plan.

Negatives

• Temporary effect: Results generally last 3–4 months, requiring repeat injections if physiotherapy is not done.

• Cost: Ongoing treatments can be expensive. (ranging from $600-$1500 per session)

• Side effects: Some people may experience bruising, swelling, or temporary muscle weakness that affects chewing.

• Does not treat underlying cause: Botox addresses symptoms rather than the root drivers of TMD.

  
  

What the Research Says

Research into Botox for TMJ has been growing, and while results are mixed, a few key themes stand out:

• Short-term pain relief is possible: Several clinical trials have shown that Botox can reduce jaw pain and muscle tightness, especially in the first one to three months after treatment.

• The benefits don’t always last: By around six months, the difference between Botox and placebo (a saline injection used for comparison) is not statistically relevant.

• Best results are in muscle-driven cases: People whose TMJ problems are linked to muscle overactivity or teeth grinding seem to benefit the most.

• It’s not a cure-all: Botox doesn’t consistently improve things like jaw opening mechanics, Range of movement, clicking, or long-term bruxism, and it doesn’t address the root cause of TMJ dysfunction.

  
  

Overall, the research suggests Botox can be helpful for reducing pain in the short term. But it works best when paired with physiotherapy and lifestyle changes aimed at retraining the jaw. By itself botox will have little effect on the chronic issue that is TMD.

If you have any questions regarding botox, always discuss them with your physiotherapist as they will be able to guide you as to whether it could be of benefit to your treatment.

For those interested in learning more, you can read:

• A systematic review and meta-analysis (2024) on Botox for TMJ here.

• A summary of a randomized controlled trial published on PubMed here.