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  • Assess the efficacy of Botulinum Toxin type A (BTX-A) as an alternative treatment for Temporomandibular Dysfunction (TMD), targeting the main group of mastication muscles.
  • Guide the Dental Hygienist’s role as
    a therapeutic advocate for the future
    of Botulinum Toxin treatment products.

Botox Injection Sites


  • Literature review searches from Cochrane, PubMed, EBSCO, Google Scholar with relevant search terms.
  • Research found from the past ten years (2009-2019), with relevant search terms.
  • Ten studies were used for this literature review, while other ten were excluded for duplicate information


  • BTX-A is a neurotoxic protein that prevents the release of the neurotransmitter acetylcholine from axon endings at the neuromuscular junction and thus causes flaccid paralysis.
  • Following treatment with Botox injection, the symptoms of various TMD conditions such as bruxism, trismus, headaches, migraines, and especially myofascial pain were observed to be eliminated with minimal chance of recurrence.
  • Potential side effects from Botox treatment range from muscle weakness to mandibular bone loss, yet they are all reversible and able to resolve in a short amount of time.
  • Compressive loading of the temporomandibular joint (TMJ) aids in reversing the reduced mandibular bone volume and density in the condylar cartilage caused by BTX-A.
  • Dental professionals should not eliminate Botox injection as a treatment option for TMDs. Patient counselling about its ease and efficacy prior to the procedure is important.


Emara, A., El-Faramawey, M., & Hakam, M. (2013). Botulinum toxin injection for the management of temporomandibular joint clicking. International Journal of Oral and Maxillofacial Surgery, 42(10), 1360. doi: 10.1016/j.ijom.2013.07.675 Desai, M. J., Saini, V., & Saini, S. (2013). Myofascial pain syndrome: a treatment review. Pain and therapy, 2(1), 21–36. doi:10.1007/s40122-013-0006-y Ataran, R., Bahramian, A., Jamali, Z., Pishahang, V., Sadeghi Barzegani, H., Sarbakhsh, P., & Yazdani, J. (2017). The Role of Botulinum Toxin A in Treatment of Temporomandibular Joint Disorders: A Review. Journal of dentistry (Shiraz, Iran),18(3), 157–164. Dutra, E. H., O’Brien, M. H., Logan, C., Tadinada, A., Nanda, R., & Yadav, S. (2018). Loading of the Condylar Cartilage Can Rescue the Effects of Botox on TMJ. Calcified Tissue International, 103(1), 71–79. Image retrieved from: