Council adopts a new position on the use of botulinum toxin and dermal fillers by Ontario dentists

In May 2013, Council approved a new position on the use of botolinum toxin and dermal fillers by Ontario dentists. The position can be summarized as follows: Ontario dentists may inject botulinum toxin and dermal fillers, but only for procedures that are within the scope of practice of dentistry.

The key points are the College’s position on this issue are:
  • 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 extra-orally for therapeutic purposes, but in either case only if they are appropriately trained and competent to perform the procedure/s.
  • It is not within the scope of practice of dentistry and members are not authorized in Ontario to inject botulinum toxin or dermal fillers extra-orally for cosmetic purposes.
Members who wish to use these substances are expected to successfully complete a course of instruction that includes pharmacological and physiological characteristics of these substances, as well as possible adverse reactions and their management.

In addition, 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. This is due to the potential for serious and even life-threatening adverse reactions to this neurotoxin.

In making its decision, Council took into consideration a number of factors. There was an expert report of an ad hoc committee with membership of specialists from across Canada. This committee examined questions about safety and education related to the use of these substances. Council also considered the scope of practice of dentistry in Ontario, as defined by the Dentistry Act, 1991 and the phrase, oral-facial complex, as it has been historically interpreted by Council. The Act states that the scope of practice of dentistry “is the assessment of the physical condition of the oral-facial complex and the diagnosis, treatment and prevention of any disease, disorder or dysfunction of the oral-facial complex.” In addition, in the course of engaging in the practice of dentistry, Ontario dentists are authorized to administer a substance by injection.