TMJ treatment can go wrong when it targets the wrong structure, uses the wrong tool, or skips a thorough diagnosis first. Hannah Berner’s widely-shared experience is a clear example of what can happen — and a genuinely useful prompt to understand what proper jaw pain care actually looks like.
- TMJ (temporomandibular joint) disorders have multiple causes, and treatment must match the specific cause — a mismatch is where things go wrong.
- Injecting cosmetic neurotoxins (like Botox) into jaw muscles can relieve grinding-related tension, but it is not a first-line TMJ treatment and must be done precisely and conservatively.
- A frozen or asymmetrical smile after jaw-area injections is a known complication when the wrong muscles are affected.
- The safest starting points for most TMJ cases are conservative, reversible options: a custom night guard, physical therapy, and anti-inflammatory support.
- If you have jaw pain, clicking, or locking, the right first call is a dentist trained in TMJ evaluation — not an aesthetic provider.
What Did Hannah Berner Say Happened?
Comedian and podcast host Hannah Berner shared a video showing that a TMJ-related treatment left her smile visibly frozen and her ability to laugh noticeably limited. The clip circulated widely in August 2026 and sparked a real conversation: how does treatment for jaw pain end up affecting your smile?
We are not going to speculate about exactly what was done or who did it. What we can do is explain the anatomy behind why this kind of complication happens — and what it tells you about choosing TMJ care wisely.
What Is TMJ Disorder, Exactly?
The temporomandibular joint is the hinge on each side of your jaw that connects your lower jaw (mandible) to your skull. It is one of the most complex joints in the body: it slides forward and backward, rotates, and handles thousands of opening-and-closing cycles every day.
TMJ disorder (sometimes called TMD, for temporomandibular disorder) is an umbrella term for pain or dysfunction in that joint and the muscles that control it. According to the National Institute of Dental and Craniofacial Research, TMD affects an estimated 10 million Americans and can include:
- Jaw pain or soreness, especially in the morning
- Clicking, popping, or grinding sounds when you open or close your mouth
- Limited jaw opening, or a jaw that “locks” open or shut
- Headaches and ear pain that seem unrelated to the jaw
- Facial muscle fatigue or tenderness
Here is the critical detail: TMD is not one thing. It can come from the joint itself (disc displacement, arthritis), from overworked muscles (often linked to clenching and grinding), from bite problems, or from a combination of all three. Treatment that helps one cause can be useless or harmful for another.
Why Would Someone Inject the Jaw for TMJ?
The masseter muscle — the thick chewing muscle you can feel bulging at the angle of your jaw when you clench — is a major driver of TMJ muscle pain. When people grind or clench heavily, the masseter can become chronically overworked, hypertrophied (enlarged), and sore.
Injecting a neurotoxin (the same family as cosmetic Botox) into the masseter temporarily reduces how forcefully it contracts. For the right patient — specifically one whose TMJ symptoms are primarily driven by muscle overactivity from grinding — this can meaningfully reduce pain and clenching force. Some dentists and oral and maxillofacial physicians use it as one tool in a broader treatment plan.
The problem? The masseter sits very close to other muscles involved in smiling, lip movement, and facial expression. If the injection diffuses into a neighboring muscle — the zygomaticus, the risorius, or the depressor anguli oris — it can temporarily paralyze movements you rely on for a natural smile and laugh. The effect is not permanent (neurotoxin wears off over weeks to months), but it is distressing, and it is exactly the kind of complication Hannah Berner described.
What Does Good TMJ Treatment Actually Look Like?
The American Dental Association recommends starting with conservative, reversible treatments before anything more invasive. Here is how a responsible approach typically unfolds:
Step 1: A Real Diagnosis First
Your dentist should take a thorough history, examine the joint and surrounding muscles, and in many cases take imaging (X-rays or a cone-beam CT scan). Pain alone does not tell you which structure is the problem. Treating blind is how mismatches happen.
Step 2: Conservative Care
For most patients, conservative measures reduce or resolve symptoms:
- Custom night guard (occlusal splint): A precisely fitted appliance keeps your teeth separated and cushions the joint while you sleep, reducing clenching load. This is different from a generic store-bought guard, which can sometimes worsen bite problems.
- Physical therapy and jaw exercises: Stretching, massage, and exercises to retrain jaw posture can make a significant difference for muscle-based TMD.
- Anti-inflammatory support: Short-term NSAIDs (like ibuprofen) and warm compresses help calm acute flares.
- Stress and habit modification: Clenching is often tied to stress. Awareness, biofeedback, and relaxation strategies address the root cause.
Step 3: More Targeted Options When Conservative Care Is Not Enough
If conservative care is not enough after several months, the next steps depend entirely on what the diagnosis shows:
- Masseter injections (neurotoxin) for verified muscle hyperactivity, done by a provider with specific TMD training — not an aesthetic-only injector
- Arthrocentesis (joint lavage) for certain disc-related cases
- Referral to an oral and maxillofacial surgeon for structural joint problems
Surgery is rarely the answer and should come only after all conservative options have been genuinely tried.
The Red Flag: Skipping the Diagnosis
The most common pattern in TMJ treatment that goes wrong is reaching for a more aggressive or cosmetic intervention without first establishing what is actually causing the pain. Injecting muscles, adjusting the bite, or prescribing splints without a thorough workup is like prescribing antibiotics without knowing if the infection is bacterial.
A frozen smile is a dramatic but real reminder of what is at stake when the facial anatomy is not respected. The good news: complications from neurotoxin injections are almost always temporary. The tissue recovers as the medication metabolizes. But weeks of an altered smile — especially for a public figure — is a meaningful cost.
Is a Night Guard the Right Starting Point for Most People?
For the vast majority of people dealing with jaw pain and clenching, yes. A custom night guard does not “fix” the underlying cause, but it protects your teeth and joints from the mechanical damage of grinding, gives the joint a chance to rest, and buys time to figure out whether more intervention is needed.
Custom-fitted guards made from dental-grade materials are significantly more effective than over-the-counter versions. At Vaksman Dental Group, our dental team can evaluate your bite, check for signs of grinding wear on your enamel, and fit you with a custom dental mouth guard designed specifically for your jaw. It is a low-risk, reversible first step — exactly what the evidence supports.
What If My Jaw Pain Keeps Coming Back?
Recurring jaw pain, morning headaches, worn-down teeth, or a jaw that clicks and catches are all worth mentioning at your next dental visit. Our dentists look for these signs at every exam, and we can help you distinguish between muscle-based TMD (very common, very treatable conservatively) and joint-based TMD (less common, may need specialist involvement).
If your symptoms are more complex, we can coordinate with oral and maxillofacial specialists or physical therapists who have specific TMJ experience. You do not have to navigate this alone.
For people who are clenching and grinding significantly, TMJ treatment in South San Francisco at our Mission Road office is a good place to start the conversation. We take the time to sort out what is actually going on before recommending anything.
Frequently Asked Questions
Can Botox or neurotoxin injections make TMJ worse?
They can cause complications — like the smile-freezing Hannah Berner described — when they affect muscles adjacent to the target area. For the right patient with verified masseter hyperactivity, these injections can reduce pain and grinding force. But they should come after conservative care has been tried, and only from a provider with specific training in facial anatomy and TMJ management.
How long does TMJ disorder last?
It varies widely. Many cases of muscle-based TMD improve significantly within weeks to a few months with conservative care (night guard, physical therapy, anti-inflammatories). Joint-based TMD can be more persistent. The good news is that most people do not need surgery — the evidence strongly supports starting conservative and staying there as long as things are improving.
What is the difference between a custom night guard and a store-bought one?
A custom night guard is made from impressions of your actual bite, so it fits precisely and distributes force evenly across your teeth and joints. Generic store-bought guards are one-size-fits-most and can sometimes create uneven contact points that irritate the joint further. For real TMJ protection, custom is meaningfully better.
Should I see a dentist or a doctor for jaw pain?
A dentist trained in TMJ evaluation is usually the right first stop — dentists understand bite mechanics, can examine your joint and muscles, and can fit protective appliances. From there, your dental team can refer you to an oral and maxillofacial specialist, a physical therapist, or a physician depending on what the evaluation shows. When in doubt, start with your dentist.
Jaw pain is common. A frozen smile does not have to be. If your jaw clicks, aches, or wakes you up at night, let our team take a look before symptoms escalate.
Schedule a TMJ Evaluation at Vaksman Dental Group
Written by the Vaksman Dental Group team and medically reviewed by Dr. Irena Vaksman, DDS — South San Francisco. Last reviewed August 2026.