New research suggests a common facial treatment given before jaw surgery could ease postsurgical discomfort and lessen the need for opioids during recovery.
A new study suggests that injections of botulinum toxin type A—commonly known as Botox—given before corrective jaw surgery may reduce postoperative pain and decrease opioid use during recovery, an important consideration amid growing concerns about opioid dependency. The research appears in the May issue of the Journal of Oral and Maxillofacial Surgery (JOMS), the peer-reviewed official journal of the American Association of Oral and Maxillofacial Surgeons (AAOMS).
Researchers found that patients who received Botox injections into their jaw muscles prior to surgery reported lower pain levels and used fewer opioid pain medications in the two weeks following their procedure compared with patients who received a placebo. These findings suggest that Botox could help patients use fewer opioids during their early recovery.
About the Study
The study focused on patients undergoing a common corrective jaw procedure known as mandibular advancement surgery, often performed to fix bite issues, improve facial balance, or address breathing problems. Recovery can be challenging because the two large muscles that control jaw movement—the masseter and temporalis—are significantly disrupted during surgery and can tighten, spasm, and ache for weeks postoperatively as they adjust to the jaw’s new position.
Because Botox has successfully reduced pain and muscle spasms after other types of surgery by relaxing muscle contractions, researchers hypothesized that it could help do the same after corrective jaw surgery.
In this study, conducted between 2021 and 2024, researchers enrolled 40 patients ages 18 to 65 scheduled for surgery at Kingsway Oral and Maxillofacial Surgery in Edmonton, Alberta, Canada, and randomly assigned them to receive either Botox or placebo injections into the jaw muscles two weeks before their procedure. Neither the patients nor the surgeons performing the operations knew who had received which treatment. Both groups followed identical post-surgery pain management plans, including access to prescription pain medication, ibuprofen, and acetaminophen as needed.
Why It Matters
The results were significant. Patients in the Botox group reported lower pain levels before taking any pain medication across the full 14-day study period, and they used nearly half as many opioid doses as patients in the placebo group—an average of about five doses compared with about nine. Researchers suggested that Botox works by reducing baseline pain, so patients feel less likely to need stronger drugs.
For jaw surgery patients, these results offer a promising alternative approach to managing postoperative discomfort while potentially reducing opioid exposure during recovery.
Consult an OMS for Next Steps
Patients scheduled for jaw surgery who are interested in learning more about pain management options are encouraged to speak openly with their oral and maxillofacial surgeon (OMS) before their procedure. Every patient’s situation is different, and an OMS—who specializes in exactly this type of surgery—is best positioned to advise on which approaches are appropriate based on individual health history and surgical needs. To find a qualified oral and maxillofacial surgeon, visit MyOMS.org.
The authors of “Effect of Preoperative Botulinum Toxin A on Pain and Opioid Consumption After Bilateral Sagittal Split Osteotomy” are Kevin E. Lung, DDS, MD, MSc, BSc; Jason Adam, DDS, BSc; Clayton Davis, DDS, MD, MSc; Matthew Fay, DDS, MD, MSc; and Daanesh Zakai, BDS (Wales), MRCS RCS Ed, MBChB.
The full article can be accessed at JOMS.org/article/S0278-2391(26)00059-5/fulltext.
About the Journal of Oral and Maxillofacial Surgery (JOMS)
The Journal of Oral and Maxillofacial Surgery is published by the American Association of Oral and Maxillofacial Surgeons to provide the dental and medical communities with comprehensive coverage of new techniques, important developments, and innovative ideas in oral and maxillofacial surgery. Practice-applicable articles help develop the methods used to handle dentoalveolar surgery, facial injuries and deformities, TMJ disorders, oral and head and neck cancer, jaw reconstruction, anesthesia, and analgesia. The journal also includes specifics on new instruments and diagnostic equipment, as well as modern therapeutic drugs and devices.
About AAOMS
The American Association of Oral and Maxillofacial Surgeons (AAOMS) represents more than 9,000 oral and maxillofacial surgeons in the U.S. AAOMS surgeons specialize in treating diseases, injuries, and defects of the mouth, jaw, and face. Learn more at AAOMS.org.
