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News / April 8, 2015

Botox: the practice of dentistry?

by Guy Hiscott

Michael Aicken discusses the Irish Dental Council’s statement on non-surgical cosmetic procedures – and whether it has a place in modern dentistry

In February, the Irish Independent published a news article on a case report from the Journal of the Irish Dental Association (Kehily et al, 2015) regarding non-surgical cosmetic procedures.

The article contained comments from the Irish Dental Council, which stated that these cosmetic treatments are ‘not the practice of dentistry’. To summarise the statement:

1. The Irish Dental Council does not consider the use of botulinum toxin and dermal filler for cosmetic reasons part of dentistry, but…
2. If dentists wish to offer these services they should ensure that they are trained, competent, taking informed consent, adequately indemnified and informing patients in writing of the first point.

Suitable advice?

I’m a medical doctor and I’ve been training dentists in non-surgical cosmetic procedures on a regular basis for the past five years with Visage Academy.

In my opinion, dentists are aware of their responsibility to maintain the above standards in keeping with every other aspect of their practice – with one exception.

Dentists are essentially being advised to tell their patients that their own council does not approve of them carrying out these procedures but cannot stop them from doing so. Surely this is a confusing and unnecessary message to force upon patients?

In my opinion, dentists are aware of their responsibility to maintain [high] standards in keeping with every other aspect of their practice

The case report in the Journal of the IDA discusses a patient who received injections of dermal filler in a beauty salon.

The patient became aware of a soft, non-tender mass intraorally, deep to the injection site of the dermal filler and presented to their dentist who then referred them to tertiary care for further assessment.

I agree with the intended message of the case report – that dentists should consider dermal filler as a possible cause of a non-tender, soft intraoral mass.

However, the confusing message delivered to the public in the Irish Independent’s article has been exacerbated by the Irish Dental Council’s equally confusing standpoint.

Risky business

I would ask the Irish Dental Council this: why do they consider dentists less well equipped to perform these procedures than medical doctors and surgeons?

The insurance companies, whose business it is to balance risk, do not, to my knowledge, charge an additional premium to dentists over and above what they charge to doctors.

So what does that tell us about the risks involved?

For references, please email

Dr Michael Aicken is an aesthetics injectables doctor at Visage Academy and has been practising cosmetic injectables for six years.