For those who may not be familiar with our practice yet, it’s important to clarify a common misconception about the term “TMJ.” This abbreviation, which stands for temporomandibular joint, is a natural component of everyone’s anatomy and not a diagnosis in itself. Simply being told you have “TMJ” is akin to being informed that you possess a “knee.” It doesn’t specify a condition or disease.

When patients experience significant jaw pain, it often stems from myalgia, or muscle pain. Our approach to treating this discomfort begins with encouraging patients to use gentle stretching techniques, utilizing tools like the passive jaw stretching device our team has developed. Should these initial methods not provide sufficient relief, we then consider trigger point injections, which involve the administration of lidocaine into the affected muscles to alleviate the pain.

If this treatment proves effective but short-lived, we may administer it again. However, if subsequent treatments fail to extend relief, we explore Botox as an alternative therapy.

We focus on the four primary muscles responsible for closing the jaw—the superficial masseter, deep masseter, temporalis, and sometimes the medial pterygoid—though not all patients require intervention in all these muscles. In cases where the medial pterygoid isn’t a source of pain, we adhere to a specific protocol, distributing Botox in a pattern that aims for balance and comprehensive care.

Our standard treatment involves administering Botox symmetrically, with a typical session utilizing a total of 100 units to address myalgia-induced discomfort effectively. This process is carefully mapped out to ensure precision and efficacy, with each injection site strategically chosen to provide maximum relief.

If we determine that the medial pterygoid muscle is contributing to discomfort, we adjust our protocol accordingly, reallocating units to treat this area inside the jaw. Our goal remains the same—to provide targeted relief while covering all bases, ensuring that each muscle involved in jaw closure is adequately treated for optimal patient comfort.