Three Questions December 25 2017

Three Questions

I have two quick questions for you to consider. The number one question is, are you busy? The second question is - are you able to handle more capacity in your office? Capacity means the capability to see more patients with the office structure that you have right now in place.

Dentists tell me all the time that they are just not busy enough. They say they have a full-time practice and there are still significant holes in their schedule. They have the capacity to see a lot more patients but just can't seem to get their treatment chairs filled. On top of this, these dentists complain, they are incredibly bored with dentistry.

The first thing I ask these dentists is what services they are offering to patients. The answer I typically get is “everything”.

Now the fun begins – I question these these dentists what services they actually provide in their office. Do you do crown/bridge and restorative dentistry? “Of course”. Do you do endodontics? “No, I never really liked endo.” Do you do orthodontics? “No, couldn’t figure out the wire bending or aligners.” How about cosmetic dentistry? “Sure, I do that, I do a couple of veneer cases a year.” Do you place implants? “No, surgery always scared me but I restore them sometimes.” What about Botox and dermal fillers, do you offer those? “No, I know my patients want Botox and my team is making me crazy to learn but I just haven't gotten around to it yet.”

Of course these dentists are having trouble filling their schedule – they are not offering a wide array of modern dentistry and they are certainly not offering procedures that patients want! And most certainly these dentists are bored, they have barely learned anything new since dental school.

With the majority of dentistry performed today being elective dentistry (1), if you want to fill those holes in your schedule, you should be offering the most popular types of services patients want and right now are getting elsewhere. If you're still providing the same services that you've always been providing and can't fill up your schedule, then you have got to do something different – you must learn new skills to provide the elective treatment patients want now.

Botox and dermal fillers are now the #1 and #2 most popular esthetic and therapeutic procedures in dentistry today, nothing else comes close. While many dentists are still scratching your heads wondering if they should add it to their practice, the over 13000 dental professionals that the American Academy of Facial Esthetics (AAFE) have already trained have rapidly expanded their dental practices by incorporating Botox and dermal fillers with everyday dental treatment plans. AAFE member practices who are giving patients what they want and average an additional $32,500 of monthly production with these procedures. What would your practice look like with that added production?

Botox and dermal fillers also have many therapeutic and esthetic uses in dentistry, including the treatment of TMJ/orofacial pain, restorative dentistry, establishing lip lines/smile lines, endodontics, gummy smile, orthodontic relapse, denture retention, eliminating black triangles, and a myriad of other uses (figure 1). From California to New York and from Washington State to Florida, dentists are allowed to use Botox and dermal fillers for dental esthetic and therapeutic uses in the oral and maxillofacial areas which are the areas that you treat on a daily basis and are well within the scope of dental practice. All you have to learn is a new skill to provide Botox and dermal filler services. It is certainly time to take “Yes” for an answer and learn how to use Botox and dermal fillers for dental esthetics and dental therapeutics that can really help your patients (figure 2).


I do have a third question for you – how long are you going to wait to fill your empty office capacity? Botox and dermal fillers should be on the menu of services you offer patients. If your patients are not ordering what is on the dental service menu in your office and you have empty holes in your schedule, you need to change the services you are providing and give people what they want and are paying for at other offices. Stop complaining and being bored, get trained, fill those chairs and get busy!

Louis Malcmacher DDS MAGD is a practicing general dentist and an internationally known lecturer and author. Dr. Malcmacher is president of the American Academy of Facial Esthetics (AAFE). You can contact him at 800 952-0521 or email drlouis@FacialEsthetics.org . Go to www.FacialEsthetics.org where you can find information about live patient Botox and Dermal Fillers training, Solid Filler PDO Threadlifts, Frontline TMJ/Orofacial Pain training, Dental Sleep Medicine, Bruxism Therapy and Medical Insurance, and sign up for a free monthly e-newsletter.


1. J Am Dent Assoc. 2000 Oct;131(10):1496-8.Elective vs. Mandatory dentistry. Christensen GJ. The reader can imagine if this was true in the year 2000 how much more so it is today.

Figure 1. Botox and dermal fillers before and after for facial volumization and gummy smile treatment as an alternative to surgical procedures.
Figure 2. AAFE member dentists learning new skills to grow their practices.