Dr. Pehling has been successfully using Botox therapy for over 8 years for treatment of jaw pain, teeth clenching and grinding, Oromandibular Dystonia and head and face pain. The effects of Botox generally last 3-6 months but can have cumulative effects after 2-3 treatments. They are also effective at reducing the Masseter muscle bulk along the sides of the face. The injections are given with a tiny needle into the face and jaw muscles thereby thinning the face. They decrease muscle contraction by blocking the nerve that attaches to the muscle. They also block the activity of the pain nerves which can be helpful in the treatment of head pain. A thorough knowledge of both Botox and the orofacial anatomy is imperative to decrease unwanted consequences of altering facial expression and swallowing. The potential benefit is that Dr. Pehling has had patients with severe jaw and head pain that went away within 1 week of treatment. Botox therapy is the only effective treatment for focal dystonias.