None — Cosmetic BOTOX® Injections
BOTOX® is the name for a drug derived from a purified form of botulinum toxin, a protein from the Clostridium botulinum bacteria. This bacteria is associated with some cases of food poisoning. However, when injected in very small doses into a muscle, the drug blocks nerve transmissions to the muscle. Without the nerve signaling, the muscles can't contract.
Skin care specialists learned many years ago that botulinum toxin could be used for cosmetic purposes, specifically, to reduce the signs of wrinkles. Some wrinkles are caused when the underlying muscles contract, pulling on the skin. When BOTOX is carefully injected into the right areas, the drug paralyzes the muscles and inhibits their ability to contract. The overlying skin is no longer being pulled and becomes smoother, making the wrinkle disappear.
Botulinum toxin injections are the most popular cosmetic procedure in the U.S. According to the American Society for Aesthetic Plastic Surgery, more than 2.5 million injections were done in the U.S. during 2009. The treatment lasts from three to six months, and must be repeated to maintain the effects.
BOTOX® in the Dental Office Some dental professionals are using BOTOX for specific treatments. Howard Katz, D.D.S., Dentist in San Diego, CA, helped develop dental use protocols for the drug nearly ten years ago. He says BOTOX is a potential option for dental problems caused by muscle contraction, such as:
Bruxism. Patients with bruxism (teeth grinding) clench their jaws tightly, causing the teeth to rub against each other. The condition not only causes jaw pain, it can lead to worn and broken teeth. By injecting BOTOX into the correct muscles, the patient has limited ability to grind the teeth, yet can still talk and chew.
TMJ Disorder. TMJ (temporomandibular joint) disorder is a condition that causes pain in the jaw or around the ear, headaches and discomfort while chewing. One cause of the disorder is persistent clenching of the teeth (not necessarily associated with tooth grinding). Symptoms can sometimes be alleviated by using BOTOX injections to prevent the muscles from pulling on the temporomandibular joint.
Gummy smile. A "gummy smile" occurs when the lip curls up above the tooth line, showing off a significant portion of the upper gums. Katz says this is often caused when the muscles that control movement of the upper lip are over-contracted. By weakening these muscles with BOTOX, the upper lip can't be lifted quite as high, reducing the "gummy" appearance during a smile.
Orthodontic retraining. The goal of orthodontic treatment is to move the teeth into a better alignment. In some patients severe contraction of certain muscles will pull the teeth back towards their original position, negating the effects of the orthodontic work. For those patients, injections of BOTOX can lessen the pull on the affected muscles and help maintain the corrected bite. Ideally, over time, the muscle will learn to relax on its own.
Graft healing. Katz says healing of gum or bone grafts can be affected by excessive pulling of the muscles inside the mouth. BOTOX injections on the opposite side of the mouth may help accelerate healing of the graft.
Dentists and Cosmetic Use of BOTOX® Patients who receive BOTOX injections for dental problems get an added bonus – removal of wrinkles in the target area. Thus, with BOTOX already a part of dental care, some say it is a natural step for dentists to offer the drug solely for cosmetic purposes. Researchers estimate about 7 to 8 percent of dentists in the U.S. are offering cosmetic BOTOX treatments. Proponents argue that dentists are well trained in injections and have a thorough knowledge of the facial anatomy. Thus, cosmetic use of BOTOX is a natural extension of their skills.
Katz doesn't necessarily agree with dentists offering cosmetic services to patients. He believes dentists should stick to treating the problems for which they received training.
The use of BOTOX for cosmetic purposes by dentists is regulated by state dental boards. The American Dental Association does not have a specific recommendation for or against the cosmetic use of BOTOX. However, a spokesperson for the Association reports it would be covered under the organization's Scope of Practice Statement:
"The ADA supports dentists performing any procedure for which they are qualified by education, training, and experience, and consistent with the laws of the state in which they are practicing."
Patients should check with their insurance carrier to see if BOTOX treatments in the dental office will be covered.
AUDIENCE INQUIRY For information on the uses of BOTOX in dentistry: Academy of General Dentistry
For general information on the use of BOTOX® for cosmetic purposes: American Society for Aesthetic Plastic Surgery
Information about BOTOX® Cosmetic can be found at: http://www.botoxcosmetic.com