The Temporomandibular joint (TMJ) connects the jaw to the skull.  These two joints are located in front of each ear.  The joint is composed of the condyle of the mandible, an articulating disk, and the tubercle of the temporal bone.  The joint allows side to side, up and down, as well as protrusion and retrusion of the jaw.  The joint along with its attached muscles, allows movements needed for speaking, chewing, and making facial expressions.  Injury of the TMJ can arise from both arthritic changes as well as local insults. Nocturnal jaw clenching, jaw clenching due to stresses, as well as local trauma can play a role in the pain and spasm associated with TMJ.  Females that smoke cigarettes have a higher risk of TMJ disorder.  This disease is often associated with hemi-facial spasms and migraine headaches.  Patients often have very strong masseter muscles and cannot widely open the mouth.

Botulinum Toxin (Botox) is an alternative treatment for TMJ and associated jaw tension and pain.  Injections along the masseter muscles and pterygoids help relax these muscles involved in the pain and spasm.  This medication can help minimize the lock jaw situation.  The procedure is simple, with little discomfort, and is effective.  Most patients experience improvement within one or two days following treatment.  The injections are at the temporalis, masseter, and pterygoid muscles near the jaw. The procedure is bilateral.Following the procedure the patient can usually return to normal activities.