I support this change to expand the scope of general dentistry to cover botox with the completion of a CE course. 

other states (like south dakota) general dentists can place botox 

thanks for your consideration of this issue

I am in favor of allowing trained dentists to administer Botox and fillers. I have done botox for patients to help alleviate the pain of bruxism with great success. Allowing dentists to help patients with their overall esthetic is beneficial to patients and providers. Properly placed botox can help with overly gummy smiles, asymetrical smiles, etc. Dentists are trained in all the facial nerves and muscles...who better to administer botox! As far as filler, full lips can help create a gorgeous smile from a plain one. 

I support the consideration of opening the scope of practice to include Botox and dermal filler’s for those professionals that have taken the required additional training.

We are specialists’ of the head and neck and spent four years plus studying it. It can be of great use during smile makeovers / cosmetic procedures. Why we should not be able to administer these (Botox especially) with some additional training to bring us up-to-date. 

I am in support of dentists being able to provide botox and fillers in the state of Virginia.  Many states already allow this.  These therapies can provide adjunct clinical benefits relevant to dentistry both therapeutically and cosmetically.  Dentists are well versed in facial anatomy and we are already comfortable doing injections in the mouth.  With proper training, dentists would probably be more competent and conscientious than many providers who are presently allowed to do these procedures.  

I have been using BTX for therapeutically on masseter and temporalis muscles in TMD for about 10 years after completing courses from the Academy of Facial Esthetics.  I have not experienced any complication and feel that dentistry is uniquely qualified to utilized BTX for esthetic procedures.  I support the petitioner's application after completion of hands-on training.

General dentists should be permitted to administer Botox and Filler with appropriate training.  Dentists actually are the most qualified medical profession to administer Botox/Filler because of our extensive knowledge of facial anatomy, muscles, and nerves.  We also routinely administered intraoral injections.  There are many states that currently allow general dentists to administer Botox/filler.  It is time for Virginia to become one of these states. 

I support Dentists in Virginia being able to provide botox and fillers services to patients after training. 

I support this amendment for dentists to be able to administer Botox and fillers after training and certification.

I wholeheartedly endorse the use of botox/dermal fillers by dentists

in Virginia.  There is a litany of professional literature about the benefit

of such therapies to the dental patient.  Also, the dentist is very well versed 

in head and neck anatomy and does injections as a matter of routine

on a daily basis.

If other states allow general dentist with additional training then why not in Virginia.This amendment will help general dental practices recover from pandemic faster.

First everyone needs to understand allowing this change would have to be through a Legislative change.  In the late 90's the scope of Dentistry was changed to allow Oral Surgeons to perform Cosmetic procedures.  This was very difficult with considerable push-back from the Plastic Surgeons.  We finally got them to agree as long as there were periodic cosmetic reviews done by an independent source and we had to have a separate Cosmetic License and a separate Oral Surgery License.  Unless I am missing something, the only way to allow Dentists to give Botox and Fillers is to Legislatively reopen the Scope of Dentistry and change it.  When you do this, then everything in the previous ruling can be challenged which could affect all Dentists and Specialists and not necessarily in a good way.  Virginia is different from other states on this, so it is not just an easy fix.  

I support Virginia Dentists being able to provide Botox/Dermal fillers with the proper CE/education. I believe with proper training this service should not be limited to only the oral cavity, but should include medical, dental and cosmetic applications from the neck up.

I believe that with proper approved training Dentists should be able to perform Botox and filler treatment. 

I support dentists being allowed to administer Botox/fillers after training

Botox has many uses besides cosmetics. Myofascial pain therapy, reducing symptoms from obsessive bruxism when counseling is not enough. It is a non-opioid tool in our toolbox against orofacial pain. The board should consider what certificate they will accept and make a recommendation for a standard.

Dentists are trained extensively in head and neck anatomy and physiology and should be allowed to do Botox and other injectible treatments with proper training.  

We have an immediate need in our community to provide Botox for patients who are dealing with stress and taking it out on their muscles. We can help them as we give injections all day long. Please allow us to provide for our patients what we know how to do. 

Botox and dermal fillers have significant benefits related to dentistry including treating orofacial pain, reshaping smiles, preventing fungal infections of the lips, and treating clenching and grinding. Dentists are some of the best trained doctors of the face, and deal more with the neurology and musculature of the face than almost any medical profession. In my town, nurse practioners working for OB/GYNs are currently administering it. Dentists have significantly more experience with facial injections, including managing complications, than almost any other medical practioner. 

I support general dentists in Virginia to administer Botox and dermal fillers.

If a nurse could do Botox, I am sure a dentist could do it too. In most states dentists are allowed to do Botox.

Dentists are more than qualified to perform Botox since they are familiar with facial anatomy. Botox administration by dentists is allowed in many states, dentists in Virginia need to be allowed too to administer with proper training certification. 

ssia

I support dentists to administer Botox and Fillers in their practices. 

Dentists are experts with regard to head and neck anatomy.  This makes us excellent candidates to undergo training and administer Botox and injectables.  Botox has therapeutic indications related to TMJ disorder that would be beneficial to our patients.  Additionally, patients seeking cosmetic benefits from these procedures would be well served by dentists due to our extensive knowledge of facial anatomy.  

Currently, in my community people can receive botox from medical professionals that practice OBGYN services, emergency medicine, and other non-traditional botox specialties. Dentists are more than qualified to add this service.

I support Dentists in Virginia being able to provide botox and fillers services to patients after training. Thank you.

I support dentists being able to administer botox and fillers as cosmetic and/ or therapeutic indications for their patients. Thank you

I support the notion. General Dentist can easily serve a large population group that does not have straight access to these services. Dentist are well suited to provide this cosmetic service through their experience and expertise as oral health specialist after proper accredited training in Botox/Fillers

I support dentists being able to administer botox and fillers as cosmetic and/ or therapeutic indications for their patients. Thank you!

I support dentists being able to administer botox and fillers as cosmetic and/ or therapeutic indications for their patients. Thank you!

I support dentists being able to administer botox and dermal fillers for therapeutic and cosmetic indications with the proper training.

MaryBeth Wicker, DDS

Dentists inject into the head more most other medical specialties and have more head and neck anatomy classes/training than most.  Who knows facial muscles better, knows structures better, the insertion and origin of muscles and where effects will occur?  Dentists. Not allowing dentists to do Botox and fillers facially for cosmetic and clinical necessity is undermining our profession, while we stand by and watch (in some jurisdictions) assistants with 6 month certificates and GED's place materials via injection.  Most my classmates and I have at least 8 years of education past high school just to become a dentist. With continuing education protocols, I estimate that I have 14 years+ of training post high school, and I am sure this is not uncommon with my peers.  Our profession needs to stop being minimized by being relegated to "tooth doctors"- and allowing dentists to do Botox is merely a stepping stone.

dentists are the best providers in performing facial injection and we practice on daily basis. Patients trust that we can relief their pain and provide the beautiful smile they hope for. Facial esthetics is what the patients seek and dentists are the best people to seek help. Me and my staff totally support 

I have been treating TMD patients for 25 years, and botox in certain instances would be a very helpful adjunctive therapy in some cases.

To whom it may concern,   

I support the amendment to allow general dentists to administer botox.     

We have been in contact with several operations that supply botox and filler education to dentists all over the country, and they will be more than willing to adapt their curriculum to the needs of the Virginia board if they see fit.     They will provide the necessary safety and hands on training to make the application of botox in the general dental office a safe and practical procedure.      

As a general dentist, I have taken hundreds of hours of dental CE that have prepared me to perform invasive procedures such as dental implants, oral surgery, and tissue grafting.    The education that we have received also makes us acutely aware and knowledgable of the facial musculature, nerve innovation, and blood supply.    The general dentist is one of the most knowledgable in the realm of facial anatomy, and would be clinically competent to administer botox.   

Thank you, 

Jason Lipscomb DDS   

Please consider broadening the scope of general dentistry to include the administration of botox.  With proper training, there are many beneficial applications of botox administration to increase a general dentists's ability to help patients both cosmetically and those in pain. 

Respectfully,

Dr. Greg LaVecchia  

Botox has been used in dentistry for many years, not only for esthetic procedures but also for treatment related to TMJ disorders, myalgia, and headaches, among others. In prosthetic dentistry, Botox has major value. Losing teeth causes loss of muscle tone, when the dentition is then replaced problematic occurrences arise such as cheek biting, sore and ulcers.  This advantage will allow the patient to enjoy their prosthesis more as we all know they are hard to manage and accommodate to. Dentists’ scoop of knowledge I believed is more than advance to place Botox. I agree a CE course should be mandatory for all of dentists that would like to complement this technique in their practices.

I support dentists being allowed to administer botox and dermal fillers in the state of Virginia.

I support Dentist performing Botox and Dermal Fillers

Dentists are experts in the head and neck. I strongly suggest this subject be visited and a decision to allow dentists to perform these procedures be approved. We have the expertise and acumen to bring a highly skilled application of these therapies. Thank you

I support the amendment to authorize general dentists in Virginia to administer Botox & dermal fillers.

We give head and neck injections multiple times per day. We are as much an expert 
in head and neck anatomy as any MD. I support this petition to provide excellent 
quality care to our aesthetic dental patients. I am a cosmetic dentist Accredited by the AACD and it would enhance my patients outcomes.

This is far more complicated than simply expanding the scope of dentistry and therfore I am against the petition.  If dentists wish to inject the face with cosmetic and therapeutic medicaments they can become Board Certified Esthetician's, Dematologists, ENT's, Plastic Surgeons or Oral and Maxillofacial Surgeons.  I'm sure all of these specialties will weigh in on the petition.  These are procedures that need to done daily in order to achieve levels of excellence.  This is not a hobby or fun work or a way to make a few extra bucks.  There are serious consequences that will affect patient outcomes and complications.  Is the dentist able to manage the litany of complications that result from an adverse outcome?  If not, they should not be doing the procedure in the first place.  If tissue dies are they prepared to reconstruct lips or eyelids?  If not they should not be injecting the materials in the first place.  If you cannot manage the complication then the procedure should not be performed in the first place.  Malpractice insurance premiums will need to address this as well.  I'd like to do brain surgery.  We work in the area.  There are plenty of people providing these services throughout the commonwealth.  There is no unmet need anywhere.

I support dentists perform facial injection with Botox and Filler.

I would welcome a cautious review of the scope of dentistry.  Please look at Dr Padgett's comments as further scrutiny on granting such procedures like  botox & cosmetic filler  would be brought  on all dentists. I'm thankful for  my  senior colleagues (Drs Strauss, Niamtu, etc) in achieving legislation in the 90s to grant  a specialty license within the specialty of oral & maxillofacial surgery to perform cosmetic procedures.  Even with careful application of fillers one must understand the risks & liability.   What policy or education needed to provide botox and fillers is something that needs further research. However,  if allowing OB/GYN, family care physicians, and emergency room doctors to provide these services  hasn't been blocked then it would be hypocritical of myself to state a properly trained dentist couldn't do it. 

Botox is used other than for cosmetic reasons: bruxism, myalgia, TMJD, etc. I do however strongly believe we should be required to have proper training, not a weekend course or quick online course. Unfortunately, it has become quite common to take short/limited training courses and become "certified in treatments" that may be best provided by a true specialist, for the benefit of our community. 

If a nurse can inject patients with Botox and Fillers there is no reason a dentist shouldn’t. The only people that seem to be concerned are the ones that think it will take business away from them.  Doctors just need the proper training which would most likely be anywhere from 16 to 32 hours of CE.  

The injection of Botox and Dermal Fillers can cause serious problems as in blindness and skin necrosis as well as foreign body reactions. A week end course is not sufficient training. Only a Board Certified Facial Cosmetic Surgeon should be able to provide these services. To allow a  dentist to do so would be dangerous for him and his patient. These procedures are OUTSIDE the Oral Cavity and no Restorative Dentist should be allowed by the Board of Dentistry to do so. This would also result in a response from the Medical Board.

Neuromodulators and injectable fillers have been a large part of my practice for decades.  I sit on multiple advisory boards for Botox, Allergan and Abbvie.  I have been a Diamond level Botox injector for over 12 years and in the top 5% of injectors in the USA.  I have taught Botox and filler techniques to every specialty including general dentists for decades, nationally and internationally for over 20 years.  I have published numerous scientific papers and textbook chapters on these techniques.

The situation concerning "who is trained to inject" should be based on the core training of the health care provider and bolstered by contemporary course work that outlines the diagnoses, treatment, and complications of available FDA approved products.  

In the Commonwealth of Virginia, Nurses are allowed to inject these products as is any person with a medical degree.  This would include professions with very little anatomic training and injection experience in the head and neck.  If a nurse can legally inject in this state (and I know many competent nurse injectors), then these services should be within the scope of general dentistry.  Very few specialties in medicine (and nursing) have the comprehensive head and neck anatomy training as do general dentists and virtually no other specialty provides the volume of injections in the facial area than do general dentists.  Many of these situations boil down to the politics of competing specialties and turf wars.   In fact, they should be based on education, experience, expanded education and safety.

Oral & Maxillofacial Surgeons in the commonwealth have these privileges and apply for a certificate from the Department of Health Professions to perform these procedures.  These procedures are part of the core training in OMS residency programs, are part of our boards and are covered under our malpractice insurance.  Cosmetic injectables are also taught in some dental schools as part of cosmetic dentistry and many states have allowed their administration by general dentists for years.

Every practitioner has the obligation to offer his or her patients the latest advances in their specialty and as long as they have the inherent training and experience that is equal to or surpasses those already credentialed, this should be viewed as progress, not competition.

Filler injection is not without possible complications, some which can be tragic, but in their day to day duties, general dentists use, handle, operate and inject with procedures that can have serious side effects.  They are well educated on safe treatment and avoiding complications.  As more and more aesthetic injectables enter the marketplace, ongoing continuing education is imperative for any an all specialties providing these services.

Joe Niamtu, III DMD

Cosmetic Facial Surgery

Richmond, Virginia

in support