Objective: The face has become as central to modern dental practice as the smile it frames, and botulinum toxin type A (BoNT-A) now sits at the centre of a rapidly expanding, non-surgical cosmetic discipline within dentistry. This narrative review examines the pharmacological basis, clinical applications, technique principles and safety profile of BoNT-A as used by dentists for both facial aesthetic enhancement and orofacial therapeutic indications, and considers the professional, educational and regulatory dimensions of this emerging scope of practice. Methodology: A narrative literature review was conducted using PubMed, Scopus and Google Scholar, focusing on peer-reviewed articles, systematic reviews and clinical reports concerning botulinum toxin use in dentistry, facial aesthetics and orofacial medicine, published predominantly between 1992 and 2025. Search terms included combinations of "botulinum toxin", "facial aesthetics", "cosmetic dentistry", "gummy smile", "masseter hypertrophy", "bruxism" and "orofacial harmonization". Major Findings: BoNT A acts by cleaving SNAP-25 within the presynaptic SNARE complex, blocking acetylcholine release and producing temporary, reversible muscle relaxation. Indentistry this mechanism is exploited both cosmetically, to soften hyperkinetic facial lines and correct gummy smiles, and therapeutically, to manage bruxism, masseteric hypertrophy, myofascial temporomandibular pain and related orofacial hyperactivity disorders. Reported complication rates are low, and most adverse events are transient, provided treatment is anchored in sound anatomical knowledge and structured training. Conclusion: Botulinum toxin represents a natural and evidence-supported extension of the dentist's existing anatomical expertise and injection skill, but its safe integration into dental practice depends on rigorous undergraduate and postgraduate education, clear scope-of-practice regulation, and adherence to informed-consent and safety standards comparable to those in medical aesthetic practice.

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