By Dr. Louis Malcmacher
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I just got back from the Chicago Midwinter Meeting, which is always one of the best dental meetings of the year. This is actually my 30th straight year at that meeting. I cannot wait until next year because the faculty from the American Academy of Facial Esthetics is giving its two-day live patient hands-on Botox and dermal filler course, which will make it the first live patient course given at the Chicago Midwinter Meeting in recent history.
You know, it’s interesting that when I give my most popular course, The Hottest Topics in Dentistry, I talk about the full range of general dentistry, from what is new in restorative dentistry, crown and bridge, periodontics, endodontics, prosthodontics, and implants, to the next generation of no prep veneers and advanced practice management techniques. I also discuss Botox and dermal fillers in dentistry, which is one of the hottest topics on the agenda.
As a matter of fact, I save it for later in the day because if I address it first, it is often all the audience wants to talk about. One of the reasons for this is because it is new and exciting, and once dentists understand what Botox and dermal fillers actually do, their dental creativity immediately kicks in and gives them all kinds of new treatment options in every other dental discipline.
There is no question that Botox and dermal fillers are well known for their esthetic results in terms of smooth skin and replacing lost volume in the face, especially the oral and perioral areas. Botox is essentially a muscle relaxer, and dermal fillers, such as Juvederm and Restylane, are volumizers or plumpers.
Once you have been trained on these procedures and thoroughly understand the anatomy, physiology, pharmacology, dealing with adverse reactions, and everything else there is to know about them, then you will find many therapeutic uses in dentistry for both functional and dental esthetic purposes. Now that over 35 states allow Botox and dermal fillers for both facial esthetic and therapeutic purposes, we’re finding many helpful uses for Botox and dermal fillers in dentistry.
Here are a few examples of therapeutic uses for Botox and dermal fillers
Botox dental therapeutic uses
▲ TMD cases
▲ Bruxism and clenching cases
▲ Facial pain cases including treating trigger points
▲ Treatment of angular cheilitis
▲ Gummy smiles
▲ Orthodontic relapse and depressed orthodontic appearance
▲ Reducing muscle hyperactivity for retention of removable prosthodontics
Dermal fillers in the nasolabial folds, lips, mentalis fold, labiomental folds, and intraorally are used in the following:
▲ Gummy smiles
▲ Establishing esthetic dental lip lines and smile lines in esthetic dentistry cases as an alternative to gingivectomy, crown lengthening, and veneers
▲ Treatment of angular cheilitis
▲ Eliminating “black triangles” between teeth after periodontal and implant treatment that did not preserve the papilla
▲ Reestablishing lip volume for proper phonetics (in addition or as opposed to teeth lengthening with fixed or removable prosthodontics)
▲ Adding lip and perioral volume around the mouth for retention of removable prosthodontics
In terms of these therapeutic uses, nearly every state in the U.S. and most Canadian provinces allow Botox and dermal fillers for the practice of dentistry as defined by the dental practice act. Many of these therapeutic uses of Botox and dermal fillers are actually quite exciting for dental practitioners because they help tackle some of the most difficult clinical situations we confront.