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Tons Of Hands-On Injection
Tons of hands-on injection
Super Convenient
Super convenient
Follow Up Support
Follow up support

Advanced Botox Injection Techniques for Dentists

A recent survey stated that around 10% of dentists in the USA currently offer Botox to their patients.  While opinions vary on whether dentists should be allowed to inject Botox and state laws vary widely on their rules about the “scope of practice”, our experience as trainers is that dentists are one of our favorite groups to train.  Their baseline manual dexterity and mastery with a syringe are superior as they inject patients daily.  Also, since their practice is already set up as a retail business, the office staff is ready for the challenges of marketing a new service. 

Botox for bruxism & TMJ disorder (Part 1)
Botox for the gummy line (Part 2)
Botox for mandibular hypertrophy (Part 3)

Not discussed:
Botox for peri-oral smoker’s lines
Botox for smile line
Dermal filler for lip enhancement
Dermal filler for smile lines
For these other areas, please sign up for our online or hands-on, onsite training, and you’ll get the videos and details about these additional areas at Cosmetic Medical Training

DISCLAIMER: All of the areas discussed below are OFF-LABEL indications for the use of botulinum neurotoxin.  This summary discusses the literature and current trends of these OFF-LABEL injection techniques.  We do not endorse the injection of these areas without thorough hands-on training and proper patient selection.

Part 1: Bruxism or TMJ Disorder

Bruxism

Bruxism is a condition where your patient will unconsciously grind or clench the teeth. Temporomandibular joint disorder is a condition where your patient experiences pain and improper function of the TMJ.  Bruxism can be caused by TMJD, and vice versa. Botox was first used in a patient with bruxism in 1990.  In 2002, Freund documented good outcomes of TMJD patients who received Botox.

People that suffer from bruxism grind their teeth. TMJ disorder is a condition that involves pain and improper functioning of the muscles and joints that attach the lower jaw to the skull. Bruxism can be caused by TMD, but bruxism can in turn also cause or worsen TMD.  Botox can break off this cycle by relaxing the muscle contraction of the masseter and temporalis muscle. 

Landmark:
First, ask your patient to clench her teeth.  The masseter and temporalis muscle will become more prominent and easier to inject.  With repeat contraction, identify the outline of both muscle groups and draw the shape with a white pencil. 
To inject the masseter muscle, draw a line from the corner of the mouth to the tip of the earlobe (superior margin).  Then, draw a line from the corner of the mouth to the angle of the mandible (inferior margin).  The two vertical lines (anterior and posterior margin) that shape the outline of the masseter muscle (which you will draw as the patient clenches her teeth) will cross-hatch these two lines.  Inject into the most prominent portion of the muscle, in 3 – 4 separate areas 0.5 – 1 cm apart, and at least 1.5cm above the margin of the mandible.  All injections should be done to the lower third of the masseter muscle.
The temporalis muscle is typically 4.5cm from the patient’s zygomatic arch.  The muscle can be divided into anterior, middle and posterior regions.  There is great anatomical variety among patients and the injector must feel this her fingers to identify the outline of the muscle.  Typically, the deep temporal nerve runs through the anterior fibers of the temporalis muscle.  The injection site should be palpated for the superficial temporal artery and its branches.

Amount:
Based on clinical experience, the following doses were used.
Masseter muscle: 20 – 30 units per one side
Temporalis muscle: 10 – 20 unis per one side
It is recommended to inject low concentrations in multiple areas to avoid incomplete effects and diffusion into undesirable areas. 

Precaution:
Aside from the typical side effects of Botox (bruising, hematoma and pain), other side effects are possible.  In the masseter muscle, side effects include chewing weakness, The facial nerve is located near the masseter muscle.  To minimize the risk of side effects, asymmetry, sagging, paradoxical hypertrophy, loss of smile, sunken cheeks, difficulty opening the mouth, sunken temporal fossa, dry mouth (if injected into the parotid gland), neuropraxia, and others. Therefore, we recommend that you inject into the center of the landmark. 
In injecting the temporalis, you must aspirate before injecting large amounts to avoid intravascular injection into the superficial temporal artery and its branches.  You also want to avoid injecting near the lateral canthus to avoid the paralysis of the lateral rectus muscle. 

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Have questions? Give us a call. 212-470-8059

Part 2: Gummy smile

A hyperactive lip elevator muscles will create what some people call a gummy smile.  This causes the patients to show excessive gingival exposure when smiling.  Previously corrected surgically, now we are able to treat this with Botox.

Yonsei University is in South Korea.  It also shares the name with a Botox injection landmark called “Yonsei point.”  Dr. Hwang is a professor at the College of Dentistry who recommended injection 3 units of Botox for the treatment of the gummy smile.  Yonsei point is the center of a triangular region where the three muscles Levator labii superioris, Levator labii superioris alaeque nasi and Zygomaticus minor passes on the area lateral to the ala.  The location of the insertion mark was found to be 1 cm horizontal to the ala and 3 cm vertically from the lip line.  While some advocate injecting 3 units, some others recommend a lower dose of 2 units.

Aside from the typical side effects of Botox (bruising, hematoma and pain), other side effects are possible.  Side effects include asymmetry, sagging, difficulty opening the mouth, neuropraxia, and others. Therefore, we recommend that you inject into the center of the landmark. 

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Have questions? Give us a call. 212-470-8059

Part 3: Masseter Hypertrophy (facial slimming)

The first off-label report of using Botox for masseter hypertrophy was published in 1994.  Since then, the request for patients to achieve the oval facial shape or a V-shaped jawline has increased.  The good news about treating this is that it is the same as the treatment for TMJ disorder without the temporalis muscle injection.  All the landmarks, units, and precautions are the same except that you do not have to inject the temporalis muscle.

Register Today

Have questions? Give us a call. 212-470-8059

Do you want a combination one-day training and start offering Botox injections in YOUR office?

Our trainers will physically come to YOUR office location for an on-site visit to train you and one additional medical provider in your office the hands-on techniques for $1499.

Have questions? Give us a call. 212-470-8059

FOR BOTOX TRAINING,

DENTIST CAN PRACTICE THE INJECTION OF THE FOLLOWING AREAS:
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Basic Botox® Areas – Frown Lines, Crow’s Feet, and Forehead Lines.

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Advanced Botox® Areas – Nasalis, Perioral Lines, Dimpled Chin, Brow Lift, Lower Eyelid, and Marionette Lines.

FOR DERMAL FILLER TRAINING,

DENTIST CAN PRACTICE THE INJECTION OF THE FOLLOWING AREAS:
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Basic Filler Areas – Nasolabial Folds, Lips, and Marionette Lines.

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Advanced Filler Areas – Nasojugal Groove, Frown Line, and Cheek Enhancement.

3 easy steps to schedule Botox training for Dentists

Registration - Step 1

Step 1

Register online for $1499.
Give us three dates that you want your training and we’ll set up the earliest training date possible.

Registration - Step 2

Step 2

Receive immediate access to the online training material with over 4 hours of instructional videos.

Registration - Step 3

Step 3

Our coordinators will help you prepare for the training day so that you will have the necessary supplies and Botox® and fillers.

Have questions? Give us a call. 212-470-8059

Included in the Online Training for Dentists:

Instructional videos (17 videos over 4 hours), powerpoint slides and essential startup files will be available to you online prior to the hands on training day.

The videos will contain instructions on both beginners and advanced injectors.

Botox® Video Objectives for Dentists:

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Mechanism of action of Botulinum Toxin

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Knowledge of the facial anatomy, physiology of pertinent muscles

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FDA approved uses and off label uses

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Safety and contraindications

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Storage, preparation and dilution

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Proper injection of Botulinum Toxin

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Patient evaluation and consultation

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Standardized procedures & protocols

Have questions? Give us a call. 212-470-8059

Dermal Filler Video Objectives for Dentists:

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Mechanism of action of Dermal Fillers

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Knowledge of the facial anatomy

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FDA approved uses and off label uses

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Safety and contraindications

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Proper injection of soft tissue augmentation

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Patient evaluation and consultation

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Standardized procedures & protocols

Sample Schedule for Dentists:

1 Hour Botox® Review & Dermal Filler Review with a live model.
Hours of Hands On Training afterwards.
Your end time depends on the number of models and your discussion with your trainer (typically 4 – 5 hours total).

Please note:

  • The areas that you will inject will vary depending on the models that are available on your training day. If you have a specific area that you want to target, then we recommend that you assist us in finding patients who will request to have the practice area injected on your training day.
  • Dysport®, Xeomin®, Jeaveau®, Restylane®, Juvederm® or Belotero® injections may also be taught at your training depending on your product purchase.
  • We ask that you reach out to your office staff, friends and family to volunteer to become injection models. Our experience has been that you will have NO problem finding volunteers if you or your staff will announce on Social Media (Facebook, Twitter, etc) that you need injection models. Most of our trainees will ask the models to pay for the cost of Botox® and Dermal Fillers used on that training day.
  • The cost of Botox® and filler is NOT included in the training price, because we won’t know how many models you will have at the training date. We typically recommend that you buy at least 2 vials of Botox® and 4 filler syringes.
  • Your non-medical office staff should be a part of the training experience for them to gain valuable sales knowledge.

Three Training Options:

ONLINE VIDEO ONLY, TELECONFERENCE HANDS-ON TRAINING, OR ONSITE HANDS-ON TRAINING


IMMEDIATE ONLINE ACCESS TO TRAINING MATERIALS

CERTIFICATE OF COMPLETION

AFTER TRAINING SUPPORT

NUMBER OF TRAINEES

LIVE TELECONFERENCE HANDS-ON TELE-TRAINING

ONSITE VISIT BY OUR TRAINER HANDS-ON TRAINING

COST

ONLINE VIDEO TRAINING

ONE

$299

TELECONFERENCE HANDS-ON TELE-TRAINING

ONE OR TWO

$1,199

ONSITE HANDS-ON TRAINING

ONE OR TWO

$1,499

Register Today

Have questions? Give us a call. 212-470-8059

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