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Name the treatment goal
Pain, bruxism and contour are different outcomes.
Risks and benefits
Intended benefit
Choose an indication-specific goal: less myofascial pain, lower bruxism contraction intensity or a contour change. Evidence for one outcome does not establish benefit for the others; improvement in muscle thickness is not a substitute for pain or functional improvement.
Risks and tradeoffs
Discuss injection discomfort, unwanted chewing weakness, asymmetry and muscle changes. Botulinum toxin can cause dysphagia (difficulty swallowing), speech or breathing difficulties; new swallowing or breathing symptoms require urgent assessment.
Make the decision together
Compare appropriate conservative treatment and define the baseline jaw function to track. Confirm the actual product, route and treatment plan; do not transfer units between toxin products.