A TikToker Says Her Smile Was "Botched" After Getting Botox for TMJ

TikTok is having a moment with Botox warnings. In March, lifestyle influencer Whitney Buha made news after sharing that a botched Botox job left her with a droopy eye. Now, there's another cautionary tale about Botox — this time, involving a TikToker's smile.

Montanna Morris, aka @meetmonty, shared in a new video that she got Botox about two months ago for TMJ (aka temporomandibular joint, which connects your jawbone to your skull; disorders of the TMJ are usually just referred to as "TMJ"). But the treatment didn't quite go as planned. (

"They over-injected me and injected it in the wrong spot," Morris said of her Botox experience. As a result, she explained, some of her facial muscles are now temporarily "paralyzed." She even shared a picture of herself smiling pre-Botox, then smiled in real-time to show viewers the difference.

Morris's comments were flooded with sympathetic messages, including some from people who've also tried getting Botox for TMJ but had better results. "OMG Botox has been my saving grace for TMJ. I'm so sorry you had this experience!!!" wrote one person. "Oh no! Luckily it's not permanent," said another.

There's a lot to wade through with this one. Even if you aren't mulling over Botox for TMJ, you probably have some questions. Here's what you need to know.

First, a little more on TMJ disorders.

When your TMJ works properly, it lets you talk, chew, and yawn, according to the U.S. National Library of Medicine. But when you have a TMJ disorder, you can struggle with a range of symptoms, including:

• Pain that travels through your face, jaw, or neck
• Stiff jaw muscles
• Limited movement or locking of your jaw
• Painful clicking or popping in your jaw
• A change in the way your upper and lower teeth fit together

TMJ disorders can be caused by trauma to your jaw or temporomandibular joint (like getting hit there), but the exact cause of the condition usually isn't known, according to the National Institute of Dental and Craniofacial Research (NIDCR).

Why is Botox recommended for TMJ?

FTR, the NIDCR doesn't list Botox as a first-line treatment for TMJ. Instead, doctors may initially recommend a bite guard that fits over your upper or lower teeth, or the short-term use of over-the-counter pain medicines or nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, according to the institute.

As for Botox, technically it isn't specifically approved by the Food and Drug Administration (FDA) to treat TMJ disorders. However, Botox is approved to treat chronic migraines, which TMJ disorders can cause. (

Here's how Botox for TMJ works: Neuromodulators like Botox "prevent your nerves from signaling treated muscles to contract," explains Joshua Zeichner, M.D., director of cosmetic and clinical research in dermatology at Mount Sinai Hospital in New York City. While Botox can be helpful in treating wrinkles, "we can also use it to address muscle-related issues like TMJ, where the masseter muscle [the muscle that moves the jaw] at the angle of the jaw is overactive," Dr. Zeichner says. Injecting Botox into this muscle essentially relaxes the area so it's not overactive, he explains.

When done correctly, Botox for TMJ can be really helpful, notes New York City dermatologist Doris Day, M.D. Research has shown that Botox for TMJ can help decrease pain and increase movement in the mouth. "Botox really is such an amazing game-changer for people with TMJ disorders," which is why it's often used as an off-label treatment for these conditions, says Dr. Day.

What are the possible drawbacks of using Botox for TMJ?

For starters, it's crucial for an injector to hit the right spot. "Neurotoxins like Botox require precise injections for proper placement of the product," explains Dr. Zeichner. "The goal of treatment is to relax only the specific muscles you want to target while leaving the others alone."

This is incredibly important, echoes Dr. Day. "If you inject too high or too close to the smile, there can be a problem," she explains. "These muscles are a little complicated. You really have to know your anatomy." If the injector doesn't know what they're doing or happens to make a mistake, "you can end up with an uneven smile or temporary lack of movement," which can last for months (as Morris shared in her TikTok), says Dr. Day.

There's also the possibility of using too much Botox, which Morris referred to as "over-injecting" in her TikTok. "Over-injecting these muscles with too high of a dose can cause problems with moving these muscles," says Gary Goldenberg, M.D., assistant clinical professor of dermatology at the Icahn School of Medicine at Mount Sinai in New York City. "It makes the muscle weaker than intended."

So-called "paralysis" of certain facial muscles can happen when muscles next to the masseter muscle (the muscle your injector should target) are unintentionally treated, or when different layers of the TMJ are not completely treated, explains board-certified dermatologist Ife J. Rodney, M.D., founding director of Eternal Dermatology Aesthetics. Cue the difficulty smiling or an uneven smile, as Morris shared in her TikTok.

Dr. Zeichner says it's "uncommon" for over-injection or misplaced injection to happen, especially when you're treated by someone who is skilled in the procedure, like a board-certified dermatologist or plastic surgeon. Still, he adds, some people can have unusual anatomy, "which you may not be able to predict in advance."

If you're one of the unlucky few to experience a Botox snafu, know that the effects on your facial muscles won't last forever. "These unwanted side effects usually resolve or become less noticeable in about six to eight weeks," says Dr. Rodney. "However, it is possible that they may last six months or more, until the Botox completely wears off."

If you're interested in trying Botox for TMJ but you're nervous about the risk of losing your smile, Dr. Goldenberg suggests asking your injector to just do a little bit at first. "In my practice, I always inject less than what I think a patient will need on the first visit," he says. "Then, the patient comes back in two weeks and we inject more if necessary. This way we find an effective dose without overdoing it."

But again, make sure you see someone who is a board-certified dermatologist or plastic surgeon (i.e. someone who frequently administers Botox). As Dr. Day says: "You don't want to cut corners when it comes to your beauty or health."