Applications of Botox in dentistry

Botox has been used for many years in the field of aesthetic medicine. Being one of the fastest growing aesthetic treatments, the annual amount spent on Botox injections is far higher than that of liposuction and breast implants combined. Over the last 7 to 8 years, the popularity of Botox has risen dramatically, with many patients requesting the treatment by name.

Botox is currently used for both cosmetic and clinical purposes. Having neuromodulating properties, Botox is used by dermatologists and plastic surgeons to reduce the appearance of moderate to severe smoker’s lines, crow’s feet, frown lines and forehead furrows. Apart from that, Botox is used clinically to treat a range of medical conditions. Botox injections are indicated for the treatment of spasticity, overactive bladder (OAB), cervical dystonia, blepharospasm (related to dystonia), urinary incontinence (resulted from detrusor overactivity related to multiple sclerosis or other neurologic conditions) and hyperhidrosis (excessive sweating). Having many off-label uses, Botox is also used to treat hair loss and sweating.

Dentists as the facial specialists

When we think of Botox, the first thing that comes to mind is aesthetic procedure. Most people (including some dentists) are skeptical of Botox in dentistry. One of the commonly asked questions is “doesn’t Botox belong in a dermatology clinic?” While dermatologists were among the first health care professionals who integrated Botox into their practice, it does not mean that Botox treatments are strictly for aesthetic purposes. As discussed earlier, Botox is not used exclusively by plastic surgeons.

In fact, it has many other clinical indications (whether FDA-approved or off label). Contrary to what most people think, there is definitely a place for Botox in dentistry. There are increasingly more health care practitioners who incorporate Botox into their practice, including registered nurses, internists, gastroenterologists, ophthalmologists, OB/GYN’s, medical aestheticians, and even podiatrists. It is about time for dentists to jump on the bandwagon. As health care providers, there are good reasons why dentists should be offering Botox treatments to their patients.

Being the true facial specialists, dentists are sometimes more qualified to inject Botox than other specialists. Some of them (particularly the nurses) learn to administer Botox through observational learning without actual training in pharmacology, physiology, and facial anatomy. In contrast, dentists generally have a good understanding on the facial nervous and vascular system, skeletal structures, overall facial aesthetics and facial anatomy. Other medical professionals usually lack knowledge in these areas.

Other specialists may not know about the details associated with Botox treatments, such as smile considerations when the patients express a full or partial smile, the proper ratios of lips to teeth and the proper phonetics. Having extensive knowledge of the maxillofacial (the face from chin to forehead) and oral areas, dentists are also familiar with complication management in these areas. Additionally, dentists perform invasive procedures in the facial, oral, and perioral region on a daily basis (more so than physicians). Having substantial experience in dealing with these treatment areas, dentists are ideal for delivering Botox.

Understandably, the idea of using Botox can feel foreign to some dentists (it is, after all, an unchartered territory in the dental industry). However, there was a time when dental implants and teeth whitening were foreign to the industry. The point is, dentists should be open to the idea of using new products that can potentially transform dentistry (like implants did).

Applications of Botox in dentistry

The mechanism by which Botox acts is fairly straightforward. Botox prevents the release of acetylcholine (ACh), thereby altering the neurotransmissions between motor nerves. As a result, the muscles cannot contract. This helps to prevent the formation dynamic wrinkles, which are mainly caused by facial movements such as frowning. Botox is estimated to have a duration of action of 3 to 4 months, after which the effects will disappear. To maintain the results, patients are required to repeat the treatment.

Traditionally used on the forehead, crow’s feet, and glabellar region, Botox can also be used to complement aesthetic dentistry cases. Plus, Botox can be used as a minimally-invasive option in the treatment of a high lip line, or in orthodontic cases to retain facial muscles. Botox injections are also ideal for patients who struggle to adjust to new dentures. Indeed, no other health care providers can help patients in so many ways like dentists do.

Interestingly, Botox is administered in the same injection areas where dentists inject local anesthetics. The only difference is the depth of injection (Botox is injected extraorally into the facial structures while anesthetic is injected intraorally). Again, this goes to show that dentists are highly suitable for delivering Botox.

Some dentists who are unfamiliar with Botox may worry about the side effects of Botox. In reality, the local anesthetics that most dentists use are more likely to cause adverse effects. This is because dentists already have a good knowledge on local anesthetics. They are also trained to manage any complications that arise from the use of local anesthetics. Similarly, with proper training, dentists will be able to use Botox with confidence.

Dentists should not limit themselves as “teeth doctors.” Being clinically proficient, dentists are already equipped with the knowledge and expertise to perform Botox treatments. With proper training, dentists could be one of the most qualified health professionals to use Botox. Many medicine fields have evolved to include the use of Botox, so should the dental industry. When it comes to Botox in dentistry, dentists can be open minded. Having a variety of uses, Botox has the potential to transform the dental industry.