Cosmetic Surgery Tips

Is Botox For Tmj Covered By Insurance Alberta

Botox is a great option for TMJ patients who suffer from clenching and grinding. It can be used in conjunction with exercises and other non-surgical treatment options to alleviate muscle spasms, reduce pain, and improve function. We are certain that Botox works well for TMJ treatment because of the numerous case studies that have been published on the topic.

You may find it hard to access the right information on the internet, so we are here to help you in the following article, providing How To Get Botox Covered By Insurance and Botox Access Program Canada

Is Botox For Tmj Covered By Insurance Alberta

For those who suffer from TMJ pain (temporomandibular joint disorder), Botox is an option to consider. The jaw muscles (masseter muscles, in particular) can get enlarged contributing to a square appearance of the lower face (masseteric hypertrophy).

The clenching and grinding causes the jaw muscles to get enlarged. For women this can have cosmetic concerns as well, as this contributes to the lower face having a more masculine appearance. Mastication habits and gum chewing can further worsen the issue which is why it’s good to avoid chewing gum if you these problems.


These are actually considered to be a secondary headache disorder. Estimates suggest that 1 in 4 people are affected by TMD.

  • Associated with teeth grinding (bruxism)
  • 1.5 times higher in women
  • Can be associated with problems with alignment of upper and lower teeth
  • Neck or TMJ trauma can be a trigger


  1. Physiotherapy including mobilization and stability exercises
  2. Occlusal bite splints
  3. NSAIDs – Non-steroidal anti-inflammatory drugs like Advil®
  4. Trigger point injections
  5. Botox injections into masseter and temporalis muscles for refractory symptoms

Is botox for TMJ pain covered by insurance?

The simple answer is no for patients that I see in Edmonton, Alberta. This question causes patients the most amount of confusion. While many patients who have 3rd party insurance plans that do cover Botox (private drug plans such as Manulife, Sunlife, or Great-West Life), it isn’t covered for TMJ pain or Bruxism. Why not? Currently, there is no official approved indication with Health Canada for the use of Botox for TMJ pain. In other terms, it is an off-label use.

While Botox it isn’t covered for TMJ pain, it is often covered by 3rd party insurance for other conditions including chronic migraine headaches and axillary hyperhidrosis.

Risks of botox injection

Botox injections are relatively safe when performed by an experienced doctor. Possible side effects and complications include:

  • Pain, swelling or bruising at the injection site
  • Headache or flu-like symptoms
  • Droopy eyelid or cockeyed eyebrows
  • Crooked smile or drooling
  • Eye dryness or excessive tearing

Although very unlikely, it’s possible for the toxin in the injection to spread in your body. Call your doctor right away if you notice any of these effects hours to weeks after receiving Botox:

  • Muscle weakness
  • Vision problems
  • Trouble speaking or swallowing
  • Breathing problems
  • Loss of bladder control

Doctors generally recommend against using Botox when you’re pregnant or breast-feeding. And Botox should not be used in people who are allergic to cow’s milk protein.

Select your doctor carefully

Botox must be used only under a doctor’s care. It’s important that injections be placed precisely in order to avoid side effects. Botox therapy can be dangerous if it’s administered incorrectly. Ask for a referral from your primary care doctor or look for a doctor who specializes in your condition and who has experience in administering Botox treatments.

A skilled and properly certified doctor can advise you on the procedure and help determine if it best suits your needs and health.

How you prepare

Tell your doctor if you’ve had any type of Botox injection within the past four months. Also tell your doctor if you take muscle relaxants, sleeping aids or allergy medications. If you take blood thinners, you may need to stop taking them several days before your injection to reduce your risk of bleeding or bruising.

What you can expect

Before the procedure

Most people don’t feel much discomfort during the procedure. But you may want your skin numbed beforehand, especially if your palms or soles are being treated for excessive sweating. Your doctor might use one or more of various methods available to numb the area, such as topical anesthesia, ice and vibration anesthesia, which uses massage to reduce discomfort.

During the procedure

Botox injections are usually performed in a doctor’s office. Your doctor uses a thin needle to inject tiny amounts of botulinum toxin into your skin or muscles. The number of injections needed depends on many factors, including the extent of the area being treated.

After the procedure

Do not rub or massage the treated areas for 24 hours. This may help prevent the toxin from spreading to a different area. You can return to your normal activities right after the procedure.


Botox injections usually begin working one to three days after treatment. Depending on the problem being treated, the effect may last three months or longer. To maintain the effect, you’ll need regular follow-up injections.

How To Get Botox Covered By Insurance

For Botox to be covered by your health insurance, you may need to meet specific requirements. This may involve things like:

Migraine headaches have been a recurrent problem in the past (15 or more headaches each month for at least 3 months)
not better after at least two other treatments

Botox Access Program Canada

The makers of BOTOX®, Allergan, have a co-pay plan in place to reduce the financial burden of treatment. Benefits under this plan could cover as much as 20% of the price of your BOTOX® injections. You can get the same great co-pay assistance through the program whether you fill your BOTOX® prescription at a brick-and-mortar or an online pharmacy. Medical professionals who prescribe BOTOX® control participant access to the program.

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