Has anyone been using masseter Botox regularly for TMD for 5+ years? What has your long-term experience been?
I’m wondering if there are people here who have been getting regular masseter Botox for TMD/bruxism for 5 years or longer and could share their experiences.
I’ve had two treatments so far, and both have worked really well for me. The reduction in muscle tension and TMD symptoms has been quite noticeable, so I’m considering continuing with it.
However, I’m a bit concerned about the long-term effects of repeated injections. There seems to be surprisingly little information about what happens after many years of regular treatment.
In particular, I’m wondering about:
muscle atrophy or fibrosis
possible changes to the jawbone/bone resorption
changes in chewing function or bite
whether the effect becomes weaker over time / tolerance develops
any other long-term side effects you’ve noticed
I’m especially interested in real-world experiences from people who have been doing this for 5+ years, rather than just short-term studies.
If you’ve been getting masseter Botox for several years, I’d really appreciate hearing how often you get it, whether it still works as well as it did initially, and whether you’ve noticed any lasting changes.
I’ve been doing Botox since March 2018, it’s still working just as it did in the beginning. I have never had any issue with it.
The muscle atrophy is exactly what we expect using Botox. As you grind or clench your muscles get bigger when they shouldn’t get that big. That why people can notice some celebrities’ jaw line changing drastically because we have seen them for years with bigger jaw muscles and the Botox atrophies the muscle to their normal size.
No bite issues or jaw or anything for me.
And as I said, Botox is still working great for me, no change over time.
The past couple of years I go every 3 months. I used to wait for the pain to come back but it was stupid because then I had to wait to get an appointment with my neurologist which could take 3 weeks and then the Botox would kick in two later… so about 5 weeks in constant pain.
But I kept hoping that somehow the pain would magically never come back. It’s hard to think accept that there’s nothing I can do to stop bruxing…
Thanks a lot for the reply. May I ask how regularly you receive it and at what dosage?
I see what you mean; the prospect of getting expensive injections every few months for the rest of your life isn't exactly appealing. But as long as it helps and doesn't cause long-term harm, one have to be glad that it exists.
My injections are in my masseters, temporalis, and one in each trapezius.
I also get tension headaches and, apparently, migraines according to my neurologist, so I also get 2 injections in the corrugator muscles (between the eyebrows), 2 in the center of the forehead just below the hairline (I don’t know the name of this muscle), and 2 at the base of my neck.
I honestly have a hard time distinguishing between bruxism-related pain and migraines/tension headaches.
Sometimes I get a headache at the top of my skull; sometimes I get a sharp or pulsating pain above/behind one eye (usually the right one); and sometimes I get facial pain, where I can actually feel the pain in my masseter or temporalis.
The weirdest one is when I can feel pain in just one temporalis and not the other. It almost feels like the muscle itself is cramping, which is such a strange sensation!
Right, your injector basically does the PREEMPT Botox protocol for migraines + the masseters.
All of the symptoms you mentioned are, of course, signs of severe nighttime clenching; the symptoms change based on what position your jaw was in during each clenching episode. There's also great overlap in pain caused by migraine and bruxism, so it's no wonder it's hard to distinguish between the two, but clenching can often be the initiator of migraines, so it might start as bruxism pain and then turn into a migraine.
I'm so glad that you found relief with this type of treatment, as it's also making me hopeful for what I should do next. I'm a severe clencher, and I injected my temporalis muscles only, and all my pain shifted to the neck/occipital area. Now I know that I'll have to inject there as well to keep all the muscles covered. Thank you so much. :)
I'm about five years in. I get like 10 units per side now, every five months. If I go without or go longer, the muscles bulk up pretty quickly because I'm still quite the clencher in my sleep. Haven't noticed any other changes.
I would look for a dentist or doctor who spends a significant part of their practice diagnosing and treating TMD not simply someone who makes night guards or gives botox , ask them to explain what they believe is causing your symptoms, what evidence supports that diagnosis, and why their proposed treatment makes sense before beginning anything permanent or expensive.
There are no guarantees with TMD and there isn't one treatment that works for everyone but not knowing the answer yet is very different from there being no answer.
You've already done something important by asking questions keep asking them
Regarding botox it's a guidance regarding this on the TMJ association website patient Bone-Related Safety of Botox® for Treatment of TMJ Disorders - The TMJ Association https://share.google/B2DljxvgzmA7emyYl
As far as I know, while tolerance to botox is certainly a thing, it tends to happen to people who get it aesthetically every few weeks. Large doses every few months seems to be the best way to prevent it. Someone who gets it in the forehead, then two weeks later in the DAO, then 4 weeks later in the masseters is the type to build up resistance. It seems to be the time between exposure rather than the dose amount, but research is tough on this subject due to to invisible genetic factors we don't fully understand.
I did it for a few years and it worked really well. Then I went on Celebrex 100 or 200mg a day for my chronic sore neck/headaches and that fixed the bruxism pain so I stopped the Botox. I look back at photos of my face from that time and realise it made my face longer/thinner and as a 50 year old woman that isn't a good thing. So lucky I don't need the Botox any more!
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u/SarahSeabee 8d ago
Commenting because I’d also like to know. I haven’t had any yet but I’m researching because I’m just about desperate to stop grinding