Australasian Dentist Issue 92

CATEGORY AUSTRALASIAN DENTIST 83 LINICAL entail orthodontic treatment to correct the dental defect so that the soft tissue defect is lessened or eliminated completely. The anterior oral seal should also be examined. Exaggerated Mentalis muscle contraction for an anterior oral seal would affect the position of the upper and lower teeth and hence the soft tissue morphology of the region. The dento-skeletal relationship affects all the above parameters. How to approach the patient When patients come to see us, they often use some of the phrases like: “I look tired.” “I want to look less angry.” “I hate the lower part of my face.” We should also think in these terms to understand our patients concerns, and to give our clients great outcomes. However when we simply solve one problemwithout considering any other areas, often we make that one feature stand out amongst the rest of the facial features. An analogy would be to repair a small crack in awall, but to ignore the broken window in the room. We should aim for balance and address multiple areas so that the patient looks better overall. This is often where lip fillers go wrong. Often the practitioners performs treatment without looking at any other parts of the face. It is important to look at the midface and chin too, so that the lips look like they belong. Lips should also be connected to the face in proportions and features. What I mean by this is, the lips are also about the marionettes, the nose and the jowls. Lips need to have curve, a strong cupids bow and have structure. They need philtral columns. When this is lacking, the lips can look like overfilled sausages. This is definitely not ideal. Areas to consider Taking a global approach to the face will deliver the best outcome for our patients. We need to look at all the little details. A combinationof injectiontechniquesusually produces a more complete correction of the patient concern. Correction of all of the deficits in a given region produces a more complete and harmonious correction than treating isolated features. With this inmind, when we are considering enhancement of the lips, we should also assess these aesthetic areas. Lips u Upper lip to lower lip ratio u Assymetry u Cupids bow prominence u Oral commissure position Above the lip u Philtral columns u Smokers lines u Symmetry when smiling u Nasolabial fold u Gummy smile u Eyes u Accordian Lines Below the lip u Smokers lines u Jowls u Mental-labial crease u Cobblestone chin u Marionette lines So where do you start? The first step is to undertake training, and that needs to focus on 4 key areas. These are: 1. The anatomy of the face 2. Diagnosis and treatment planning to achieve good outcomes 3. Treatment techniques in both dermal filler (using cannula and needle) and neurotoxin for a great result. 4. Supportive treatments to help the patient achieve a more harmonious appearance. At Dermal Distinction Training Academy, Dr Giulia D’Anna is a dentist working in the dental and cosmetic industry. She understands the skills that need to be developed to produce great cosmetic results, for dental patients. It is important that although you may only be interested in studying the use of dermal filler and botulinum toxin for the mouth area, you should also understand the complexity of ageing and how other treatments, such as dermal filler in other areas that can help address these changes. Similar to when a patient is concerned about some misaligned teeth, we need to consider the entire skeletal pattern when looking at the lips, we should also consider the jowls, nasolabial folds, chin, maxilla and so on. It is then that we truly master the concept of a global approach to cosmetic dentistry. u To learn these techniques and treatment planning strategies, or to find out more, head over to www.dermaldistinction.com Patient presentations Global approach before and after