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Home / What's New? / Michigan Dentists Can Perform Botox and Dermal Filler Treatments

The following is a press release sent to Dr. Meadows’ office by the American Academy of Facial Esthetics stating that Michigan dentists can now perform Botox and dermal filler treatments. This opens up many aesthetic and therapeutic treatment options for Dr. Meadows’ patients.  


Michigan Board of Dentistry removes Botox Statement from its website: Dentists can now confidently use Botox and dermal fillers in their dental practice.

The Bottom Line:

As the result of the American Academy of Facial Esthetics (AAFE) letter sent below to the Michigan Board of Dentistry, I am happy to report that, as of 10-2-13, the Michigan Board of Dentistry has completely removed both the Botox Statement and the “Questions and Answers about Michigan Board of Dentistry’s Statement on Botox” from their board website.  This allows Michigan dentists to now be confident in the full use of Botox and dermal fillers for esthetic and therapeutic uses within the scope of dentistry defined in the dental practice act and in line with the practice of dentistry nationwide.

The AAFE’s next live patient Frontline TMJ and Orofacial Pain Therapy, Botox and Dermal Filler training for dentistry will take place January 23-25, 2014 in Detroit, MI.  Interested dentists can go to www.FacialEsthetics.org for more information and registration – this course is already near capacity so contact the AAFE as soon as possible.

The AAFE is distributing this letter directly to Michigan dentists so that you can understand exactly and accurately how facial injectables such as botulinum toxin (Botox) and dermal fillers have been integrated into dentistry and is within the scope of practice as defined by the Michigan Dental Practice Act.

The AAFE Letter the MDA Refused to Print:

The Michigan Dental Association’s reaction to this exciting news for their members has been disappointing and should concern every Michigan dentist. The MDA first accepted and then refused to publish the letter below in the MDA Journal.  The AAFE informed the MDA of the Board’s action but the MDA has refused to remove these documents from the MDA website causing continued confusion on these issues. Michigan dentists should contact the executive director, Grace Deshaw-Wilner at gwilner@michigandental.org or 517 346-9413 and the MDA Executive Committee http://www.smilemichigan.com/pro/Contact/BoardofTrustees.aspx , Dr. Norm Palm, President, to express their dismay and urge them to remove these outdated and erroneous documents immediately from their website.

The Letter:

The following letter was sent to the Michigan Board of Dentistry in response to the board’s “Botox Statement” and the “Questions and Answers about Michigan Board of Dentistry’s Statement on Botox” which was printed in the September Michigan Dental Association (MDA) Journal.


To the Editor of the Journal of the Michigan Dental Association:

I appreciate the opportunity to share with you some important information regarding the Michigan Board of Dentistry Botox Statement and the Questions and Answers document.

I am President of the American Academy of Facial Esthetics (AAFE) which has over 7000 members of which a significant number are Michigan dental professionals.  I personally have been working with some of the Michigan Board of Dentistry members for a few years on this issue and some of the board members have attended the AAFE live patient Botox and dermal filler training course. These treatment options are accepted dental treatment throughout the US and the Michigan dental practice act allows you to provide these treatments to your patients.

The first thing to understand is that botulinum toxin (Botox) and dermal fillers are pharmaceutical agents used in dental treatment, they are not treatment procedures.  Botox and dermal fillers are equivalent to local anesthetics and antibiotics in their use in dentistry, they are not dental procedures but are used to accomplish dental treatment.  There are now many uses for Botox and dermal fillers in dentistry for both dental esthetic and frontline TMJ and orofacial pain treatment.

It is important to know that the Michigan Botox Statement is only that – it is a statement and it is not the dental practice act. It is a completely unnecessary statement that Michigan dentists can practice within the scope of dentistry as defined in the dental practice act. The Botox statement is poorly written and does not even quote the entire definition of dentistry properly and then in the Questions and Answers document, question number 30, defends the limited definition of the Statement.  The Michigan Board of Dentistry and all Michigan dentists ultimately have to use the definition of dentistry in the dental practice act and not the limited and incorrect quotation in the Botox Statement.

To the issue of the term “dependent tissues” that is stated in the definition of dentistry of the Michigan dental practice act, anyone who suggests that the lips are not considered “dependent tissues” is either not a dentist or knows nothing about dentistry.  I would bet that every single Michigan state dental board member and MDA board of director member has at the very least done a biopsy on a lip or placed sutures for a traumatic lip injury.  In the Questions and Answers document, the Michigan dental board has correctly left the definition of the term “dependent tissues” up to the individual practitioner so that “each practitioner must use their own best judgment regarding whether they are providing services within their scope of practice”.  The Board’s answer allows you, the dentist, to define the term “dependent tissues”.

So how does a practicing clinician define this term?  The answer as to what the dependent tissues are of the “teeth, alveolar process, gums, or jaws” can be found in peer reviewed dental journals and continuing education provided by the American Dental Association, dental universities (including the University of Michigan School of Dentistry) and at regional and national dental meetings.   Clearly, all of those venues teach the oral and maxillofacial areas including the entire head and neck as included in what the Michigan definition of dentistry calls “dependent tissues”.  As just one example, on September 20, 2013, the University of Michigan School of Dentistry had a continuing education program titled Technological Innovations in Pain Rehabilitation by Dr. Alexandre DaSilva who is an Assistant Professor at the Biologic & Materials Sciences Department at the University of Michigan School of Dentistry.  One of the course objectives was “The practitioner will understand and be able to identify the symptoms of chronic pain and the variety of treatments available for them” and included topics such as migraines, TMD and facial neuralgias.  At this year’s ADA annual session, the AAFE is presenting its live patient Botox training and I am performing live patient Botox and dermal filler demonstrations in the ADA Education in the Round Series.  It is obvious that the University of Michigan School of Dentistry and every other dental university, the ADA, AGD, and all of these venues has the broad (and the correct) definition of “dependent tissues” which every Michigan dental practitioner can rely on.

Now that we have support for including the oral and maxillofacial areas in the scope of practice of dentistry in Michigan, the Botox Statement seeks to limit the use of Botox to only therapeutic uses and not allowing it for cosmetic uses.  Nowhere does the Michigan dental practice act in its definition of dentistry limit dentistry to therapeutic uses only and disallow cosmetic treatments.  If that were so, then Michigan dentists would have to stop performing teeth whitening and porcelain veneers which are solely for cosmetic reasons.  Dentists who are AAFE members and have been properly trained already know that nearly all of the uses of Botox and dermal fillers in the oral and maxillofacial areas are for dental esthetic and dental therapeutic uses which are allowed by the Michigan dental practice act. The Botox Statement which states “The Board further notes that the general practice of dentistry does not include injections of these substances for cosmetic purposes” cannot disallow cosmetic procedures which clearly fall within the Michigan dental practice act.

As dental professionals, it is our obligation to provide the best treatment possible to our patients and Botox and dermal fillers are new tools that every dentist can use to treat many dental conditions non-surgically and better than before.

One thing I am sure the Michigan Board of Dentistry, the Michigan Dental Association, and the American Academy of Facial Esthetics can all support is the importance of comprehensive training in the use of Botox and dermal fillers and any new area of dentistry that dentists want to include in their practice.  Dentists must be proficient in any treatment they provide to patients as it is our combined duty to protect the public and deliver the best possible esthetic and therapeutic clinical outcomes. 

Sincerely Yours, 

Dr. Louis Malcmacher

President, American Academy of Facial Esthetics

Email: drlouis@facialesthetics.org

Phone: 800 952-0521