Hannah Berner, TMJ and Masseter Botox: What Can Go Wrong and What Helps

Short answer

• Comedian and podcast co-host Hannah Berner has said publicly that masseter neurotoxin injections she had for her TMJ left her, for a time, unable to lift the corners of her mouth into her usual full smile. That is her own account, as she told it on her podcast. It is not a clinical finding about her, and this article does not diagnose her or name a cause for her smile change. The wider topic is real and common. Temporomandibular disorders, often shortened to TMJ, can cause jaw pain, stiffness, clicking, headaches and trouble opening the mouth. Masseter Botox, meaning botulinum toxin injected into the large chewing muscle at the angle of the jaw, can reduce clenching force for some people for a few months. It is an off-label use in the United States: the National Institute of Dental and Craniofacial Research (NIDCR) states that botulinum toxin type A is approved by the US Food and Drug Administration (FDA) for some conditions, such as chronic migraine, but not for temporomandibular disorders, and that it remains unclear whether it is effective for those symptoms. It can also go wrong: chewing weakness, an uneven or shortened smile, bruising, and changes in jaw contour. This article is general information only. It is not a diagnosis or a treatment recommendation for you, and it is not medical advice about Hannah Berner. If you have jaw pain, a locking jaw, or symptoms that interfere with eating, speaking or sleep, see a dentist or physician.

What Hannah Berner Has Said Publicly, and What Has Not Been Shown

Separating a person’s own words from commentary about them matters here, because online discussion has run ahead of what has actually been said.

NewBeauty, reporting on the Friday, June 26, 2026 episode of her Giggly Squad podcast, summarized her account this way. About two weeks earlier, she went to a new provider she had not seen before for masseter neurotoxin injections for her TMJ, and she said she did not know there were risks. A few days later, she said, she woke up, tried to smile, and noticed her mouth felt, in her reported words, “kind of tight.” She later realized she could not lift the corners of her mouth into her usual full smile. CafeMom, also reporting her podcast remarks, quoted her naming the product herself: “Two weeks ago, I innocently went to get masseter Dysport for my TMJ, and I went to a new place.”

Three points follow. First, the product she named was Dysport, a different brand of botulinum toxin type A from Botox. Botox is used as shorthand for this class of treatment, including in this article’s title, but the brands are distinct, non-interchangeable products.

Second, everything above is her account of how her smile felt and looked to her. Other outlets have repeated it in stronger language, such as “botched” or “frozen.” Those words are headlines and commentary, not findings. No treatment record for her has been published, and no treating clinician has, in the reporting read for this article, published an examination, a dose, an injection map or a confirmed cause.

Third, the explanation most often quoted alongside her story is speculation by clinicians who did not treat her. Dermatologists interviewed by NewBeauty suggested that, in cases like this, neurotoxin reaching a nearby muscle involved in smiling, the risorius, could shorten a grin. That is a plausible general mechanism, explained below. It is not a diagnosis of Hannah Berner, and it has not been shown that any injector made an error in her case, or that her experience predicts anyone else’s. Her story is a prompt for better questions, not evidence about rates.

What TMJ and TMD Actually Mean

TMJ is the name of the joint, not the name of a disease. NIDCR explains that “TMDs” refers to the disorders and “TMJ” refers to the temporomandibular, or jaw, joint itself. You have two of them, one on each side of the jaw, and you can feel them by placing your fingers in front of your ears and opening your mouth.

Temporomandibular disorders are a group of more than 30 conditions that cause pain and dysfunction in the jaw joint and in the muscles that control jaw movement. NIDCR groups them into three broad categories: disorders of the joints, including disc disorders; disorders of the muscles used for chewing; and headaches associated with a temporomandibular disorder. A person can have more than one at the same time, so no single treatment fits every case.

These disorders affect about 5 percent of adults in the United States, by NIDCR’s cited estimate, and are about twice as common in women as in men. In most cases the exact cause is not clear: injury can lead to some disorders, but for many people symptoms start for no obvious reason, and research points to a combination of genes, psychological and life stressors, and how a person perceives pain. NIDCR also states that research does not support the belief that a bad bite or orthodontic treatment such as braces causes these disorders, which undercuts the pitch that permanently changing the bite will fix jaw pain.

For a fuller map of the conditions, see the separate TMJ symptoms, causes and treatment guide.

Symptoms, and Whether TMJ Comes and Goes

Yes, symptoms often come and go. NIDCR notes that many of these disorders last only a short time and go away on their own, while some become chronic. A quiet week does not prove a problem has resolved, and a bad week does not prove permanent damage.

The symptoms NIDCR lists as signals of a possible disorder are:

• Pain in the chewing muscles and the jaw joint, which it calls the most common symptom
• Pain that spreads to the face or neck
• Jaw stiffness
• Limited movement or locking of the jaw
• Painful clicking, popping or grating in the joint when opening or closing the mouth
• Ringing in the ears, hearing loss, or dizziness
• A change in the way the upper and lower teeth fit together

One distinction matters. Clicking or popping without pain is common, is considered normal, and does not require treatment, according to NIDCR. It is not, on its own, a reason to book injections or accept irreversible dental work. Painful clicking, clicking with locking, or clicking with limited opening deserves an examination. Jaw pain can also come from a tooth, an ear or a sinus, so a clinician may need to rule out other conditions first.

Bruxism: Clenching and Grinding

Bruxism means clenching, grinding or gnashing the teeth, awake or asleep. It is not the same as a temporomandibular disorder, although the two often travel together and each can aggravate the other. Sustained overactivity of the chewing muscles can leave the masseter enlarged, the muscles sore, and the teeth worn, cracked or sensitive. Morning jaw ache, temple headache on waking, and flattened or chipped teeth are common reasons people first connect the two.

Not everyone who grinds has pain, and not every painful jaw is caused by grinding, so treating the muscle alone can miss the driver. If tooth wear is part of your story, the guide to grinded teeth repair options and what to expect explains how a dentist assesses that damage. Poor sleep can also raise overnight clenching, so this sleep hygiene wind-down routine is a useful support alongside jaw care.

What Masseter Botox Is

The masseter is a main chewing muscle, running from the cheekbone to the angle of the jaw. You can feel it bulge if you clench your back teeth and press the back corner of your jaw.

Masseter Botox involves injecting botulinum toxin type A into that muscle. The toxin temporarily reduces the signals that tell the muscle to contract, so it works with less force. Reviews of botulinum toxin for masseter enlargement describe localized relaxation, reduced muscle volume over time, and a temporary effect, so repeated treatments are needed to maintain it. A weaker masseter can also look smaller, which is why the same injection is used cosmetically to soften a wide jaw. Pain relief and face shape are not the same goal, and a consultation should say which one is being treated.

The injection does not move a displaced disc back into place, repair arthritis, fix a cracked tooth, or stop the habit of clenching. It lowers muscle force for a while, and if clenching continues, symptoms may return as the effect fades over several months.

It also cannot be undone quickly. Unlike filler, neurotoxin cannot be dissolved once it has taken effect. The dermatologists interviewed by NewBeauty made that point in connection with Berner’s story: the effect wears off over about three to four months as movement returns, with no reversal injection. Weigh that before the appointment, not after it.

Is Masseter Botox FDA Approved for TMJ or Bruxism?

No. This is the clearest regulatory fact in this article, and it is worth giving in full.

FDA status wording used here: Botox is not FDA-approved for TMJ disorders. NIDCR states that botulinum toxin type A is approved by the FDA for some conditions, such as migraines, but not for temporomandibular disorders, and that studies for those disorders have had mixed results, so it remains unclear whether it is effective for their symptoms. The FDA approved labeling for BOTOX lists other uses, and temporomandibular disorders, bruxism and masseter treatment are not among them. Masseter injection for jaw pain, clenching, grinding or jaw slimming is therefore an off-label use in the United States.

Off-label does not mean illegal, or automatically unsafe. Clinicians may lawfully use an approved medicine for an unapproved use when they judge it medically appropriate for an individual patient. What it means is that the FDA has not evaluated that specific use through its approval process, so the labeled dose and evidence summary that exist for an approved use do not exist for this one. That raises the standard for the conversation beforehand: why this treatment, for this diagnosis, at this dose, and ahead of which simpler options. Brands are not interchangeable either, and their units are not convertible.

What the Evidence Can and Cannot Show

The honest summary is that the evidence is suggestive and unsettled, not settled.

For bruxism, a 2025 overview in Toxins gathered 14 earlier systematic reviews. In most, botulinum toxin type A showed effectiveness in reducing pain, bruxism events and maximum bite force. But every included review scored low or critically low on methodological quality, overlap between reviews was high, and none effectively evaluated functional movements. Its authors concluded that methodological limitations prevent definitive conclusions. A separate 2024 review of nine randomized trials in sleep bruxism, with only 137 participants in total, likewise called its findings preliminary.

So there are signals that reducing masseter force can reduce pain and bite force for some adults for a few months, but not the long term evidence that would let anyone promise pain relief, tooth protection, or safety across repeated rounds over years. Falling bite force is also double edged: it is the intended effect, and the mechanism behind chewing weakness. Individual stories cannot fill that gap, whether they sell treatment or warn against it.

What Can Go Wrong

Any injection carries general risks, and masseter treatment adds specific ones because of where the muscle sits and what its neighbors do.

More common and usually temporary effects include soreness at the injection sites, bruising, and headache. Temporary muscle weakness is also expected: the muscle is meant to work less hard. Its functional version is chewing weakness, where tough meat, hard crusts or chewy sweets become tiring or difficult for a period. Reduced bite force was the measured outcome in the trials above, so chewing strength is the treatment working, sometimes further than intended.

Smile change and asymmetry are the effects Berner’s account has made familiar. The masseter sits close to muscles that move the mouth, including the risorius, which helps draw the mouth corner outward in a smile. The comprehensive review in Toxins (2025) describes transient facial asymmetry and altered chewing mechanics as side effects that can result from unintended weakening of adjacent muscles such as the risorius, and notes reported cases of smile change after toxin spread toward those muscles. A smile can look shortened, held back, uneven or weaker on one side until the effect fades.

Other contour problems appear in the same literature. Paradoxical bulging can occur, where part of the muscle still bulges despite the intended reduction. Repeated or strong weakening can also reduce the muscle bulk supporting the lower face, and review tables list sagging skin among the risks: a slimmer, less supported jaw area can emphasize loose skin or a jowling look, particularly where skin elasticity is already reduced.

Less common but more serious effects need naming because the labeling names them. Botulinum toxin labels carry a boxed warning, the FDA’s most serious warning, about distant spread of toxin effect. Postmarketing reports describe effects spreading beyond the injection area, hours to weeks after injection, including general weakness, double vision, drooping eyelids, and difficulty swallowing, speaking or breathing, which the labeling states can be life threatening. Those reports relate to these products and uses generally, mostly at other doses and for other conditions, and are not a prediction for a masseter patient. They are why new difficulty swallowing, speaking or breathing after any such injection means seeking immediate medical care.

Finally, there are non medical costs: paying again every few months, and living with a result you dislike that cannot be dissolved, possibly through an important event. One dermatologist quoted by NewBeauty said a smile can look uneven for the first week or so even when treatment is placed correctly, and that an event such as a wedding is a reason not to book within a week or two beforehand.

Why It Does Not Help Every Jaw Problem

Because these disorders are more than 30 conditions, a muscle relaxing injection fits only the muscle part of the picture. It does not treat a displaced disc, joint inflammation or arthritis, a structurally locking joint, a dental infection, a cracked tooth, or headache conditions that only resemble jaw pain. Weakening the masseter then spends months and money while the actual problem continues.

Assessment therefore comes first. NIDCR describes diagnosis as a detailed history and an examination of the head, neck, face and jaw for tenderness, clicking and difficulty with movement, with imaging only where the picture calls for it. There is no standard test for all of these disorders. A consultation that goes straight to units and prices has skipped the part that decides whether this treatment fits at all.

What Helps Besides, and Usually Before, Injections

NIDCR’s central advice is conservative: because evidence for many treatments is limited, experts recommend conservative treatments, and avoiding treatments that permanently change the jaw joints, teeth or bite, or that involve surgery. Start simple, keep it reversible, and escalate only where a specific diagnosis justifies it.

Self-care during a flare

NIDCR lists steps a doctor or dentist may suggest when discomfort first appears: eat soft foods; apply heat or cold to the face, with exercises to gently stretch and strengthen the jaw muscles; take over the counter pain medicines such as nonsteroidal anti-inflammatory drugs, for example ibuprofen, where safe for you; and reduce clenching, gum chewing or nail biting. This article gives no dose or schedule for any medicine, so check suitability with a pharmacist, dentist or physician. Avoid very hard foods while symptoms are active, and do not force wide opening or follow aggressive online stretching routines.

Splints and night guards

Intraoral appliances, also called night guards, splints or occlusal splints, fit over the teeth. NIDCR explains that they protect the teeth, may help with habit reversal such as clenching, and do not change the teeth or bite. It also states that there is not a lot of evidence on whether they improve pain. If one is suggested, make sure it is not designed to permanently change your bite, and stop and consult your dentist if it causes pain. The guide to a gum shield for bruxism covers fit and when a shop-bought guard is a poor substitute for a fitted one. A guard is a physical barrier, so grinding wears the guard rather than the tooth surface. An injection lowers muscle force but adds no barrier, so if both are offered, ask what each part of the plan is meant to achieve.

Physiotherapy, habit reversal and behavioral approaches

Physical therapy aims to maintain, improve or restore movement and function. NIDCR notes that research suggests manual therapy, in which a therapist stretches the soft tissues and muscles around the joint by hand, can help improve function and relieve pain. A physiotherapist may also teach jaw exercises, posture work and relaxation of the jaw, neck and shoulder muscles.

Behavioral approaches work on the habit side. NIDCR lists learning about your specific disorder, reducing clenching, gum chewing or nail biting, relaxation techniques and goal setting, and describes cognitive behavioral therapy and biofeedback as approaches that can help, with biofeedback using a jaw sensor to help a person notice jaw tightening and learn to relax it. Habit reversal addresses something an injection does not: the daytime clenching pattern itself. Neck and shoulder tension often accompany jaw tension in desk work, and this stretching routine for desk workers may help general stiffness, but it does not replace jaw assessment.

Medicines, and the last resort position of surgery

Medicines may be recommended by your own doctor or dentist. NIDCR cautions that evidence to decide which are most effective for this pain is limited, and that some medicines used for these disorders can lead to addiction or other serious side effects, so this article recommends no medicine, dose or duration for any reader. Surgery sits at the far end of the pathway: NIDCR advises trying simpler treatments first and getting second opinions, and notes for open surgery that it makes permanent changes, with no long term studies on its safety for these disorders or how well it works.

Questions to Ask Before Consenting to Masseter Injections

A good consultation answers these questions before treatment, in plain language:

• What is my diagnosis, in specific terms, and what did the examination show?
• Is my problem mainly muscle, mainly joint, dental, or a mix, and what part will this injection change?
• Which product are you using, Botox, Dysport or another brand, and are its units being described for that product only?
• Can you explain that this use is off-label, and what evidence supports it for my diagnosis?
• What dose and injection sites are planned, and how will you stay within the masseter, away from the muscles that move my smile?
• What are the risks for my anatomy specifically: chewing weakness, smile asymmetry, uneven contour, bulging, and loss of lower face support or jowling?
• How long should the effect last, and what is the plan if I dislike the result, given it cannot be dissolved?
• What conservative options, such as a splint, physiotherapy, habit reversal and sleep measures, have we tried first, and why move past them now?
• Who do I contact if my smile changes, chewing becomes difficult, or I develop difficulty swallowing, speaking or breathing?

Write the answers down, including the cost across a year if the effect is maintained. Vague answers on diagnosis, dose or smile risk are themselves information, and pausing for a second opinion costs nothing but time.

If Something Feels Wrong After Treatment

Contact the treating clinician promptly if your smile looks markedly uneven or cannot lift as usual, chewing weakness stops you eating normally, or you develop spreading swelling, increasing pain, or new bulging. Take dated photographs, note when symptoms began, and do not book corrective treatment elsewhere before that clinician has seen you. Early unevenness can change as the effect develops.

Seek immediate medical care for difficulty swallowing, speaking or breathing, marked general weakness, double vision or drooping eyelids after any botulinum toxin injection. Those are the symptoms the labeling’s boxed warning describes for spread of toxin effect. They are uncommon, but not symptoms to monitor at home.

Do not assume that a bad result proves malpractice, or that a result you dislike must be endured in silence. Document, report, and get assessed.

When to See a Dentist or Physician Sooner

Book a prompt assessment rather than self-treating if you notice any of the following:

• Your jaw locks open or closed, or you cannot open your mouth enough to eat comfortably
• Pain is severe, is getting worse, or keeps returning over weeks rather than settling
• Swelling or fever develops, or swelling is spreading
• Your teeth suddenly feel as though they meet differently, or your bite has changed
• Symptoms follow an injury to the jaw or face
• Chewing, speaking or sleep is being disrupted by the symptoms
• Clicking is painful, or comes with limited movement or locking
• You have tooth pain, a broken or loose tooth, or signs of a dental problem alongside jaw pain

A dentist, physician or clinician trained in orofacial pain can examine joint movement, muscle tenderness and the bite, arrange imaging where needed, and separate a muscle problem from a joint, dental or referred pain problem. Self diagnosis from a celebrity story is no substitute for that examination.

Frequently Asked Questions

Did Hannah Berner have botched Botox?

That description is not established as a clinical fact. What is established, through reporting of her own podcast remarks, is narrower: she said she had masseter Dysport, a botulinum toxin product that is not the Botox brand, at a new provider for her TMJ, and that a few days later her mouth felt tight and she could not lift the corners of her mouth into her usual full smile. “Botched” comes from headlines and commentary. No treatment record, dose or treating clinician’s findings for her have been published, so this article does not diagnose her or state a cause.

Is masseter Botox FDA approved for TMJ?

No. Botox is not FDA-approved for TMJ disorders. NIDCR states that botulinum toxin type A is FDA approved for some conditions, such as chronic migraine, but not for temporomandibular disorders, and that study results for those disorders have been mixed, so it remains unclear whether it is effective for their symptoms. Masseter use for jaw pain, bruxism or jaw slimming is off-label in the United States.

Does TMJ come and go?

Often, yes. NIDCR notes that many temporomandibular disorders last only a short time and go away on their own, while some become chronic. Flares can alternate with quieter periods, so a good week does not prove a problem has gone. Persistent, worsening or locking symptoms should be assessed rather than waited out indefinitely.

Is masseter Botox permanent?

No. The effect develops over days to weeks and wears off as muscle movement returns, typically over several months. NewBeauty reported dermatologists describing about three to four months for unwanted effects to fade. It cannot be dissolved in the meantime. Repeated treatments are needed to maintain an effect, and repeated weakening can reduce muscle size and change lower face contour, which should be discussed in advance.

Can masseter Botox change your smile?

Yes, temporarily. The masseter lies close to muscles involved in smiling, including the risorius. Reviews describe transient asymmetry and smile changes where toxin affects those neighboring muscles, as well as chewing weakness. That is a general risk of the treatment, not proof of what caused any one person’s smile change.

What helps TMJ pain without injections?

Conservative, reversible care is the usual starting point: soft foods during flares, heat or cold, gentle jaw exercises as advised, reducing clenching and gum chewing, a fitted splint where a dentist advises one, physiotherapy including manual therapy, habit reversal and biofeedback, attention to sleep and stress, and pain medicines only as advised by your own clinician.

Sources & references

• National Institute of Dental and Craniofacial Research (NIDCR), TMD (Temporomandibular Disorders). https://www.nidcr.nih.gov/health-info/tmd
• US Food and Drug Administration approved labeling for BOTOX (onabotulinumtoxinA), via DailyMed: boxed warning on distant spread of toxin effect, indications, and lack of unit interchangeability between botulinum toxin products. https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=a6f42753-d31e-4b23-8da0-4b990fee4b38
• NewBeauty, Hannah Berner Turned Her Masseter Injection Mishap Into a Bit, published 30 June 2026: reporting of Berner's Giggly Squad remarks of 26 June 2026, and interviews with dermatologists Joel Schlessinger, MD, and Daniel Schlessinger, MD, on risorius involvement as a general possibility, non reversibility, and duration of about three to four months. https://www.newbeauty.com/view/hannah-berner-masseter-injections
• CafeMom, Celebrity Podcaster Got Botox For Her TMJ and It Went Horribly Wrong, published 3 August 2026: reporting of Berner's podcast remarks, including her own naming of masseter Dysport. https://cafemom.com/entertainment/hannah-berner-botox-smile
• Ferrillo, M. et al., The Role of Botulinum Toxin for Masseter Muscle Hypertrophy: A Comprehensive Review, Toxins, 2025. https://pmc.ncbi.nlm.nih.gov/articles/PMC11860558/
• Botulinum Toxin for Bruxism: An Overview (overview of systematic reviews), Toxins, 2025: 14 included systematic reviews all rated low or critically low confidence, with reductions in pain, bruxism events and maximum bite force reported but definitive conclusions prevented by methodological limits. https://pmc.ncbi.nlm.nih.gov/articles/PMC12115368/
• Efficacy and Safety of Botulinum Toxin in the Management of Temporomandibular Symptoms Associated with Sleep Bruxism: A Systematic Review, Dentistry Journal, 2024: nine randomized trials, 137 participants, findings described as preliminary. https://pubmed.ncbi.nlm.nih.gov/38920857/