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Important! Lower Face injectable treatments you need to know

By Dr Giulia D’Anna, BDSc, MRACDS, FIADFE, Grad. Dip. Derm. Ther Cert IV TAE, Grad. Cert laser, Email: giulia@dermaldistinction.com.au D entists are in a prime position to be looking after their patients lower third

Dr Giulia D’Anna

of the face. at is our scope of practice and where our expertise naturally lies. We obviously focus on the teeth and smile as primary concerns, but the soft tissues that frame the smile are equally important to your outcomes. ere are a number of lower face treatments that are especially complimentary to cosmetic dentist treat ments you already o er. Our lower face plays a signi cant role in how our face ages. is includes the jaw, teeth and overlying layers. As such, there are a number of non-invasive cosmetic treatments that all practitioners can learn to improve their outcomes. is is especially true of cosmetic dentists due to their particular area of expertise. ere are many factors contributing to an ageing appearanceof the lower face that arebeyond our control. For example, genetics, trauma and dental health. However, preventative lifestyle changes, such as good dental hygiene and regular check-ups, can help to mitigate these e ects. is is a message dentists are clearly well-placed to deliver. Dentists also already have a practice to which they can introduce cosmetic injectables, with the right training (www. dermaldistinction.com) and insurance. is means an existing potential patient base with who you already have a trusting relationship is going to bene t from you growing your skillset. By adding on certain injectable treatments to your dental practice, you can provide patients with a more holistic o ering. is can help them to minimise the e ects of ageing and restore a more youthful appearance. Gummy smile treatments: A patient sued! e reasonIbeganmy journey intocosmetic injectables was for this exact treatment. I had heard of a case in the USA where a patient underwent successful orthodontic and oral andmaxillofacial surgery to correct her maxillary excess, but still was able to sue her treating practitioners successfully anyway. She claimed that had she known about botulinum toxin as an option to

correct her gummy smile, she would not have undertaken the years of treatment that she had as it put her career and personal life on hold. And to be honest, I see her point. Surgery is invasive and it takes weeks or months to recover from it. Whilst it is a truly legitimate and life-changing journey, but it is not for everyone. And as dentists, it is our responsibility to o er all the treatment options to our patients, even if we feel that there are long-term options that are best suited to them. A similar example would be if we only o ered All-On-4 to our patients instead of removable dentures. ere is a huge cost and treatment procedure di erential between the two. Patients should be able to choose what they see as the best treatment for themselves. So if you are not o ering the option of cosmetic injectables to your patient, you are omitting a legitimate treatment options with very low risk and cost. Similarly where a patient requires mandibular advancement, one option

is orthodontic treatment followed by orthognathic surgery to correct the chin position. But not all patients want this or are suitable. So other options include a surgical chin implant or dermal ller to advance the position of the chin. Of course all the options carry risks, and di ering time lines and costs, and it is our role to introduce these options to our patients and let them decide which treatment they want for themselves. ink about the consequences if you don’t. You have no recourse if the patient decides to take legal action, so you owe it to yourself and your patient to discuss which treatments are available. e most common aesthetic complaints that I hear in my practice are centered around the lower face, because as we get older, our lower face becomes squarer and the excess tissue drapes there. So let’s now look at why this happens, and how cosmetic dentists can help. Causes of ageing in the lower face Signs of ageing in the lower face are primarily caused by a combination of loss of skin elasticity and changes in the underlying facial structure. Some of the main contributing factors are: u Loss of collagen and elastin u Changes in bone structure and teeth u Loss of deep fat pads which shrink and descend over time u Repetitive facial movements causing dermal atrophy u Sun damage and elastosis (loss of elasticity) u Lifestyle factors such as smoking, poor diet, and lack of exercise.

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