Does Insurance Cover Botox for TMJ And Bruxism?

23rd Aug 2020

Does Insurance Cover Botox for TMJ And Bruxism?

If the question, “ Does insurance cover Botox for TMJ and bruxism?” has crossed your mind as you nurse the painful symptoms of TMJ and bruxism, you’re not alone.

Botox can be a very effective treatment for TMJ (also known as TMD) and bruxism, as many people who have the procedure report minimal side effects and significant relief from their TMJ or bruxism.

However, repeated Botox treatments aren’t cheap. Though Botox is typically billed to medical insurance, many insurance companies do not cover Botox treatments for TMJ and bruxism.

is botox for tmj covered by insurance

Insurance Coverage for Botox

Botox can be a valuable tool to treat bruxism and TMJ — as long as you can afford it. The procedure is typically run through medical insurance companies rather than dental insurance companies. Note that Botox has not yet been approved by the FDA to treat bruxism and TMJ.

While most insurance plans don’t cover the treatment, it never hurts to ask. Depending on your plan, your insurance company may offer some coverage for Botox to treat TMD and bruxism. However, you need to understand your coverage before scheduling a Botox consultation. If you get the treatment done and later find out it’s not covered, you will be responsible for the cost.

For instance, Healthline explains, "Medicare does offer coverage when botox is used as a medically necessary treatment".

Botox for TMJ or bruxism could cost up to $1,500 per treatment. If your insurance company does not cover Botox treatment for bruxism and TMJ, you can manage your symptoms and protect your teeth with other, more affordable treatment options.

Most notably, those with bruxism can turn to night guards as a cost-effective way to protect your teeth and reduce symptoms. You can get a professionally-made, custom-fit night guard online for as little as $160.

Rather than order online, those with TMJ should consult with a dentist about night guards and other treatment options. TMJ mouth guards are different from mouth guards for bruxism — they help reposition, stabilize, and take pressure off the jaw.

Does Insurance Cover Botox for TMJ and Bruxism

How Botox Injections Treat TMJ and Bruxism

Botox is an alternative treatment for TMJ and teeth grinding that works by weakening and relaxing the jaw muscles. It’s typically injected into the masseter muscle, which is just below the cheekbones. Though this muscle will be relaxed, you can still smile, chew, and operate your jaw normally.

Although the FDA has not approved Botox for treating TMJ and bruxism, studies have shown it can reduce symptoms. And because it is an effective treatment, a few insurance plans may offer coverage regardless of whether it is approved by the FDA.

Some patients who use Botox report mild side effects such as bruising and bleeding at the injection site. This side effect may increase after repeated use.

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TMJ and Bruxism Background

TMJ and bruxism are related conditions, both affecting the jaw muscles. These conditions create very similar symptoms, so we’ll take a look at each in turn.

TMJ, or temporomandibular joint disorder, is a condition involving dysfunction in your jaw joints. Symptoms of TMJ disorders can include:

  • Pain or difficulty chewing
  • Lockjaw
  • Clicking and popping when opening and closing the jaw
  • Jaw pain or soreness
  • Ringing in ears
  • Limited range of motion in the mouth
  • Sore facial muscles

Bruxism is a condition where people grind and clench their teeth (usually at night). Symptoms of clenching and grinding can include:

  • Facial pain
  • Jaw tension
  • Tension headaches
  • Jaw pain
  • Tooth pain or sensitivity
  • Tooth damage

These symptoms are annoying at best and can be extremely painful and damaging at worst. When you suffer from bruxism or TMJ, you seek any treatment that could offer relief, including Botox. But because it’s not covered by most insurance plans, you may want to look into other ways to ease your symptoms.

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Conclusion

Many people find Botox relieves their bruxism and TMJ symptoms. However, it’s often too expensive because many insurance plans don’t cover it.

A night guard is an affordable and successful treatment for most people. Night guards can relieve common bruxism and TMJ symptoms such as sore jaw muscles, and they protect against tooth damage caused by clenching and grinding.

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While we don’t recommend online mouth guards to those with TMJ, bruxism sufferers can get a custom-fit mouthguard at an affordable price from Pro Teeth Guard. We make our night guards in a professional dental lab, and every night guard is guaranteed to fit comfortably with our 110% money-back guarantee.

Sources:

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