CALL US AT 800-952-0521
Close this search box.




I am asked all of the time what the next big thing is going to be in dentistry. What new technology or technology is going to change dental practice? We certainly have made huge advancements in a number of areas, such as restorative therapy, implants, and esthetics.

I believe the direction of the next great thing in dentistry is actually going to take place in the oral-systemic connection. Most dentists are familiar with this connection as being how oral health affects systemic health. I’m going to look at the oral-systemic connection from a completely different angle – the oral-systemic esthetic perspective.

We all can do a magnificent job of making teeth look great and giving people a healthy and beautiful smile. Esthetic dentistry has been an absolute boom over the last 30 years when it comes to such innovative techniques as teeth whitening and minimally invasive veneers. Now that the teeth look good, what about the peri-oral areas around the mouth? If the teeth look good but we ignore the rest of the face, then we have really limited what we have done in esthetic dentistry.

It is time to seriously give serious consideration to extending the oral-systemic connection to the esthetic realms of the face which dentists are more familiar than any other healthcare practitioner. Dermal fillers, such as hyaluronic acid (Juvederm, Restylane) are commonly used to add volume to the face in the nasolabial folds, oral commissures, and marionette lines. As we age, collagen is lost in these facial areas and these lines start to deepen. These dermal fillers are injected right under the skin into to plump up these areas so that these lines are much less noticeable. Botox® is a wrinkle remover and temporarily affects the muscles that create the wrinkles in the forehead, between and around the eye and around the lips. Once the muscle cannot contract, the skin will smooth out all by itself. The face looks more youthful and esthetic and is the perfect complement to any esthetic dentistry. Botox® also has been used therapeutically in dentistry for almost 20 years for the treatment of facial pain, TMJ syndrome and bruxism. These concepts are taught at major dental universities including UCLA in their post graduate programs.

I have been performing Botox® and dermal filler procedures for years. We as dentists give injections all the time – this is just learning how to give another kind of injection that is outside the mouth but is in the same area of the face that we inject all the time. We also have a distinct advantage over dermatologists, plastic surgeons, medical estheticians, and nurses who commonly provide these procedures in that we can deliver profound anesthesia in these areas before accomplishing these filler procedures. I will never forget that during my training, my patients were completely comfortable during dermal filler and lip augmentation therapy because of my ability to deliver proper anesthesia to these areas. The patients treated by other health practitioners were quite uncomfortable and indeed this is one of the biggest patient complaints about dermal fillers.

Many state boards are allowing general dentists to provide Botox® and dermal fillers to patients for both therapeutic and cosmetic use.. Is there a market for these services? In 2009, close to 5 billion dollars were spent on botulinum toxin and dermal filler therapy in the US. Think about this – that was money spent on non-surgical elective esthetic procedures that could have been spent on esthetic dentistry but the patient made a choice. Interestingly, these procedures become more popular in an uncertain economy because patients want to do something to look better that is more affordable than surgical esthetic options.

Like anything else a dentist does, this requires some training and the learning curve is incredibly short because you already know how to give comfortable injections. The American Academy of Facial Esthetics gives over 50 two day training sessions in Botox® and dermal fillers and dentists are amazed how easy these procedures are compared to everything else we do. Finding practice models is easy – start asking family and friends who will fight to have you practice on them. If you want further proof, ask women in your practice if they have had or would like dermal filler therapy. You will be overwhelmed at the positive response.

The next big thing in dentistry? It may come as we start expanding outside of the teeth and gums into the oral and maxillofacial tissues, which is within every dentist’s skill set. All a dentist needs is knowledge and practice. Then, dentists will be able to deliver these new services to patients and truly complement their dental practice.

Dr. Louis Malcmacher is a practicing general dentist and an internationally known lecturer, author, and dental consultant known for his comprehensive and entertaining style. An evaluator for Clinicians Reports, Dr. Malcmacher is the President of the American Academy of Facial Esthetics. You can contact him at 440 892-1810 or email His website is where you can find information about his Botox® and dermal filler training, lecture schedule, audio cd’s, download his resource list, and sign up for a free monthly e-newsletter.

Blog Categories

Related Posts