Dentist and Botox

By VancouverFace on 08 Mar 2011

I was at my dentist for a cleaning and I was offered botox injection for my wrinkles even though I had botox injection. My new botox doctor is excellent and he makes me look natural by purposely leaving a little bit of wrinkles. I guess they couldn't tell I had botox last month. I looked up his certifications on the way out and googled it at home. Wow! He learned it in one weekend to do both botox and fillers. No thank you. Enough said. I am an interior designer sometimes.... but I think I had more training in furniture selection than he had in botox injection. Making me think twice before I go back for any dental work. I am sure there are gifted and superhumans out there but I don't my dentist is one. Share your horror or miracle stories......

Comments (11)

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Jason Pozner, MD 14 Mar 2012

In every state continuing education is necessary to keep ones medical license. Board certified plastic surgeons are also required to recertify and keep up with maintenance of certification. There are many training courses on injectables and I have taught at some and listened at others. In addition, there are online webinars and other modes of learning. However, there is no requirement for physicians to attend these courses. Agree with Dr. trussler - the consumer should do their homework.

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Megan P (Community Manager) 14 Mar 2012

Thank you Dr. Pozner, I appreciate you filling me in!

Cindy Trosen Sundet, DDS 30 Sep 2012

absolutely not true regarding your statement on Injection techniques and facial aesthetics.

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Cindy Trosen Sundet, DDS 1 Oct 2012

In many if not all dental schools, dental students have an extra semester to year of head and neck after the same gross anatomy with med students. Everyday in dental education injection techniques, phonation, how muscles work and look under the draped skin and facial aesthetics. We have art classes as well in facial aesthetics, morphology and color. Most of the dental student's 1-3 yrs are with the medical students in addition to and alongside are the dental labs and classes. There are no summer breaks to get in all of the education required. Most public and MD's who graduated a while back may not know this or if they did not have a dental school associated with their medical school. Some dental schools admission requirements are an additional yr of credits than to apply to medical school.(I recently found this out when writing recommendations), and the admissions test(DAT's) require additional testing in spatial aptitude. Dentistry is a specialty in medicine/surgery. Perhaps this would help include dentistry in medical ins. rather than dental benefits that cap at $1000.00(same as it did in the late '60's) and be included in medicare/medicaid. I might add that each operatory is a surgical suite, each surgically wrapped tray costs a min. of $175 not including overhead, staff, DDS's time, treatment, recommendations and salary... that is just to examine and basic diagnostic. I refer so many of my patients back to their MD's(internist, ENT, Derms, Neurologist) when necessary, which is quite often I am writing a detailed referral letter to MD's... can't we get along and respect each other? I too have offered and treated with "Botox" for several years and I still get from not only pts. but MD's/DO's, CRNA's, LPN's, RNS, NP's, PA's that I am a Dentist...why would I think I can do Botox? I don't think they were being disrespectful but just didn't know or remember. I hope that this reaches all of those who are not informed. "Botox" or any injectables should not to be "the wild wild west", they need to be in the hands of educated, experienced, really know head and neck anatomy injectors.

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Andrew P. Trussler, MD 13 Mar 2012

In general, only trained and certified doctors, as well as properly trained nurses should be injecting Botox. Injection techniques and facial aesthetics are not part of dental training. Do your research on what kind of doctor is performing and/or offering injectables. Plastic surgeons and/or physicians trained in facial surgery would be the most appropriate in offering this injectable medication.

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Megan P (Community Manager) 13 Mar 2012

From what I understand, dentists undergo pretty extensive training in injections, so I'm assuming you are speaking specifically to injecting toxins and fillers. If so, perhaps you could answer my one question that has remained unaddressed. What kind of continuing education is required for a plastic surgeon or derm who graduated before these techniques were part of the curriculum being taught?

Jason Pozner, MD 8 Mar 2012

All good comments. My impression is that some dentists can do a good job injecting neuromodulators and fillers especially for TMJ issues and lip enhancement as this is related to their area of expertise. I am not as convinced regarding upper face injections as I think this is out of their area of expertise.
In our multispecialty practice we have plastic surgeons, dermatologists and physicians assistants injecting patients and performing laser procedures. Many patients prefer the physician assistants as they are very experienced and do an excellent job. Ultimately, I am responsible for them and quite confident in the care they provide.

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Michael A. Persky, MD 6 Mar 2012

Though anyone can inject Botox or other neuro-modulators, when I want my teeth cleaned, cavity filled, or root canaled, I will see my dentist. Anyone can do a rectal exam, but for that I prefer a proctologist or gastroenterologist. Likewise, any physician can operate on the brain, but, call me dumb, I'm going to stick to the best neuro-surgeon. For facial aesthetics I would strongly recommend choosing your injecting PHYSICIAN most carefully. That be someone with artistic vision ("Without artistic vision there can be technical success but aesthetic failure") who is board certified in one of the core aesthetic specialities...plastic surgery, facial plastic surgery, aesthetic dermatology, or oculoplastic surgery. I cannot begin to list the number of times that I have been asked to take care of complications from injectors who attended "weekend" injection courses. I'd love to continue here, but I am practicing my classical piano Rachmaninoff 3 day mail order course for the Carnegie Hall performance I plan to give next weekend. Good luck and be well.

View answers from Michael A. Persky, MD

Megan P (Community Manager) 7 Mar 2012

Haha, Dr. Persky - love your very candid answer!

Being a layperson when it comes to this, I feel my thoughts and questions on the subject might be more in line with that of a general consumer, so I would love it if you would help me (and hopefully others with the same questions) understand more.

You mentioned seeing complications from injectors who have attended weekend courses. I'm curious about the continuing education received by plastic surgeons or derms who have been practicing for years, and thus graduated before fillers or toxins were part of the curriculum taught.

The other thing I'm very curious of, is it seems many (even board certified) plastic surgeon or derm offices have staff other than the doctors do the injections. Since this could represent the same lack of artistic eye/skill as a dentist injecting, do you feel that a person should always insist that only the doctor themselves perform the injections?

Stu1 5 Mar 2012

VancouverFace, I realize that it may seem that a weekend course in botox is minimal to someone who is not a healthcare provider. If you were in the field you would know that dentists attend school for 8 years and are more highly trained in head and neck anatomy and physiology than most medical doctors. In addition, facial injections are a specialty of a dentist. The major difference between local anesthetic injections and botox injections is that one is done intra-orally and the other is extra-oral. In addition the experience of administering painless injections may be something that would prove beneficial to you in the future. While you may be certified to pick out furniture and fabric, google does not make you an expert in the qualification of a dentist to administer Botox. If it did, you would know that most medical professionals providing Botox do not receive formal training in medical school or even residency programs. That is if you are lucky enough to have a physician who is in fact the one giving the injections. Most of the time assistants and aestheticians are the providers with as little as on the site training, much less a college degree. Finally, the dental field uses botox for far more than esthetic treatment and it has proven to be a beneficial addition to many patients.

VancouverFace 8 Jul 2011

Good call. When a magazine recommends a botox clinic it is likely that the clinic bought ads from them. I prefer real people referrals.

Lola22 7 Jul 2011

I went to a dentist the other day bc they were recommended by a magazine where I live for botox. having never been there before..wow, it was unbelieveable.

they were giving me totally false information, like telling me that several companies make Botox.
then they made me wait for over an hour in a dentist chair. finally an elderly man comes in with two assistances holding him up, I am not exaggerating.
he tells me he is going to perform my botox. his hands were shaking and not to be mean..but I was like no friggin way are you going to stick a needle in my face when your hands are shakin like that and you look about to keel over.
I told them I had to go and left.