Last month, I made my way to the Upper East Side in search of one thing: a round of Botox for my jaw. While Botox is known for easing the look of wrinkles, it also helps to relax whatever muscles it's injected into. In this case, I was hoping to soothe my case of temporomandibular joint disorder (TMD). See, over the last few months, every time I'd lie down on an esthetician's table, they'd bring up TMD. More specifically, that I had it and needed to do something about it. Without wanting to seem uninformed, I'd nod, tell them, "I know, I really should," and try my best to change the subject.
What Is TMD?
Temporomandibular joint disorder is a problem with the hinge-like joint that connects the skull to the jaw, which can create pain in the jaw and muscles around it.
The fact of the matter, though, is that I was pretty unclear about what TMD actually was—and why they could tell it was affecting me. First was the obvious conclusion: I grind my teeth. But then during a facial with Take Care founder Sadie Adams, who is also an anatomy, yoga therapy, Ayurveda, and body-mind–centering specialist, I learned I was afflicted because of the way I "propped" my head on the pillow rather than relaxing and letting my head sink in.
Once I realized this was something I really had to start looking into (and the more I thought about it the more I realized my jaw was tense most hours in the day), I contacted Lisa Goodman of GoodSkin Los Angeles, an injection specialist I'd met earlier in the year and really connected with. And her answer to my concern was far from what I expected: Botox.
Keep reading to learn how jaw Botox worked to relieve my TMD symptoms.
What Is Jaw Botox?
Jaw Botox is injected into the masseter muscles (the muscle that runs down the cheek, and is responsible for chewing as well as opening and closing the jaw). It works particularly well for those suffering from TMD, according to Julia Carroll, FRCPC, a dermatologist at Compass Dermatology in Toronto. "It works by immobilizing the muscles causing the TMD symptoms," she says. "Botox temporarily relieves the tension in the jaw that causes pain and difficulty speaking, chewing, and swallowing. This treatment may also alleviate headaches experienced due to TMD and prevents involuntary movements such as grinding and clenching of the teeth."
So how does it work, exactly? In a couple different ways. "Botox can be used both functionally (to weaken the masseter muscle, which is the main teeth-grinding muscle, and improve the pain of TMD from teeth grinding), or cosmetically to thin the masseter muscle and take away a square look to the angle of the jaw from a hypertrophied (or overgrown) masseter muscle, softening the look of the lower face," explains Dara Liotta, MD, a plastic surgeon based in New York.
Benefits of Jaw Botox
- Helps to relieve jaw tension
- Decreases pain from teeth grinding and jaw clenching
- Eliminates headaches
- Balances the face
"I recommend injecting Botox into the masseter muscle," says Goodman. "A lot of people think mouth guards help, but these only protect against your teeth." Botox works to relieve that jaw tension and pain, she told me. It can eliminate headaches, teeth grinding, and lockjaw by relaxing the muscle that unconsciously creates such stress. This will keep your jaw muscles from looking defined and your jaw from seeming wider. So when she was in town, I headed over to her office in search of a lot less tension.
TMD may lead to a misaligned bite and deformed jaw; jaw botox essentially works to correct that, creating a more symmetrical look and warding off any major damage that could happen if the issue goes uncorrected. "TMD can be a result of bone deformity, favoring one side while you sleep, or sleeping without consideration of alignment and support," Adams tells me. "It can also form from grinding your teeth with a misaligned bite. There's also favoring one side while chewing (as it can lead to teeth wear and an unbalanced bite). It can also contribute to changes in your face as your muscles become disorganized, with some overworking while others atrophy. The natural aesthetic of the face can be altered if teeth shift, if bone loss occurs, or if the bite and jaw are off-balance."
What to Expect from Jaw Botox
The entire process took only a few minutes, with a few injections on either side of my face, placed directly into my jaw muscles. "The injections go into the masseter muscle," says Liotta. "The masseter muscle is one of the muscles activated during chewing. It's located at the angle of the jaw. I usually start with 50 units of botox (25 units on each side). It takes five minutes."
The process didn't hurt really (and you can believe it—I'm a wimp), and it was over before I knew it. "You won't start to notice results for a week or two," Goodman told me, and I left with hope for a clench-less future.
Any sort of injection can lead to minor swelling or bruising, but a simple ice pack (placed on the site of injection for 10-20 minutes) can help thwart that. It's also important to heed doctor's orders after receiving jaw Botox. That means waiting at least four hours before laying down and avoiding strenuous exercise for at least 24 hours (all to prevent the Botox from migrating to other parts of the face, thereby rendering it ineffective for the problem at hand). And take into account that the effects won't be immediate—and they will eventually wear off. "Additional treatments are necessary after a few months," says Carroll.
The Final Takeaway
I didn't notice any difference for the first few weeks. I was grinding, clenching, and getting my usual tension headaches, which Liotta explained would likely happen.
"When Botox is used to relax the facial muscles that cause fine lines, the maximum effect is seen in seven to 10 days," Liotta says. "Similarly, when Botox is used to relieve the pain of TMD and teeth grinding, you should expect some pain relief in around a week. When Botox is used to reduce masseter muscle hypertrophy cosmetically, the maximum effect is not seen for between six weeks and three months."
But then something new happened. I found myself having to actively relax my muscles less and less, the headaches stopped turning up, and I mostly forgot about my affliction until having to research TMD to write this piece.
There's no downtime, no residual pain, and I was on my way back to work without any marks or bruising. In the coming weeks, I started to notice far less clenching. It still happens but not at every moment of the day (as it was previously). I'm going back in for another appointment in two months to maintain the results, as they're supposed to last six months (and up to nine after you've been getting them for a while). I'm super happy with the results and can't wait for the pain to continue to lessen. I'll keep you updated.
Ed note: If you suspect that you have TMD issues, consult with a dentist first—they may recommend an alternate plan like a nightguard.
Cleveland Clinic. Temporomandibular disorders (TMD): overview. Updated May 10, 2016.
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