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Treatments with botulinum toxin by the dentist

Botulinum toxin injection is an effective method for teeth grinding, also known as bruxism. The drug can be used outside the known approvals under the so-called off-label use for wrinkle treatment.

Mechanism of action of botulinum toxin

Botulinum toxin is a neurotoxin, a nerve-active substance that temporarily blocks the transmission of neurotransmitters in the nerves. This occurs due to a strong binding of botulinum toxin to the nerve endings, whereby these are blocked and no more impulses can be transmitted to the muscle fibres. As a result, the muscle can no longer move and becomes flaccid.

Therapies with botulinum toxin

Botulinum toxin treatment can be used for various medical conditions and aesthetic procedures. These include eye tremors, strabismus, migraine, swallowing spasms muscle or vascular spasms and excessive sweating.

The sympathetic nerves regulate the amount of sweating, with acetylcholine transmitting the impulses to the sweat glands. This is where botulinum toxin acts to stop increased sweating. As a result, the transmission of nerve impulses to the sweat glands is blocked for about 3-6 months.

Can a dentist inject botulinum?

Whether treatment with botulinum toxin may be performed by a dentist depends on whether the intervention is the practice of medicine. If this is the case, it must be clarified whether this treatment falls within the scope of dentistry.

Dental Health Act

The practice of dentistry is defined by Section 1 (3) of the Dentistry Act (ZHG). According to this, the practice is defined by the detection and treatment of dental, oral and maxillofacial diseases. If wrinkles in more distant regions are to be injected, such as on the eyes or in the forehead area, these body regions no longer fall within the scope of dentistry and may therefore not be treated by the dentist.

Botulinum in healing science

The term "healing science" is defined by the healers law (German law on non-medical practitioners) and is used to determine, cure or alleviate pain. Since the purely aesthetic injection of wrinkles does not correspond to these guidelines in the first place, the term was expanded here and also includes treatments that require medical expertise and can cause damage to health. The treatment with botulinum toxin requires anatomical knowledge and is accordingly a medical treatment.

Side effects

Treatment with botulinum toxin can have side effects, such as minor bruising or nerve dysfunction. Allergies or hypersensitivity, for example to the medication or the anesthetic, can also occur.

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Bibliography

  1. Artikel in DZW „Zahnarzt-verliert-Approbation-nach-Botoxbehandlungen” Tim Oehler
  2. Sommer, B., G. Sattler: Botulinumtoxin in der ästhetischen Medizin 2006 Georg Thieme Verlag KG, Stuttgart
  3. S1-Leitlinien Definition und Therapie der primären Hyperhidrose der Deutschen
  4. Artikel Lex medicorum „Dürfen Zahnärzte Botox spritzen“ von 2011