Should you get Botox for jaw pain or clenching?
Everyone loves a quick fix, and Botox is often touted as the ‘miracle’ solution for clenching and jaw pain, but is this really the case?
Botox (Botulinum Toxin) is a neurotixic protein created by the bacterium Clostridium botulinum. It is often used as a way to temporarily relax/paralyze specific muscles. In the case of TMJ disorders, the most commonly injected muscle is the masseter muscle - one of our main chewing muscles.
Anecdotally, clients often tell me that their first Botox injection is amazing, often leaving them thinking that they’ve been cured. But several weeks (and if they’re really luck 2-3 months) later, they notice that their symptoms return. They then go back for another injection which also feels great, but this time the effects are even more short-lived. With each injection the effects get lesser and lesser to the point where it has almost no effect at all.
What does the research tell us?
A review looking at all the current evidence on Botox and TMJ disorders found that the effects of Botox on mouth opening, muscle contraction and clenching/grinding are similar to a placebo (saline) injection (Saini et al, 2024)
Botox injection into the masseter can lead to reduced bone quality in young and post menopausal females (Hong & Kang, 2020)
One of the issues that going straight to Botox for a solution for clenching or jaw pain, is that it ignores all the other factors that contribute to the symptoms such as: poor habits (eg. nail biting), stress, muscle and joint issues, sleep-disordered breathing and many more. It’s important to get a fully individualized assessment to address these factors and ensure that we don’t miss any serious underlying issue. For example we know that teeth grinding is often associated with sleep apnoea, if it is left untreated, can lead to a whole host of other health issues.
The other problem with Botox, is that it’s expensive, with prices ranging between $350-800 depending on the qualifications of the person administering it.
So would we ever recommend Botox?
Possibly. There would be a scenario where Botox may be helpful. If an individual’s pain levels are so high that they cannot tolerate any physiotherapy treatment, we may recommend one course of Botox to reduce the pain enough to commence physiotherapy treatment. The other time we might recommend Botox is for the treatment of migraines - however this is in a situation where the migraine is unrelated to the jaw and does require a referral to a neurologist to trial several medications first.
You may also see other health professionals such a dentists offer Botox however this is rarely used in isolation and may be used as an adjunct to another form of treatment such as custom splints.
If you’d like some more details on TMJ physiotherapy or would like to book in to see us, visit our Contacts page