This article will demonstrate how the use of botulinum toxin is integrated into daily dental treatment in a number of disciplines. Non-surgical, minimally invasive treatment of the muscles of the head and neck is essential for frontline TMJ and myofascial pain therapy as well as treatment of bruxism, removable prosthodontics, orthodontics, periodontics, and implant therapy.

Parafunctional activities associated with the stomatagnathic system include lip and cheek chewing, fingernail biting, and teeth clenching. Bruxism can be classified as awake or sleep bruxism. Patients with sleep bruxism are three to four times more likely to experience jaw pain and limitation of movement than people who do not experience sleep bruxism. Signs and symptoms of bruxism and parafunctional activity include hypertrophied masseter and temporalis muscles, myocitis of these same muscles, morning jaw stiffness, and sensitivity in a tooth or teeth. Additionally, migraine is associated with parafunctional activity. Dental professionals are responsible for diagnosing and managing parafunction. Patients can be managed with oral appliances of various designs.

Modern-day mouthguards and oral applications have been used since the early 20th century. They are currently in use for protection against athletic injuries; the treatment of TMJ, bruxism and sleep apnea; and athletic performance enhancement. The American Dental Association and the American Academy of Pediatric Dentistry both recommend the use of protective mouthguards to help prevent sport-related injury. The treatment of burxism was, in fact, the first use of modern mouthguards and was followed by customized designs for protection of the oral structures and to treat specific conditions. More recently there has been a resurgence of interest in athletic performance mouthguards, which have been found in a number of studies to improve reaction time, muscle strength and sensory functions. The purpose of a mouthguard dictates the materials and designs most suitable for optimal results.