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Botoxonomics DE May 2015


One of the most frequently asked questions by dentists about Botox® and dermal fillers is how will it impact their practice from both a clinical and practice management perspective. This column has shown the many clinical uses of Botox® for dental esthetics, facial esthetics, gummy smiles, TMJ, brux­ism, trigger point therapy, orofacial pain, and dental sleep medicine. Dermal fillers have given dental professionals incredible new options in treating smile lines, lip lines, gummy smiles, black triangles, and smile design.

Trigger-point therapy with lidocaine and/or Botox® has opened up new vistas for clinicians in treating TMJ and orofacial pain predictably so that dentists can cease to be afraid of these patients. Dental sleep medicine, when com­bined with bruxism therapy, adds an entirely new dimension to dental practices. It gives them the ability to ensure an excellent long-term prognosis to every dental case by ob­jectively monitoring bruxism and definitively treating it.

It is easy to demonstrate the clinical aspects of the above-mentioned therapies via case studies, photographs, and objective monitoring data. Botox® and dermal fillers have provided expanded services and better therapeutic and esthetic outcomes for patients than ever before. But let’s ask an honest question-are these services productive and profitable for dental practices? If they are not, then dental offices will not use these therapies no matter how good they are.

Indeed, dental professionals are always impressed by what can be accomplished clinically with Botox® and dermal fillers. The most common questions I get are: What are the patient fees associated with these therapies? How much should I charge for Botox®, dermal fillers, trigger points, and oral appliances for dental sleep medicine? Many dentists are curious about how profitable these are, and they need to know this before they consider these procedures for their practices. Dentists too often make investments in capital equipment, new technology, or new techniques, only to be burned later when they find out that production is poor and profitability is minimal or nonexistent.

Now that more dentists have been using Botox®, dermal fillers, trigger point therapy, bruxism monitoring, and dental sleep medicine in their practices over the last few years, we can see how these have affected their practices. The American Academy of Facial Esthetics (AAFE) recently did a survey of members who have successfully integrated all of these areas and now use them routinely in everyday dental practice. Now we can see exactly the kind of impact these treatments have on monthly productivity, and we can break them out by category so that dentists can see for themselves which areas make sense for their own practices.

It’s important to note the following about dental prac­tices who took part in this survey: the dental clinicians have been trained in at least two levels of botulinum toxin and dermal fillers, as well as in frontline TMJ / orofacial pain treatment and bruxism monitoring and dental sleep medi­cine. These offices have been performing these treatments for a minimum of 18 months.

There are no capital equipment purchase or laboratory fees necessary for most of these practice areas with the one exception noted below.

These offices, like your office and most offices, have the capacity to add these new services with no additional in­vestment, such as additional treatment rooms or schedule time. In other words, most dental professionals have gaps in their office schedules to perform more procedures that patients desire. The difference between the patient fee and profitability is the cost of the botulinum toxin and/ or dermal fillers.


Botulinum toxin (Botox®/Xeomin®) treatment
The average botulinum toxin treatment appointment took approximately 10 minutes, with the actual injection time being five minutes or less. The average patient production fee was $1,402, with a profit of $1,014.

Dermal filler treatment
The average dermal filler treatment appointment took approximately 18 minutes, with the actual injection time being 11 minutes or less. The average patient production fee was $1,475, with a profit of $988.

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