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Education requirements for the use of botulinum toxin and dermal fillers by Ontario dentists

Originally published in the November/December 2013 issue of Dispatch

As reported in the last issue of Dispatch, Council has approved a new College position on the use of botolinum toxin and dermal fillers by Ontario dentists:

Members who wish to use botulinum toxin and dermal fillers may do so, but only for procedures that are within the scope of practice of dentistry.

Members may inject botulinum toxin and/or dermal fillers intra-orally for either therapeutic or cosmetic purposes, or botulinum toxin extraorally for therapeutic purposes, but in either case only if they are appropriately trained and competent to perform the procedures.

It is not within the scope of practice of dentistry and members are not authorized in Ontario to inject botulinum toxin or dermal fillers extraorally for cosmetic purposes.

Members who wish to use these substances as described are expected to successfully complete a course of instruction that adheres closely to the following criteria. The course should:

  • be conducted by persons who have had recognized education and training, preferably university-based, and significant experience in the parenteral administration of these substances.
  • include a didactic component with formal evaluation that addresses:
    • pharmacology of these substances;
    • physiological activity of these substances;
    • diagnosis of relevant conditions;
    • indications for the use of these substances, as well as other first-line treatment modalities;
    • contraindications for the use of these substances;
    • related head and neck anatomy;
    • adverse reactions and their management;
    • include a hands-on clinical or clinical simulation component with formal evaluation;
    • promote the critical evaluation of research and literature on related topics.

Due to the potential for serious and even life-threatening adverse reactions to this neurotoxin, members who wish to use botulinum toxin extra-orally for therapeutic purposes, such as for the management of certain temporomandibular disorders and other oral-facial conditions, are expected to pursue more extensive training.