Australasian Dentist Magazine Nov Dec 2021

Category AustrAlAsiAn Dentist 83 liniCal recognizing that these services are health and medical treatments that just happen to have an aesthetic benefit, several rogue operators have emerged in the dental profession, which risk undermining this professional progress and threaten practitioner and patient safety. AADFA has never advocated that dentists stop being dentists. in fact, skilled, regulated, responsible, conservative Dentists are among the only practitioners to be able to offer such a comprehensive approach to dento-facial health and aesthetics, with extra-oral services being treatment planned alongside traditional intra-oral treatments, in a truly holistic approach to care. Yet what has now emerged is a group of practitioners who are encouraging the profession to move into cosmetic injecting, using the lesser standards of beauty therapists and nurses as a guide. We are even seeing dentists being encouraged to call themselves cosmetic injectors, in a move solely designed to mislead patients into thinking these individuals possess some specialized qualification or ability when compared to other practitioners. this term is being used inmuch the same way as cosmetic surgeon is used by some GP doctors to mislead their patients into thinking they are akin to specialist plastic surgeons. thankfully regulators are starting to notice such behaviour and the unscrupulous targeting of weaknesses in a patients’ self-image. A cosmetic injecting approach not only prays on the vulnerabilities of patients rather than educating them on how to make real health-based decisions; a serious issue with the rising prevalence of Body Dysmorphic Disorder; but a focus on purely cosmetic outcomes poses some very real dangers to practitioners and patients alike. Chief among these is a limited set of tools and an over-reliance on cosmetic injectables like Botox and Dermal Fillers. A knowledge of and ability to deliver facial injections was only ever a small part of what AADFA advocated and of what is required of practitioners to be able to develop a comprehensive, holistic treatment plan for patients to achieve safe and effective, long-term clinical results, without complication. in fact, injectable treatments like Botox and Dermal Filler should come a long way down the list and it has reached a point where if a practitioner is only promoting Botox and Dermal Filler for facial rejuvenation, they should stop immediately! If all you have is a hammer... in much the same way as dabbling in implants and orthodontics has the potential for disaster for patients and practitioners, so too does simply trying to address the complex, multi- factorial nature of facial ageing and skin deterioration, with a limited array of cosmetic injectables. A failure to understand all of the available treatment options and the proper sequence of their use; limiting treatment to certain isolated areas of the lower face; and an over- reliance on a limited range of tools, leads to a multitude of problems, from a lack of informed consent, through to inappropriate treatment, clinical complications and poor aesthetic outcomes. When a single tool is being applied as a cure-all, problems soon follow, for as the law of instrument states – if the only tool you have is a hammer, you tend to see every problem as a nail. For example, in the facial aesthetics realm, we see practitioners with limited education, skills and tools applying excessive amounts of dermal filler to lips and, classically, to the cheek region, resulting in an unaesthetic, over- inflated, thick mid-face, characterized by a drastically reduced ocular region or squinty eyes. it is also this excessive use of inappropriate products and services that exposes patients to serious clinical complications, beyond just looking strange and plastic. successful Dento-Facial Aesthetics can neVer just be about learning Botox and Dermal Filler injections. Dentists need to become knowledgeable in the full spectrum of facial rejuvenation, able to appropriately consult patients; diagnose and treatment plan utilizing an array of techniques, ranging from scientifically proven at-home skincare products and sunscreen, through to dissolving fat deposits and performing thread-lifts to address skin laxity. A further issue for practitioners who follow a cosmetic injecting approach is the real risk of undermining credibility as a health professional. especially when introducing dento-facial services to your long-standing patients, a purely cosmetic focus on wrinkles and voluptuous lips will invariably offend many and rather than being positioned as a health expert who understands the field in-depth, practitioners risk looking opportunistic, foolish and money-hungry. A cosmetic, anti-wrinkle focus for services like Botox also then makes it difficult to utilize them for the beneficial treatment of conditions like tMD. The education problem the key to ensuring safe and successful practice, for practitioners and patients, is no secret and is the same when developing skills and techniques in all areas of dentistry – comprehensive education coupled with a responsible approach to gain competency. university degree courses for dentists are thoroughly vetted to ensure an appropriate standard of education is being delivered, to produce the highest quality practitioners with the ultimate goal of protecting the wellbeing of patients. Yet many skills of a modern practitioner, including dento-facial aesthetics, are learnt and refined, only after graduation, through Continuing Professional Development (CPD) programs. the issue is that CPD lacks the same level of oversight and in many facets of dentistry, has become the Wild West, directly impacting patient experiences down the line. From implants and full mouth rehabilitation, through to orthodontics and laser, it seems there is a growing pool of dentists who think they are perfectly equipped to train others, with little more than the limited experience in their own clinic or the re- working of a course they took, which was developed by someone else. now it’s not to say that many dentists don’t have unique individual perspectives, skills, and knowledge to share, but that is a long way from being equipped and experienced enough to provide quality comprehensive CPD to keep patients and practitioners safe. simply put, there is a reason why treatments like implants, orthodontics and advanced restorative techniques now top the charts in terms of patient complaints and regulatory action. there is a clear correlation between this and a rise in random, short-term training courses in dentistry, without any of these being vetted by an independent body. the field of dento-facial aesthetics has The over inflated cheeks and squinty eyes, typical of a dangerous cosmetic focus – if you see this in a cosmetic injector... run!