Does your jaw hurt?
If all you knew about was the masseter in your jaw, please think about the temporalis for a moment too.
If you found this article because bruxism has been stressing you out, you've come to the right place.
You wake up with a stiff jaw, and some days even your temples throb.
I only slept all night, so what on earth is happening inside my mouth?
If you often hear the person you live with say, "You were grinding your teeth again last night...", or if your jaw feels tired and the headaches keep coming back every morning, take your time and read this today.
I'll explain simply why grinding your teeth makes your jaw ache, why your temples can feel tight, and what exactly the masseter and the temporalis are doing all night long.
Once you understand it, the reason is surprisingly simple.
I slept — but my jaw muscles may not have.
Today, let's talk about what kind of overtime(?) the masseter and temporalis are putting in while we sleep.
While You Were Sleeping, Your Jaw Is Working Hard
While you were sleeping……
Hello. I'm Dr. Jaeho Jeon, an oral and maxillofacial surgeon at ARC Dental Clinic near Jongno, Euljiro, and Myeongdong.
Not long ago, during evening clinic hours, a female patient came in urgently, saying her jaw hurt terribly.
"My jaw keeps hurting, so I've been to a few local dental clinics, but it never really seems to get better."
She said she had searched deliberately for a place where an oral and maxillofacial surgeon looks at the TMJ, and came all the way to our clinic. When I asked where she lives, she said Yongsan.
ARC Dental's oral & maxillofacial approach to TMJ and bruxism botox in Jongno.
Honestly, whenever I see people who travel this far on purpose, I'm always grateful — but a part of my heart feels a little heavy. Because there really are so many dental clinics nearby, and she had passed all of them to come here.
"She came a long way, so she should receive proper treatment before she leaves."
As a doctor, that thought comes first. And strangely, I feel a little more responsibility too. "I really hope this person goes home feeling better." Well, that's the feeling. Haha.
Ah... I've wandered off-topic again. Let me get back to the jaw.
The patient said, "Doctor, I grind my teeth a lot while I sleep."
Most people don't know it themselves. It happens while they're asleep. But by morning, the traces remain. The jaw is stiff, the temples feel heavy, and some days even the head hurts.
Her family had asked her first. "You were grinding your teeth again last night. Are you okay?"
The patient's bruxism was fairly severe. When I checked the X-rays and the oral condition, her molars were already heavily worn down. "Badly ground down" would be a better way to put it.
But what the patient said still stays with me.
"Doctor, when I wake up in the morning, it feels like there's tooth powder left in my mouth."
It's a little surprising the first time you hear it. Just how much did she grind to produce that...? She was asleep, yet her teeth and jaw muscles were working hard all night.
So I asked her.
"Doesn't your jaw feel stiff when you wake up in the morning?"
And she answered like this. "Yes. My jaw hurts, and my temples are tight and the headaches are bad too."
And right here, the masseter and the temporalis I want to talk about today make their entrance!
Now Bite Down Once, Hard
You can feel that you're not using only your jaw, right?
If you place your hands on both sides of your jaw, you'll feel a muscle that firms up with force. This muscle is the masseter. It's what we commonly call the "square jaw" muscle. When the masseter is well developed, the jawline can look a bit more square. Haha.
Now, this time, move your fingers up and place them on your temples, then bite down hard again. How is it? This one tenses up and firms up too.
This muscle is the temporalis.
In other words, when you grind or clench your teeth at night, the masseter isn't working alone. The temporalis is working too. In the end, both are pulling an all-nighter. Haha.
That's why when treating people with severe bruxism or clenching, it's important not to look only at the masseter, but to check the condition of the entire masticatory (chewing) musculature, including the temporalis.
ARC Dental's oral & maxillofacial bruxism botox.
Bruxism Botox — Will Botox Help If I Grind My Teeth Badly?
"Doctor, my bruxism is so bad — will I get better if I get jaw botox?"
Among the questions people who come in with jaw pain from bruxism ask, this is a regular one. Haha.
Alright, let me explain it simply! When you grind your teeth or clench down hard, the muscles that move the jaw repeatedly use strong force. Among them, the representative muscles are the masseter and the temporalis I've been talking about.
If you clench and grind all night, these muscles can't rest and keep working. Simply put, I'm asleep, but my jaw muscles are working overtime. Haha.
Hmm... think of it as your jaw continuously doing a "bulk-up." Hahaha.
Botox is used to reduce the contraction force of muscles that use excessive force for a certain period of time.
So in patients whose bruxism or clenching is severe and whose masseter or temporalis tension is excessive, botox can help reduce the excessive force the muscles generate, and thereby help relieve stiffness or muscle-related pain around the jaw.
Here, the important thing is that you shouldn't think of it as "a shot that completely eliminates bruxism." Rather than a treatment that erases the habit of grinding your teeth while you sleep, it is more accurate to understand it as a treatment that reduces the excessive force the jaw muscles generate when you grind.
So I explain it to patients simply like this.
"It's not about erasing the habit of grinding — it's about taking a little of the force out so your jaw doesn't work so hard when you grind."
Especially if your teeth are heavily worn, you shouldn't think about botox alone — you should also look at whether a splint is needed to protect the teeth, and whether there is any problem with the TMJ joint itself.
In the end, the purpose of bruxism botox is closer to reducing the "overwork" of the jaw muscles that are working too hard every night, rather than to make your jaw immovable no matter what.
I Have a Grinding Habit... Do I Need Botox Too?
Not everyone who grinds their teeth needs botox.
At ARC Dental, we selectively apply physical therapy, spray-and-stretch therapy, massage and stretching, botox, and splints depending on the patient's condition.
If the muscle tension isn't very severe, I sometimes start by observing with just simple massage and stretching that I teach in the treatment room, at-home self-care, and physical therapy.
On the other hand, if bruxism or clenching has caused severe tension in the masseter and temporalis and the pain continues, we consider botox as one of the treatment options.
Also, if bruxism is severe enough that the teeth are visibly worn — like the patient I mentioned earlier — you shouldn't look only at the jaw muscles, but also think about how to protect the teeth.
When teeth are worn down and disappearing, there is a high risk of not only jaw problems but also tooth problems. So in cases like this, we sometimes consider a device such as a splint.
Of course, this isn't absolute either. In the end, there's one important thing.
Even if you came for botox, don't decide on botox first. Look first at why it hurts, which muscles are under the most strain, and what changes have occurred in the teeth — and then decide on treatment.
TMJ Pain — Is It Okay to Just Leave It?
"A few days passed and it got better, so I've been putting off treatment."
There are more people than you'd think who just endure it even when their jaw hurts. "It'll get better in a few days." "A little noise from the jaw is normal, isn't it?" Like that.
Of course, most TMJ pain doesn't suddenly progress to a serious state. But if the pain keeps getting worse, or the range you can open your mouth keeps shrinking, leaving it for a long time is not good.
It's not common, but if the structural problem of the TMJ progresses severely, it can become difficult to open your mouth properly or even to eat, and in the worst case, surgical treatment may need to be considered.
Hold on a moment!
"By the way, which department performs TMJ surgery?"
It's an area handled by oral and maxillofacial surgeons like me, who are trained at university hospitals. Usually, this kind of TMJ surgery is performed at a university hospital. Haha.
Oral and maxillofacial surgery is not a department that only does wisdom tooth or implant surgery. It handles the surgical diagnosis and treatment of the jaw, face, and oral region — TMJ disorders, oral trauma, fractures of the jaw and face, and intraoral tumors and oral cancer.
Of course, you don't need to think about surgery first just because your jaw hurts. You don't need to worry too much that you'll have to have TMJ surgery. What I think is important is to accurately check the current state so that you don't reach the stage where surgery is needed, and to manage it well with conservative treatment as much as possible.
Why We Look at the Masseter and Temporalis Together — An Oral & Maxillofacial Surgeon's Approach
Bruxism botox — why treat the masseter and temporalis together?
You all remember when we bit down hard earlier, right? Not only the masseter but also the temporalis at the temples tensed up together.
For exactly that reason, at ARC Dental, when we decide to do botox treatment related to bruxism or clenching, we don't inject the masseter alone — we treat the temporalis together as well.
Since they worked together all night, we can't rest only one of them. Haha.
Especially for people with severe bruxism, not only the masseter but also the temporalis tightens repeatedly, so many say their jaw is stiff in the morning and their temples feel heavy too.
So what we look at isn't simply the jaw — it's how the jaw muscles are working.
Jaw Botox — The Difference
"Doctor, jaw botox is also given at dermatology clinics. What's different about getting it at a dental clinic?"
This is also one of the regular questions from office workers who come in for TMJ issues in the Euljiro and Jongno area. Haha.
That's right. Botox doesn't suddenly turn into a different drug just because it entered a dental clinic. What differs is where you look, and why you inject.
The "square jaw botox" commonly talked about in aesthetic clinics focuses mainly on an aesthetic purpose — reducing the volume of a developed masseter to make the jawline slimmer.
Of course, getting jaw botox for treatment at an oral and maxillofacial clinic doesn't mean you have to give up the prettier effect. Haha. As the volume of the masseter decreases, the jawline can look a bit slimmer!
But when an oral and maxillofacial dental clinic performs botox for bruxism, clenching, or TMJ pain, the starting point of the question is different.
"How much slimmer will my face get?" — we look first at "Why does this person's jaw hurt so much?"
We check together how much you clench, whether there is bruxism, how worn the teeth are, whether there is any problem with the TMJ itself, and how much the masseter and temporalis are tightening.
Does that mean botox given at a dental clinic has no face-slimming effect?
As I said, that's not the case. Haha. As the volume of the masseter decreases, an aesthetic change — the jawline looking a bit slimmer — can appear together.
To put it simply: we were trying to reduce the jaw muscles' overtime, and the face line getting a little tidier is a welcome side effect. Haha.
"I had jaw botox a few months ago. But my jaw still hurts."
Actually, quite a lot of these people come too. They got square jaw botox a few months ago at a clinic specializing in aesthetics, and over time their jaw became stiff and painful again, or their temples felt heavy, so this time they come to a dental clinic.
Don't misunderstand here. It doesn't mean the botox you got earlier was wrong. The purpose may have been different from the start.
Square jaw botox starts from looking at the jawline, whereas in TMJ care, finding out why the jaw hurts is the starting point.
So if you've already had botox, we check when, where, and at what dose you received it, and first look at whether the cause of the current pain is muscle or the TMJ itself.
Depending on the case, physical therapy, spray-and-stretch therapy, or lifestyle correction may come before getting botox again.
To sum it up in one line:
The jawline looking pretty is good, of course. Haha. Before that, I'll look first at why that jaw hurts.
The Jaw Gets Stressed Too
Treating patients around Jongno, Euljiro, Myeongdong, and Gwanghwamun, there are many times I genuinely feel how much stress office workers live with.
At work you hold it in,
in meetings you hold it in,
in front of your boss you hold it in……
Many people, more than you'd think, are letting their jaw release all the stress they held in all day, at night. Haha.
During the day, without realizing it, you clench your teeth, and at night, while asleep, you grind them. You're definitely resting, but the masseter and temporalis are effectively working 24 hours.
So when I'm talking with TMJ patients and ask, "You've been under a lot of stress lately, haven't you?" most smile and say, "Ah… yes. A lot."
So at the end of the appointment, I sometimes add one very non-medical(?) prescription.
"Don't get too stressed. And be happy. Haha."
Words are so easy, right. Haha.
I know that living without stress is the hardest thing of all. Still, if you have a habit of gritting your teeth and enduring, from time to time consciously let the tension out of your jaw.
You can't avoid work, but your jaw doesn't have to work overtime too.
And if you were clenching your teeth hard while reading this article…… first, let the tension out. Haha.
Lower your upper and lower teeth slightly apart, and let the tension out of your shoulders too!
And from today, those of you suffering because of your jaw — ask your jaw.
"Are you working again right now?"
If it is, clock it out. Haha.
If your jaw keeps hurting, if your jaw and temples are stiff every morning, or if your bruxism is severe enough to wear down your teeth — rather than enduring it blindly, I hope you'll check first why it hurts.
Finally, let me leave one more prescription I give to my TMJ patients. ^^;
Don't live while gritting your teeth.
Even your jaw needs to clock out.
Don't get stressed.
And above all, be happy. Hahaha.
Today too, from Jongno, I'll be cheering on your jaw's clock-out.
This has been Dr. Jaeho Jeon — oral and maxillofacial surgeon at ARC Dental Clinic, clinical professor at Seoul National University Dental Hospital — working hard around Jongno on wisdom tooth extraction, implant revision, oral cysts, clear aligners, and TMJ treatment. :)
