Understanding Botox

Botox is a trade name for botulinum toxin, a neurotoxic protein produced by the bacterium Clostridium botulinum. While it’s commonly known for its cosmetic applications in reducing wrinkles, Botox has a variety of medical applications, including the treatment of certain types of orofacial pain.

When considering Botox treatment, it’s essential to consult with an orofacial pain expert to ensure that the therapy is appropriate and to receive the best possible outcomes.

Ways Botox Works to Treat Orofacial Pain

Muscle relaxation: One of the primary mechanisms of Botox in treating orofacial pain is its ability to cause muscle paralysis. When injected into specific muscles, Botox can reduce or eliminate muscle contractions.

Pain modulation: Research suggests that Botox may interfere with the transmission of pain signals in the body. Besides affecting the muscles into which Botox is injected, this may also apply to the surrounding tissues.

Reduction of inflammatory mediators: Botox may play a role in reducing the release of certain inflammatory mediators, which can further contribute to pain relief.

Chronic migraine relief: While the exact mechanism isn’t fully understood, it’s believed that the toxin can prevent the release of neurotransmitters involved in the pain pathway of migraines.

Applications in Orofacial Pain

TMJ disorders: Botox can be beneficial in reducing the pain associated with TMJ disorders by relaxing overactive or tense muscles of the jaw.

Bruxism: Patients who grind their teeth, a condition known as bruxism, can benefit from Botox injections. By reducing muscle activity, the force of grinding can be lessened, which may lead to decreased wear on the teeth and reduced pain.

Migraine: For patients whose migraines manifest in the orofacial region, Botox can serve as a preventive treatment. Botox has been approved by the FDA for the prevention of chronic migraines.

Neuropathic pain: Certain cases of neuropathic pain, such as trigeminal neuralgia, may benefit from Botox treatment.

Side Effects

Botox injections are generally safe when performed by experienced professionals. However, as with any medical procedure, there can be potential side effects. 

It’s important to note that the side effects depend on the specific area of the body being treated and the dose of Botox administered. If a person is considering Botox injections, whether for cosmetic or therapeutic reasons, they should discuss potential risks and benefits with their healthcare provider. 

Most side effects will clear up within 48 hours, but any lasting side effects should be reported to the provider as soon as possible. If any unusual or severe symptoms occur after receiving Botox, it’s crucial to seek medical attention immediately.

Common Side Effects

  • Bruising and pain at the injection site
  • Headache
  • Droopy eyelids
  • Crooked smile or drooling
  • Dry eyes or excessive tearing

Less Common Side Effects

  • Difficulty swallowing
  • Muscle weakness
  • Speech difficulties
  • Breathing difficulties
  • Allergic reactions, including itching, rashes, wheezing, asthma symptoms, or dizziness

Insurance Information and Timelines

Many insurance providers cover the cost of Botox treatment, but reimbursement for these treatments vary from one insurance plan to another. Insurance companies will pay only for services they determine to be medically necessary under their current policies.


Most insurance plans require authorization for Botox in order for the treatment to be covered. Please check with your insurance company to see what is covered in your benefits package. 

Botox Appointments and Follow Up


In order to receive Botox treatment at Facial Pain Specialists, the patient must first have an initial consultation with their provider to determine that it’s the best path of treatment for them.  

Botox Appointment

This appointment includes a checkup on the patient case and the actual injection.


A follow-up appointment three weeks post-injection is required to monitor treatment effectiveness. If any side effects from treatment occur before this follow-up, the patient should report them to their FPS provider promptly. If any unusual or severe symptoms occur after receiving Botox, it’s crucial to seek medical attention immediately.

If Botox treatment is successful, patients may receive injections every three months.

Botox Discharge Instructions

After receiving Botox treatment, patients should follow certain guidelines to ensure optimal results and minimize potential complications. Below are general post-treatment recommendations.

Remain upright for at least 4 hours post-injection

  • Avoid rubbing or massaging the area
  • Refrain from strenuous exercise or heavy physical activity to prevent bruising 
  • Stay hydrated and avoid alcohol
  • Avoid heat exposure, such as saunas and hot tubs 
  • Avoid blood thinners

Be vigilant for potential side effects, such as swelling, bruising, headache, or any unusual symptoms. If any adverse reactions or complications arise, contact  Facial Pain Specialists promptly.

FPS requires a follow-up appointment three weeks post-injection to evaluate the results.

For answers to your questions about Botox therapeutic injections, talk with your FPS provider.