Orofacial Harmonization as a Dental Specialty in Brazil

"I'm a dentist, can I do harmonization?" and "do I need to be a specialist?" are two different questions that tend to arrive together. The first is about acts: what the rules allow a dental surgeon to do. The second is about the title: who may present themselves as a specialist in orofacial harmonization and register that with the council. Confusing the two is the source of a lot of trouble with the CRO (Regional Dental Council), with advertising, and sometimes in court.

This guide explains what it means for HOF to be a dental specialty in Brazil, how title registration works, and which CFO (Federal Dental Council) rules define the field. Status of the rules checked on October 20, 2026, in the CFO's official sources. The regulation has changed several times and is under legal dispute: before any professional decision, check the text currently in force and consult the CRO of your state. This page is not legal advice.

What does CFO Resolution 198/2019 say?

CFO Resolution 198/2019, of January 29, 2019, recognized Orofacial Harmonization as a dental specialty and defined it as "a set of procedures performed by the dental surgeon within their area of practice, responsible for the aesthetic and functional balance of the face."

Article 3 lists the specialist's areas of competence. In summary:

The requirements for the specialization course (at least 500 hours, the split among concentration, related, and mandatory areas, coordination, and faculty) are detailed in specialization in HOF: how to choose, and are not repeated here.

What changes with the specialist title?

The title is the formal recognition, by the Dental Council, that the professional completed the training required by the specialty's rule. In practice, it matters on four fronts:

1. Practice. CFO Resolution 198/2019 describes the competences of the specialist. Some later CFO rules expressly refer to the HOF specialist when defining what is or is not prohibited.
2. Advertising. The CFO's ethics and advertising rules only allow professionals to advertise as specialists in the field in which they hold a title registered with the council. Advertising as a "harmonization specialist" without registration is an ethical violation, even if the course was completed.
3. Teaching. The rule requires that the faculty of the concentration area of specialization courses be made up exclusively of HOF specialists registered with the CFO.
4. Liability. In an ethical or legal challenge, proven and registered training is part of the defense. See lawsuits over harmonization: how to prevent them.

How do you register the title with the CRO?

Article 4 of the resolution says that a specialist, with the right to enrollment and registration with the Dental Councils, is the dental surgeon who meets its provisions. Article 8 limits registration to titles obtained at institutions accredited by the Council System or at teaching institutions regulated by the MEC.

The usual path:

1. Complete the specialization and obtain the certificate and transcript with course hours and subjects.
2. Check with the CRO of your state the list of documents and fees for specialty registration.
3. File the request with the CRO, which forwards the registration to the council's system.
4. Keep the proof of registration and only then use the title in communications.

The resolution also provided, in Article 9, transition rules for those already practicing before 2019: completion or coordination of a course begun before the rule and regulated by the MEC, or proof of practice in the previous five years combined with other requirements, depending on the specialty already registered. The 180-day deadlines set for some of those cases ran from 2019; today, the regular path is specialization.

Which procedures does the CFO prohibit for dental surgeons?

CFO Resolution 230/2020, of August 14, 2020, regulated Article 3 of 198/2019 to contain broad readings of the expression "related areas." It has three blocks:

The wording of the sole paragraph was given by CFO-SEC Resolution 285, of March 19, 2026, which also revoked Article 3 of 230/2020. CFO Technical Note No. 001/2026, of March 26, 2026, states that the sole paragraph is declaratory: it does not expand competences, and the practice of the HOF specialist remains governed by 198/2019, "without any expansion." The procedures in Article 1 remain conditioned on the Orofacial Aesthetic Surgery specialty.

What changed in the CFO rules in 2026?

In March 2026, the CFO published a set of resolutions that directly touches the question "can a dentist without specialization do it?":

• CFO-SEC Resolution 284, of March 19, 2026. Recognizes that the dental surgeon's anatomical area of practice includes the head and neck, prohibits treatment of malignant neoplasms, and revokes CFO Resolution 176/2016.
• CFO-SEC Resolution 285, of March 19, 2026. Amends 230/2020, as described above.
• CFO-SEC Resolution 286, of March 20, 2026. Recognizes Orofacial Aesthetic Surgery (CEOF) as a specialty, with its own registration and training.

CFO Resolution 176/2016 was the rule that authorized the use of botulinum toxin and facial fillers by dental surgeons, "for functional and/or aesthetic therapeutic purposes," as long as within their anatomical area of practice. Many general practitioners relied on it. With its revocation, the regulatory basis became 284/2026 and the rules of each specialty. Because these changes are recent and there are differing interpretations, do not assume: ask the CRO in writing what applies to someone who does not hold the title.

And the TRF1 decision of August 2026?

On August 19, 2026, the 8th Panel of the TRF1 declared, by majority, that CFO Resolution 198/2019 is unlawful, in a case brought by medical entities. The CFO announced an appeal and stated that, at that point, there was no change in scope of practice. The decision is not final. The case number, the parties' positions, and how to follow it are in the legal dispute over HOF, and the overview of the council's rules is in HOF regulation at the CFO.

For day-to-day practice, the practical effect is this: the title continues to be issued and registered by the CFO's system, but the rule that created it is under challenge. Impeccable documentation, a complete patient record, and a specific informed consent protect you in any scenario.

Specialty, short courses, and other professions

Physicians, biomedical professionals, pharmacists, and nurses have their own rules, also in dispute. See harmonization in biomedicine (CFBM) and facial harmonization and the CFM.

How to answer a patient who asks if you are a specialist?

If you do not yet hold the title, do not dodge: state your real training. People who ask about specialty generally want reassurance, and an honest answer, with the plan explained and a well-done medical history, conveys more confidence than a label.

And in Harmy?

HOF specialist title checklist

1. The specialization course meets CFO Resolution 198/2019 and the institution is accredited or regulated by the MEC.
2. Title registration filed with the CRO and proof kept.
3. Title used on cards, website, and social media only after registration.
4. Restrictions of CFO Resolution 230/2020, as worded in 2026, known by the team.
5. Situation of the general practitioner without a title confirmed in writing with the CRO.
6. Progress of the legal dispute followed in official sources, with the date noted.
7. Specific patient record and consent in every appointment.