An escaped mental patient poses as retired dentist Dr. Caine in Paradise town. His new life seems perfect until jealousy over his landlord Jamie triggers his murderous urges, just as figures from his past arrive.

A pair of well-meaning, but socially inept brothers try to find their perfect mates in order to provide their dying father with a grandchild.

Dr. Caine, the murdering dentist from the original movie, has escaped from the mental hospital where he has been since being caught. Hoping to resume a normal life, he makes his way to a quiet Midwestern town under a false name and takes on the responsibilities of the town dentist Things are starting to look up for Caine, until the day when he catches his new love in the arms of someone else. Just as in the first movie, this sends him back over the edge and into another homicidal rampage, with his unfortunate patients bearing the brunt of his hostility.