Botox

Medically reviewed by Dr. Pejman Ghorbani, DDS

Botox has moved well beyond the dermatologist’s office. Dentists have used it for jaw pain and clenching for years, and since 2023 Virginia law has allowed dentists who complete Board-approved training to use it for cosmetic reasons as well. This guide explains what it is, what it can and cannot do, and what to ask before you have it — wherever you choose to be treated.

What Botox actually is

Botox is the best-known brand of botulinum toxin type A, a purified protein that temporarily stops a nerve from telling a muscle to contract. Injected in tiny, measured amounts, it relaxes only the muscle it is placed in. It does not fill anything, tighten skin or change its texture: it works on lines and problems caused by a muscle working too hard, and the effect fades over a few months as the nerve endings recover.

Cosmetic and therapeutic uses

On the cosmetic side, the classic areas are the upper face: the vertical “11” lines between the brows, horizontal forehead lines, and crow’s feet at the corners of the eyes. On the therapeutic side, dentists use it in the jaw muscles — chiefly the masseter — for clenching, grinding and muscle-related jaw pain, where it lowers the force the muscles can produce. The two sides overlap more than people expect: the same knowledge of facial muscles underpins both.

FDA-approved versus off-label

Each product is approved by the FDA for specific areas, and it is worth knowing which. BOTOX® Cosmetic is approved for frown lines, forehead lines, crow’s feet and neck bands. Dysport and Daxxify are approved cosmetically for the frown lines between the brows. No botulinum toxin is FDA-approved for teeth grinding or TMJ pain.

Using a product outside its approval is called off-label. It is legal and very common, and often well supported by clinical experience — but the research behind an off-label use is usually thinner, and you are entitled to be told. Virginia’s training requirement for dentists specifically includes informed consent for off-label use.

The brands are not interchangeable

Botox, Dysport and Daxxify are all type A toxins, but they are made differently and measured in units that cannot be compared or converted between brands. That has one practical consequence: a price per unit tells you very little across brands. Compare the price of treating an area. Beyond that, the differences are in approvals and duration — Daxxify was studied for longer-lasting results, and Dysport may contain traces of cow’s milk protein, so it is not for anyone with that allergy.

Is it safe?

In trained hands and at cosmetic and dental doses, serious problems are rare, and the common side effects — bruising, a headache, a small bump at the injection point — pass quickly. The side effects specific to each area are predictable: a drooping eyelid after frown-line treatment, a heavy brow after forehead treatment, tired chewing muscles after masseter treatment. All of them wear off.

Every botulinum toxin product also carries an FDA boxed warning: rarely, the effect spreads beyond the injection site, causing difficulty swallowing, speaking or breathing, hours to weeks later. That needs emergency care. People who are pregnant or breastfeeding, who have a nerve-and-muscle disorder such as myasthenia gravis, or who have an infection at the injection site should not be treated.

Questions to ask before you are treated

• Who will do the injections, and what training have they completed?
• Which product will you use, and is it FDA-approved for this area?
• What dose do you recommend, and what does treating this area cost in total?
• What side effects are most likely for this area, and what do I do if one happens?
• When should I expect to see results, and when would I come back?

A good provider answers all of these without hesitation — and will sometimes tell you that Botox is not the right tool for what is bothering you.

Treatments at Shield Dental Care

What we do for this, and what each appointment involves.

• Botox in Burke, VA

  Botox, Dysport and Daxxify at Shield Dental Care in Burke, VA — for frown lines, forehead lines and crow’s feet, and for jaw pain, grinding and clenching.

• Botox for Frown Lines (the “11s”) in Burke, VA

  Botox for the vertical “11” lines between the eyebrows at Shield Dental Care in Burke, VA: how it works, what to expect, results, side effects and who should wait.

• Botox for Forehead Lines in Burke, VA

  Botox for horizontal forehead lines at Shield Dental Care in Burke, VA: why they are treated with the frown lines, what to expect, results and side effects.

• Botox for Crow’s Feet in Burke, VA

  Botox for crow’s feet — the smile lines at the outer corners of the eyes — at Shield Dental Care in Burke, VA: how it works, what to expect, results and side effects.

• Botox for Teeth Grinding & Clenching in Burke, VA

  Botox in the masseter muscles for teeth grinding and jaw clenching at Shield Dental Care in Burke, VA: how it works, the evidence, side effects, and how it pairs with a night guard.

• Botox for TMJ & TMD Relief in Burke, VA

  Botox for TMJ and TMD relief in Burke, VA. Learn how Botox helps jaw pain, teeth grinding, clenching, headaches, and muscle tension.

• Botox Lip Flip & Lip Lines in Burke, VA

  A Botox lip flip and Botox for vertical lip lines at Shield Dental Care in Burke, VA: how each works, what it cannot do, how long it lasts and side effects.

• Botox for a Gummy Smile in Burke, VA

  Botox for a gummy smile at Shield Dental Care in Burke, VA: when relaxing the lip muscles helps, when it will not, how long it lasts and side effects.

• Masseter Botox for Jaw Slimming in Burke, VA

  Masseter Botox for a slimmer jawline at Shield Dental Care in Burke, VA: how it works, why it is off-label, how long the change takes and the side effects.

• Botox for Chin Dimpling in Burke, VA

  Botox for a dimpled, pebbled or orange-peel chin at Shield Dental Care in Burke, VA: how it works, what it cannot change, how long it lasts, side effects.

• Botox for Downturned Mouth Corners in Burke, VA

  Botox for downturned mouth corners at Shield Dental Care in Burke, VA: how relaxing the DAO muscle helps, why it won't fix deep marionette lines, side effects.

• Botox for Bunny Lines in Burke, VA

  Botox for bunny lines, the creases on the sides of the nose when you scrunch or laugh, at Shield Dental Care in Burke, VA: how it works, limits, side effects.

• Botox for Neck Bands in Burke, VA

  BOTOX Cosmetic for vertical neck (platysma) bands at Shield Dental Care in Burke, VA: the FDA-approved dose, what to expect, limits and neck-specific risks.

• Dysport in Burke, VA

  Dysport (abobotulinumtoxinA) at Shield Dental Care in Burke, VA: what it is approved for, how it compares with Botox, results, side effects and who should not have it.

• Daxxify in Burke, VA

  Daxxify (daxibotulinumtoxinA-lanm) at Shield Dental Care in Burke, VA: the longer-lasting option for frown lines, how it compares with Botox, results and side effects.

• Botox Cost in Burke, VA

  What decides Botox cost at Shield Dental Care in Burke, VA: areas, product and dose, why unit prices mislead, insurance, HSA/FSA and written quotes.

Articles

6 articles from the Shield Dental Care team.

• Botox Aftercare: The First 24 Hours

  Botox aftercare explained: what to do in the first day, which rules are evidence and which are convention, what is normal, and the warning signs.

• Botox or a Night Guard for Teeth Grinding?

  A night guard protects your teeth; Botox turns down the force of clenching. What each does, what the evidence shows, and why many patients need a guard first.

• Botox vs Dysport vs Daxxify: What Is the Difference?

  Botox, Dysport and Daxxify compared: FDA approvals, why units do not convert, what the evidence says on onset and duration, ingredients, and how we choose.

• First-Time Botox: What to Expect

  A first Botox appointment, step by step: what to tell us beforehand, what the injections feel like, the first two weeks, and realistic results.

• How Long Does Botox Last?

  Why Botox wears off, how long Botox, Dysport and Daxxify last according to their labels and trials, what changes it, and when to rebook.

• Why Get Botox at the Dentist?

  Why dentists offer Botox, what Virginia law requires of them, how it fits with jaw and bite care, and the questions worth asking any Botox provider.