Botulinum toxin type A (BoNT-A) is being increasingly used off-label for the treatment of orofacial pain, although there are reports of pain relief while the effect of the toxin persists, some studies indicate long-term adverse effects such as loss of bone density in the mandibular condyle, weakness of the masticatory muscles, difficulty opening the mouth, among others. Methodology: This study qualifies as a literature review having the database "Pubmed" as a bibliographic survey, using keywords such as "Botulinum toxin type A", "BoNT - A", "Orofacial Pain", "Bony changes", "Masseteric hypertrophy", "TMD". We conclude that because it is a means of treatment without regulated protocols and the scarcity of studies related to adverse effects, it can become a dangerous intervention for the patient, causing more harm than good. Therefore, it requires a closer look at this area and more studies are needed to prove the real effectiveness of botulinum toxin in the treatment of orofacial pain.

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