Can Botox help your aching jaw?

A few weeks ago, a young woman named Debbi came to see me asking about Botox injections for her masseter muscles.  The masseter muscles are on both sides of your jaw. These muscles help clench your jaw when chewing.  Debbi realized that she tends to clench her jaw when she is stressed, and she also grinds her teeth when she sleeps.  In addition to jaw discomfort she also noted bulging masseter muscles which made her face look swollen .  Botox can help treat this problem as well as several other areas that most people are not aware of.  Debbi heard from her friends that I have extensive experience with Botox and authored the book “Botox and Beyond: Your Guide to Safe, Nonsurgical, Cosmetic Procedures”.  She came to see me in consultation to help her with her aching jaw.

Botox is a prescription drug in a class known as neuromodulators.  This class also includes other FDA approved medicines such as Dysport, Xeomin, and Jeuveau.  Another neuromodulator known as Daxi is expected to receive FDA approval sometime in the very near future.  The potential advantage of Daxi is that it is supposed to last longer.  These drugs all work via the same basic mechanism, they relax muscles.  For a muscle to contract, it must receive a signal from a nerve cell known as a neuron.  Neuromodulators function just like a mute button on your phone blocking the message getting from the nerve cell to the muscle.  If the muscle does not receive the signal to contract it remains in its relaxed state.

Botox is best known as a wrinkle relaxer.  It works to soften what are called “dynamic wrinkles”.  These are the lines caused by the folding of the muscles under the skin.  The constant folding and creasing etches lines into the skin.  Botox relaxes the muscles and the lines gradually soften over time as the skin is no longer being folded.  Botox doesn’t act as a filler. Injectable fillers such as Juvederm, Restylane and RHA will fill and plump up wrinkles but that is the subject of another article.  Areas that Botox is FDA approved include the glabellar lines or so called “11s”, forehead lines as well as lateral canthal lines most commonly known as “crows feet” on the side of your eyes.  With skilled technique Botox can get great natural results.  It is currently the most popular nonsurgical cosmetic treatment.

Debbi’s problem was easily solved with Botox.  Treating the masseter muscles with Botox is considered an “off-label” use of the drug as it is not specifically FDA approved for this. Using medicines “off-label” is very common practice.  When we inject the masseter muscles, because they are so strong, we typically treat with a slightly higher dose than some of the fine lines.  At Debbi’s visit we treated her masseters as well as her glabellar frown lines.  Debbi returned 2 weeks after treatment and reported a dramatic improvement in her jaw pain as well as softening of her bulging muscles creating a slimmer appearance.  She also noted softening of her frown lines.  Like many patients who receive Botox treatments Debbi also noted an overall improvement in her moods.  She was delighted.

Debbi’s case represents one of the many ways Botox can help our patients.  Results with Botox tends to be technique dependent.  Results should look natural and not obvious.  It is always best to seek your treatment with an expert whether it be for cosmetic injectable treatments or treatments that are more medical in nature.