Uploaded May 2026 | Updated September 2026, 23 hours ago
I wanted to take a second to correct the information I spoke about the other day in a video around Masseter Botox and what I thought was muscle atrophy happening. I intend to never mislead you, but instead provide the best information I can as a TMJ Dentist.
Having said that, please keep in mind that I do not use Botox as a first line or long-term treatment for TMJ/TMD because it is simply not appropriate. This is why I did not recognize paradoxical bulging.
If you are using Botox as a long-term solution and doing it every 3 to 4 months for your patients, I strongly believe you’re doing them a huge disservice.
Additionally, I think it’s important to be kind on the Internet. It is very easy to make broad statements and say things like: “ you’re spreading misinformation” (like I’m saying incorrect things purposely. 🙄) and “make sure your information is evidence-based” when truthfully speaking, the evidence around Botox for treating TMD is not great.
NOW - Let's get into the meat of it. Botox is a Neurotoxin. When injected into the Masseter muscles, it paralyzes those muscles, and they essentially "stop functioning," to reduce clenching activity and reduce pain.
Two potential side effects of Botox:
💉 1) Paradoxical Bulging: when there is an uneven distribution of Botox into the muscle fibers.
💉 2) Muscle Atrophy. This occurs after Botox is injected multiple times - every 3-4 months for about a year. This can cause the masseter muscle to atrophy, weaken, and get significantly smaller. This will change the shape of the face AND affect the size of the airway when sleeping AND cannot be easily reversed.
As a TMJ Dentist, Botox is not my first line of treatment for TMJ/TMD; I do not recommend it. It isn’t treating the root problem; it’s only paralyzing it.
I hope this helps with any questions! Sound off below 👇
I wanted to take a second to correct the information I spoke about the other day in a video around Masseter Botox and what I thought was muscle atrophy happening. I intend to never mislead you, but instead provide the best information I can as a TMJ Dentist.
Having said that, please keep in mind that I do not use Botox as a first line or long-term treatment for TMJ/TMD because it is simply not appropriate. This is why I did not recognize paradoxical bulging.
If you are using Botox as a long-term solution and doing it every 3 to 4 months for your patients, I strongly believe you’re doing them a huge disservice.
Additionally, I think it’s important to be kind on the Internet. It is very easy to make broad statements and say things like: “ you’re spreading misinformation” (like I’m saying incorrect things purposely. 🙄) and “make sure your information is evidence-based” when truthfully speaking, the evidence around Botox for treating TMD is not great.
NOW - Let's get into the meat of it. Botox is a Neurotoxin. When injected into the Masseter muscles, it paralyzes those muscles, and they essentially "stop functioning," to reduce clenching activity and reduce pain.
Two potential side effects of Botox:
💉 1) Paradoxical Bulging: when there is an uneven distribution of Botox into the muscle fibers.
💉 2) Muscle Atrophy. This occurs after Botox is injected multiple times - every 3-4 months for about a year. This can cause the masseter muscle to atrophy, weaken, and get significantly smaller. This will change the shape of the face AND affect the size of the airway when sleeping AND cannot be easily reversed.
As a TMJ Dentist, Botox is not my first line of treatment for TMJ/TMD; I do not recommend it. It isn’t treating the root problem; it’s only paralyzing it.
I hope this helps with any questions! Sound off below 👇
