Content Dam De Print Articles Volume 107 Issue 11 1711demal P01

3 questions

Nov. 9, 2017
Louis Malcmacher, DDS, MAGD, explains how dentists who say they aren't busy enough typically have one thing in common: they don't provide Botox or dermal fillers to their patients. 

I have two quick questions for you to consider. First, are you busy? Second, are you able to handle more capacity in your office? In other words, are you capable of seeing more patients with the office structure that you have in place right now?

Dentists tell me all the time that they are just not busy enough. They say they have full-time practices, yet their schedules still have significant holes. They have the capacity to see more patients but can’t seem to get their chairs filled. On top of this, these dentists are bored with dentistry. The first thing I ask is what services they are offering to patients. The answer I typically get is “everything.”

Now the fun begins. I question these dentists further. Do you do crown and bridge and restorative dentistry? “Of course.” Do you do endodontics? “No, I never really liked endo.” Do you do orthodontics? “No, I couldn’t figure out the wire bending or aligners.” How about cosmetic dentistry? “Sure, I do a couple of veneer cases a year.” Do you place implants? “No, surgery always scared me, but I restore them sometimes.” What about Botox and dermal fillers? “No, I know my patients want Botox, and my team wants to learn, but I haven’t gotten around to it.”

Figure 1: Before and after photos show how Botox and dermal fillers were used for facial volumization and gummy smile treatment as an alternative to surgical procedures.

Of course these dentists are having trouble filling their schedules. They are not offering a wide array of modern dental procedures, and they certainly are not offering procedures patients want. Of course these dentists are bored. They have learned barely anything new since dental school. If you’re still providing the same services you’ve always provided and can’t fill up your schedule, you should be learning new skills to offer the elective treatment patients want now. Right now, patients are getting that treatment elsewhere.

Botox and dermal fillers are the first and second most popular esthetic and therapeutic procedures in dentistry today. While many dentists are still scratching their heads wondering if they should add these services to their practices, the American Academy of Facial Esthetics (AAFE) has already trained more than 13,000 dental professionals, who have expanded their dental practices by incorporating Botox and dermal fillers into everyday dental treatment plans. AAFE member practices are giving patients what they want and averaging an additional $32,500 of monthly production. What would your practice look like with that added production?

AAFE member dentists learn new skills to grow their practices.

Botox and dermal fillers have many therapeutic and esthetic uses in dentistry, including treatment of TMJ and orofacial pain, restorative dentistry, lip lines or smile lines, endodontics, gummy smiles, orthodontic relapse, denture retention, black triangle elimination, and a myriad of other uses (figure 1). From California to New York and from Washington State to Florida, dentists are allowed to use Botox and dermal fillers for dental esthetic and therapeutic uses in the oral and maxillofacial areas, which are the areas that you treat on a daily basis.

All you have to learn is a new skill to provide Botox and dermal filler services.

I have a third question for you: how long are you going to wait to fill your schedule holes? If your patients are not ordering from the menu in your office and you have holes in your schedule, you need to change the services you are providing and give people what they want and what they are paying for at other offices. Stop complaining and being bored. Get trained, fill those chairs, and get busy!

Author’s note: Go to to sign up for a free monthly e-newsletter or for information about live-patient Botox and dermal fillers training, frontline TMJ and orofacial pain training, bruxism therapy, sleep medicine, and Medicare and medical insurance for every dental office.

Louis Malcmacher, DDS, MAGD, is a practicing dentist and an internationally known lecturer and author. He is president of the American Academy of Facial Esthetics (AAFE) and serves as a consultant to STATDDS. Contact him at (800) 952-0521 or drlouis@

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