The popular wrinkle-smoothing treatment can shrink the jaw muscle responsible for stress-related grinding and clenching.

By Ashley Mateo
Updated: December 06, 2017
Photo: Getty / Bill Diodato

If there's a stress response out there, I have it. I get stress headaches. My body gets tense and my muscles physically ache. I even lost a ton of hair from stress during a particularly miserable job stint (it grew back, thank god).

But one of the most persistent stress symptoms I deal with is clenching my jaw and grinding my teeth-not just during stressful moments, but while I'm asleep and not even aware of what I'm doing. I'm not alone in this-between 8 and 20 percent of adults suffer from awake or sleep grinding. Doctors typically tell jaw clenchers and teeth grinders to stress less (if only it were that easy…) or get a mouth guard (cute). But given where our society currently stands on the collective stress-o-meter, more people are turning to another solution: Botox.

Yes, Botox. The same kind of Botox people have been shooting into their faces for decades to get rid of wrinkles and frown lines. While it isn't clear exactly how many people are seeking Botox-which remains the top minimally invasive cosmetic procedure in the United States-for stress relief, "the number of patients has doubled every year for the past couple of years," says Stafford Broumand, M.D., of 740 Park Plastic Surgery in New York City. "More and more people are being educated as to what Botox can do beyond smoothing out wrinkles."

The protein Botulinum toxin (Botox is the brand name) works by binding to muscle receptors so that when the nerve releases a chemical that triggers the muscle to fire, it doesn't fire. "It's not exactly freezing the muscle," explains Dr. Broumand. "It just doesn't allow the electric impulse from the nerve to reach the muscle."

What exactly does this have to do with stress-related jaw clenching? "The muscle that moves the jaw is called the masseter muscle," says Dr. Broumand. "It starts broadly up your forehead and comes down underneath the zygoma, the cheekbone, and inserts into your jaw. So when you close your jaw, this muscle contracts. And it's a strong muscle that generates a lot of force."

Over time, if that force is being used for clenching and grinding, it can do serious damage-from cracked teeth to temporomandibular joint (or TMJ) disorders that can lead to spasms and severe pain or headaches. "But if you inject Botox in the masseter muscle near the jawbone, where it attaches, it won't have the ability to contract as hard-meaning you can't clench or grind as hard," says Dr. Broumand, who says his office has received referrals from dentists as well as from other medical doctors and patients.

At Dr. Broumand's office, he examined my face and decided that Botox in my jaw could be a potential solution for my daytime and nighttime grinding. I learned that my jaw is slightly asymmetrical-"one side is a little rounded, while the other has a little depression in it," Dr. Broumand informed me. My muscle doesn't bulge out, so it's not totally overexerted, but the Botox could provide some relief. (There's no guarantee Botox will work for every patient, says Dr. Broumand. "There are different degrees of improvement for different people." For severe grinding and clenching, it should be considered alongside other treatments like mouth guards, medication, or even therapy.) He injected me three or so times on each side, which hurt about as much as accidentally pricking myself in the stomach while trying to pin on a racing bib. Then I iced my jawline for about 15 minutes before walking back out into the world with nary a sign of the procedure.

Botox works best if the procedure is repeated every three months, Dr. Broumand told me before I left. (One treatment could cost between $500 and $1,000, depending how much Botox is needed, he said.) Over time, though, the muscle can weaken and injections may be needed less frequently. "In people with very strong masseter muscles, which can make the face look almost trapezoidal versus heart-shaped, we inject the muscle to decrease its activity; over time, that muscle, without having the ability to contract, atrophies or thins," he explains. "The more it atrophies, the less strength your jaw will have and the smaller the muscle will become."

It typically takes about five days to notice the effects of Botox, and, in this case, it wasn't like I was going to be looking in the mirror and watch my wrinkles smoothing out. It was more what I didn't notice the next week-I didn't wake up feeling like my jaw had gotten a workout during the night and I didn't notice so many headaches while working at my computer all day. Was it the Botox, or a less stressful workweek? I felt as stressed as normal, so I'm inclined to say the Botox had at least something to do with it.

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