TMJD (Temporomandibular Joint Dysfunction) is extremely common, affecting about 30% of the population. The masseter and temporalis muscles are the main muscles of mastication (chewing) along with some of the smaller muscles such as the pterygoid. The masseter muscle is the strongest muscle in the body and can exert a very large amount of force on the teeth and TMJ. Sometimes clenching of the teeth can occur because of stress or gum chewing resulting in enlargement of the masseter and/or the temporals muscles. Grinding of the teeth is often done during sleep and can affect the teeth and cause asymmetric enlargement of the masseter muscle. These conditions are associated with jaw pain, headaches, temple pain and masculinization of the female face. Some people, especially those of Asian decent have genetically enlarged masseter muscles causing an unwanted rounding of the face.
Treatments often include night guards, arthroscopic surgeries, muscle relaxers etc. Botox is a treatment option that should be considered first line therapy as it is low risk and extremely effective. A typical treatment strategy involves 15-30 units of Botox per side every month until the symptoms are improved and the muscles begin to weaken.-, typically 3-4 treatments in a row. Maintenance is usually done every 8-9 months. While symptoms improve in the first few months, jaw slimming may take 1-2 years of consistent treatment, especially in the jaw bone has enlarged as well.