Dr. Smillie

Botox - A Message from Dr. Smillie

Botox used for medical and cosmetic purposes is a commercially produced protein. Injectable Botox works by temporarily inhibiting muscle contraction in a localized area by preventing nerves from communicating with muscles. Dysport® is very similar to the brand name product Botox and works in exactly the same way. The product begins to noticeably take effect by around day 3 or 4 and peaks a couple of weeks after administration. The effects slowly fade away over the next 3-4 months.


Botox is used therapeutically in many ways but the two that are most relevant to dentistry are migraine and TMJ dysfunction treatment. Cosmetically, it is used to reduce forehead lines, crow’s feet lines beside the eyes and furrow lines between the eyebrows. I have found that these areas can be treated successfully with a very low rate of complications. Areas that I have found to have less consistent results and higher complication rates are lines around the mouth.


In recent years, I have noticed a rise in patients receiving Botox and fillers from unqualified practitioners. In British Columbia, only specially trained dentists and physicians are permitted to order and administer Botox for therapeutic or cosmetic reasons. Physicians are the only practitioners permitted to administer dermal fillers. Nurses may be legally permitted to administer Botox only under the direct supervision of a qualified physician. Allergan is the only company that ships Botox in Canada, and the product is shipped in a very specific way and only directly to qualified doctors. It is express-shipped in a foam-style cooler containing dry ice to maintain its temperature throughout the shipping process. Even in the ice-filled cooler, the product must be placed in a fridge or freezer within 48 hours of departing Allergan’s facility to maintain temperature and therefore product stability. It must also remain consistently refrigerated or frozen during subsequent storage to maintain that product stability. If you are searching for discounted rates and come across options for treatment from practitioners other than a doctor, then it is likely that the product you are receiving is being administered by an unqualified practitioner and the product was likely obtained on the black market with potentially serious issues with product stability or legitimacy. Given that you will be injecting something not just into your body but very close to important structures like your eyes, it is best to be confident that you are receiving a product that is safe and administered by an insured practitioner with adequate experience and qualification in the field.

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