Temporomandibular disorders (TMD) are the most common chronic pain disorders of the orofacial region after pain caused by teeth. They can affect the temporomandibular joint (TMJ) and/or masticatory muscles, and they are divided into painful and painless conditions. The treatment is sometimes complex and long-term since these are multifactorial disorders with somatic and psychological components. The main treatment methods of TMD are non-invasive methods such as occlusal splints, pharmacotherapy, kinesitherapy, and cognitive-behavioral therapy. Although these methods are generally successful, they provide limited results in some patients, leading to the search for new, alternative therapeutic options such as botulinum neurotoxin (BoNT). BoNT is a bacterial protein toxin obtained from the Clostridium botulinum, which has been used for medical purposes for over 30 years. BoNT, as a therapeutic option in dental medicine, is considered in painful muscle conditions (myalgia), intra-articular disorders (disc dislocation), and parafunctional habits such as bruxism. It is believed that BoNT can have a triple role in the treatment of chronic pain: 1) it causes reversible muscle paralysis by blocking the release of the neurotransmitter acetylcholine from the nerve endings of motor neurons, 2) it has an antinociceptive effect by reducing the release of pain mediators in the periphery, and 3) it achieves its central action by acting on the spinal level. Although recent literature shows the beneficial effect of botulinum neurotoxin on the aforementioned pathological conditions, further high-quality and well-designed research is needed to determine the exact therapeutic effect as well as the botulinum neurotoxin application protocol, and possibly expand the indications for its use in dental medicine.