Cosmetic Botox in The Dental Office

The dialogue about whether or not dentists should be treating patients with cosmetic BOTOX and fillers has been going on now for years.  I have been peripheral to it, and have never really had a strong opinion either way. The number of states that have weighed in on the side of “yes” is increasing year after year, and yet the debate continues. This last weekend I attended a continuing education program and one of the presentations was on cosmetic BOTOX and fillers. To be honest the thirty minute presentation didn’t inspire me to want to be able to offer cosmetic BOTOX and fillers as a service in my practice. The next day I had the opportunity to closely observe two live patient demonstrations. The patients had very specific attributes of their appearance they were interested in changing.

The exam and evaluation were extremely thorough, and I was incredibly impressed by the extensive knowledge of the dentist doing the procedures. More than a simple knowledge of the chemistry behind how the Botox works, or even the skill to give an injection, it was his knowledge of the muscles of the face, how they interact and pull against one another that was astonishing. It was this knowledge of the underlying muscle function, and how the groupings of muscles firing resulted in the skin appearance that is critical to being successful when administering cosmetic Botox. This evaluation and diagnosis is what determined where to administer the medication. Now you add to that, understanding the chemistry and the mechanism of action of the Botox. Factor in the age of the patient and the appearance of the skin to calculate the dose. Added to all of this was utilizing fillers to augment the procedure, and special injection techniques to minimize the swelling and post operative response and maximize the precision of how he placed the materials under the skin.

It was absolutely amazing to watch, and the results were impressive. The day before he had said in his lecture the results are subtle. This is true, and seeing it in person was impactful, because the day before in photos it had not been. I also realized we want the results to be subtle, or said differently, natural, and not obvious that the patient has had anything done. It’s magical if others know something is different, but can’t quite figure out what it is. I aim for this same response in my esthetic dentistry, I never want my patients to hear, “Wow, nice crowns”. What wasn’t subtle was the response of the patients. It was that same incredible moment as when you first show a patient their new veneers. How they see themselves changes in an instant , along with their self-confidence. One thing I walked away with was knowing that this is just a different way of helping people feel better about themselves, and that always has positive results in so many aspects of their lives.

So where do I go from here. I have to say I am intrigued, I am also clear this is not something you take on lightly, and that between me and ever working on a patient is intensive training. I can see how the dentists who teach this and use it in their offices are passionate about it’s value. I can also see it is a valuable service and combining it with the esthetic procedures I do every day could take my results to a higher level. I’ll let other folks figure out the answer at a legislative level.