Your teeth are fine but let’s do something
about those wrinkles;
It makes sense to allow dentists to administer Botox, given their extensive training and demand of patients for more services
By Dr. Andrew Shannon, Special to the Sun
January 5, 2009
B.C. dentists are bringing a
whole new meaning to the word “filling.”
About a year ago, the College of Dental Surgeons of
British Columbia, which licenses and regulates the province’s dentists and
certified dental assistants, quietly introduced a policy allowing dentists to
administer Botox, a substance that had, to date, been used mainly by
dermatologists to reduce facial wrinkles and treat certain therapeutic
Until then, only physicians, their nurses and oral
surgeons were permitted to administer Botox.
That has all changed.
B.C. is now the first and only Canadian jurisdiction
in which dentists can administer Botox. Some U.S. states allow dentists to inject it, but until
recently, no Canadian dentist was permitted to perform the procedure.
As you read this, your first question may likely be —
To me, it makes eminent sense for dentists to
administer Botox. Consider the extensive training that dentists receive —
eight years on average.
In that time, they receive an intimate education about
the musculoskeletal and nerve makeup of the face and neck.
Dentists, of course, provide regular injections into
this part of the anatomy as well. So, the administration of Botox calls upon
the very skills that we dentists employ daily, into a region of the body we
also work upon regularly.
Despite the decision by the college, the decision by British Columbia dentists to incorporate the administration of Botox
into their practice has come about slowly. I began to administer Botox only
this past fall.
I chose to offer it for several reasons.
First, I regard it as a further evolution not only of
my own practice, but also of the practice of dentistry overall. The discipline
has come a long way over the past several decades. Not that many years ago,
dentists filled cavities, performed root canals, and performed other basic
procedures, such as applying crowns and bridges (and in those days, metal-based
crowns, not today’s porcelain ones, were the norm).
Second, I am responding to a demand. As baby boomers
age, they are requesting more and more esthetic types of dental services to
make them look and feel younger. The profession has responded with the addition
of many more esthetic components to their range of existing services.
Bleaching is an example. Since the 1990s, patients
have been able to take home bleaching trays and administer the bleaching
substance themselves. Even that treatment has become more sophisticated, with
the advent of laser lightening of the teeth.
Porcelain veneers, which are thin layers of porcelain
bonded onto the teeth to treat discoloured, worn, chipped or crooked teeth, are
relatively new dental innovations, having been introduced in the 1980s.
Dental implants have also been available since the
’80s, to replace missing teeth.
And braces, once almost a rite of passage for
adolescents whose crooked teeth forced them to sport metal and highly visible
“train tracks” for several years to straighten their teeth, have
advanced and entered the adult realm. Now, they are transparent to minimize the
adult’s — or teen’s — self-consciousness.
Invisalign® treatment, a teeth-straightening procedure that
doesn’t use braces at all, is another example of how the practice of dentistry
But back to Botox. What about training, some people
may ask. Certainly a dentist knows how to inject drugs, but isn’t the
administration of Botox into the face quite different from freezing gums?
Indeed it is, and as a requirement of the college, dentists must have the
appropriate knowledge and skills to administer Botox in their practice.
I underwent training by a Vancouver dermatologist to acquire these skills. I reviewed the
facial and head anatomy and the specific muscles where the injections of Botox
are given and was given training in the use of needles that administer Botox
(they are smaller than the average “freezing” needle).
I believe there are many advantages for patients who
come to their dentists for both dental work and Botox.
There is certainly the time-saving factor. And
patients already have an existing relationship with their dentist. In getting
Botox injections, they need not have to start from scratch with another
Botox is a quick, safe procedure. And as boomers age,
the demand for esthetic and health procedures will only increase.
I am pleased the college has allowed dentists to
administer Botox and I predict that the number of dentists who choose to add it
to their practice is bound to increase.
Dr. Andrew Shannon practises esthetic and general
dentistry in downtown Vancouver.
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