Dentists Banned From Cosmetic Botox Business

Rules changed in wake of a barrage of complaints by patients.

Dentists will no longer be allowed to perform cosmetic treatments that do not involve the oral cavity, including Botox injections, according to new regulations to be issued shortly by the Ministry of Health. The rules are being changed in the wake of a barrage of complaints by patients who have received cosmetic facial treatments from their dentists.

Currently, the law mentions that dentists are allowed to administer chemical treatments such as Botox on a patient's oral cavity. It does not prohibit them from administering these treatments elsewhere. Hence, in recent years, it has become more and more common for dentists to give their patients Botox injections and other cosmetic treatments.

The Health Ministry plans to utilize disciplinary measures that are already in force for other types of misconduct to enforce the new regulations. Thus, dentists who perform cosmetic treatments without having been officially qualified to do so can be reprimanded, suspended, and extreme cases, they can even have their licenses taken away.

"The current dentistry law defines the area of practice for dentists, and our role is to interpret it and give advice to the system," says Health Ministry director general Prof. Ronni Gamzu. "There is a deviation here from proportionality and from the limits of the profession. It is our duty to say this to those in the dentistry field."

Israeli Medical Association ethics committee chair, Prof. Avinoam Reches, explains that the specialization in plastic and aesthetic surgery, which allows doctors to give cosmetic treatments, is approved solely by the IMA's Scientific Council. "Many general practitioners, who are not qualified plastic surgeons, do plastic procedures like liposuction and Botox injections," he says. "If the patient thinks the person who is treating him is a specialist in aesthetic medicine, even though he holds no such qualification, then the doctor is depicting himself to the patient in an improper and deceptive way, totally contrary to the rules of ethics."

Dr. Amos Leviav, chair of the Israel Society of Plastic and Aesthetic Surgery, sent a letter this week to members of the organization in which he criticized the IMA ethics committee for lack of action, beyond reprimanding doctors who depict themselves as aesthetics specialists, and noted that the Health Ministry would take further action under the new rules. "Since falsely depicting oneself as a medical specialist constitutes a criminal violation, it has been agreed with the deputy director general of the ministry that criminal complaints will be filed against doctors who falsely depict themselves as specialists in aesthetic medicine," he wrote.

But Prof. Gamzu insists criminal charges will not be brought against these doctors, despite the concern that patients might be misled.

Many plastic surgeons believe that some general practitioners and dentists are administering aesthetic treatments because they are very profitable. But they say it is a dangerous way to make money. "In their studies dentists learn extensively about the nerves in the oral cavity, which have no connection to the muscles in the ... area of the eyes," says Dr. Nimrod Friedman, a plastic surgery specialist. "It's not a matter of a few little injections but rather they have to have perfect knowledge of the movement of the muscles and the anatomy, and this is taught only in the context of plastic surgery studies.

Dr. Friedman adds that in recent years there has been a pattern of general practitioners going through an abbreviated course of studies in aesthetic medicine, only a few weeks long, at the end of which they receive certification as specialists in aesthetic medicine. He says this violates Health Ministry regulations.

Israel Dental Association chairman Dr. Itzhak Chen has told Haaretz that he is unaware of a phenomenon of dentists who offer aesthetic treatments that do not involve the oral cavity. "The injection of Botox began with dentists, who to this day inject it in order to reduce the tension on the mastication system and relax the muscles," he says. "Dentists have great expertise in injections."

Chen adds that he has contacted the dental health department at the Health Ministry in an attempt to arrange advanced studies for dentists, which would include professional training and an examination. According to him, such a move could enable dentists to work in the field. But he says the ministry is taking the easy way out. "Instead of doing this, the ministry is publishing a prohibition," he says. "It's the easiest thing to publish orders and regulations when the problem is amenable to a solution. Why are they allowing this to the rest of the medical doctors, like orthopedists and gynecologists? They, after all, don't have any more experience."