According to the American Society of Plastic Surgery, Botox and dermal filler procedures
are the two fastest growing cosmetic treatments over the last decade and the dollar
amount spent on the two exceeds the combined amount spent on breast implants and
liposuction. These procedures have become popular in this uncertain economy because
patients want to look better with options that are more affordable and less radical than
surgery. The trend is here to stay and if dentists can provide these services in a
completely painless way, the added benefit is remarkable.

Cosmetic dentistry has been part of every dental practice for the past 20 years. It is
almost safe to say that all dentists are cosmetic dentists. Would we purposely place a
restoration on a front tooth that does not look good? Dentists have been designing
perfect smiles with veneers, crowns and sophisticated materials, like the newest
porcelains that mimic natural enamel, in a superb manner like never before.

Now that dentists have reached such a level of sophistication in facial aesthetic
practices, should we keep ignoring the perioral muscles and lips? After all, they are the
structures that frame our beautiful “tooth work.” Ignoring the rest of the face will limit the
final, overall aesthetic result. If dentists can deliver beautiful restored teeth, but they are
framed by thin wrinkled lips, creased marionette lines and downward facing oral
commissures, would the desired effect be the same?

As dentists, we are very familiar with two things: the function of each muscle in the face
and giving intra-oral injections. Having the ability to deliver dermal fillers and Botox in a
completely painless manner is one of the biggest advantages of getting these
procedures done in the dental office. Most patients who have experienced fillers
delivered with just topical skin anesthetics say that the level of pain does not grant the
results and would not go through the experience again.

Dentists have also been trained in the oral and maxillofacial areas (chin to forehead) as
much, or more than, any other health care professional that is allowed to deliver Botox
and dermal fillers. A dentist’s knowledge of these areas, in addition to having the ability
to take care of complications in facial areas, makes them the provider of choice for Botox
and dermal filler procedures.

Another critical point is that dentists master in the knowledge of facial expression
muscle dynamics. Two units of Botox administered in the wrong area of the muscle will
produce an unwanted effect that will not go away for 3 to 4 months. If it is placed too
close to the eyebrow the patient will get “droopy eyes” and if too close to the lips one
would experience lip incompetence and inability to function normally, including eating
and smiling.

Botox was introduced about 20 years ago to reduce frown lines between the eyes, but
today the cosmetic application has multiple advantages. Although the most common
areas treated are the forehead, between the eyes, corners of the eyes and occasionally
the corners of the mouth, Botox can also reduce pain and enhance a patient’s smile.
Botox blocks the release of neurotransmitters on the motor nerves that govern
movement and prevent them from contracting. Therefore, it can be used as a muscle
relaxer to reduce chronic facial pain, teeth grinding and as an alternative to surgical
treatment of “gummy smiles” (when the patient raises the upper lip too high while
smiling, so pink gum tissue shows).
Dermal fillers, which provide an appearance of fullness at the injection site and smooth
out fine lines and wrinkles, are mostly used for marionette lines, corners of the mouth,
lip augmentation and deeper folds. The results are visible immediately, but dentists only
use temporary fillers as permanent ones risk the need of surgery if something goes
wrong. Therefore dermal filler therapy at the dentist’s office needs to be repeated every
six months.

Patients now have access to information on what Botox and dermal fillers are
aesthetically capable of and are therefore becoming more educated on the treatments.
They are increasingly pleased knowing they can now receive the procedures at the
dental office and receive equal or better results while being completely comfortable.

While training for these procedures is not offered in dental school, the learning curve is
very short. Dentists already inject on a daily basis and are becoming competent in the
mechanisms of these materials: indications, risks, benefits, prevention and managing
complications. Despite this, only 10% of dentists perform Botox and dermal filler
therapies, according to Allergan Corporation. There is some resistance in the dental
community to incorporate these services, but it only seems logical to integrate Botox and
dermal fillers to the cosmetic/ aesthetic dental practice as dentists already have the
proper training needed to master the techniques.
For more information on cosmetic dental procedures, aesthetic dental practice, dermal
filler procedures, visit: http://www.drlauratorrado.com/