Many of us think of Botox primarily as a cosmetic treatment for lines and wrinkles on the face, but the botulinum toxin that Botox is derived from has a long history of medically therapeutic uses. With more and more countries including the UK and United States utilising both the therapeutic and cosmetic benefits of Botox in the dental setting, is it time that we in Australia do the same?1
Botox therapy was originally applied to conditions of the eyes such as for abnormal muscle spasms of the eyelids (blepharospasm) and for crossed eyes (strabismus). Today, the pharmacological processes of Botox therapy have become well understood and the medical applications are wide-ranging. Conditions such as migraine, excessive sweating, urinary incontinence, MS and muscle spasms, tennis elbow, Bell’s palsy and tremors can be treated very effectively with Botox therapy. From a cosmetic perspective, the bonus of effect of Botox intervention is a reduction in the tone of the injected muscle, leaving the surface smooth and aesthetically pleasing.1,2
Botox is now being increasingly used in dentistry as well, due to its therapeutic uses in treatment
of certain oral conditions. Botox therapy is a minimally invasive procedure and is showing quite promising results in management of muscle-generated dental diseases like TMJ disorders (jaw joint), bruxism (grinding), clenching and masseter hypertrophy (enlargement of the cheek muscle). Botox can also be effectively applied to treat aesthetic dental conditions like deep nasolabial folds, radial lip lines, high lip line and black triangles between teeth.1
What are the advantages of dentists performing Botox treatment?
Dentists spend each day, every day, working on the inside of clients’ mouths and know facial anatomy better than most. Their education and training is in anatomy, specifically in the muscles, the nerves, the vascular system and the physiology of the face. As well, dentists inject in the face all day as part of their practising life; so from this standpoint, dentists are an ideal practitioner to be carrying out Botox treatment to the head and face.2
More dentists are embracing the opportunity to offer cosmetic facial injections as part of a ‘full-face makeover’, with dental surgeries on Queensland’s tourist strip reportedly embracing the service. “There’s no point spending all your money on the frame if you don’t have a nice picture to put in it,” says Dr Myles Holt from North Queensland.3 Dr Holt adds that “dentists are not trying to perform new or radical procedures here. We are talking about procedures that are already performed by lesser-trained individuals across Australia every day. What we are talking about is allowing patients to receive treatment from the most qualified and experienced health practitioners.”3 Dr Holt believes allowing dentists to administer Botox for cosmetic purposes is good for both patients and the profession.3
Dr Damian Ryan, from Hastings Street Medispa and Dental on Noosa’s boutique Hastings St on the Sunshine Coast, told the Courier Mail that cosmetic medicine was a perfect fit with dentistry. “When we fix patients’ teeth and they start smiling again they start noticing they have crow’s feet, so you need to look at the whole kit. Or you get people in with a face and lips that have been done but when they smile you notice they have old teeth,” he said.3
There is also the element of maintenance. If you’re going to the dentist to have your teeth cleaned and checked, you have to return for regular maintenance because plaque and stain will come back over time. It’s the same with Botox; you have a treatment, your wrinkles are smoothed and then it wears off—why not tie these maintenance visits together?2
Current policy regulations for Dentists in Australia using Botox
As it stands, dentists are only able to use Botox for therapeutic purposes in instances of jaw joint and facial pain. They have not been authorised to use it for what we would call cosmetic purposes.2 Currently the Dental Board of Australia states that under the laws of most states and territories, “prescribing [of Botox] must be for dental treatment only”. Therefore there is a grey area where cosmetic procedures are concerned. Thankfully this policy has been temporarily removed from the website while it undertakes a review but the Board was unable to say when that would be completed.2
A spokesperson for the Australian Dental Association (ADA) said that the ADA would support the use of Botox for cosmetic purposes if a new policy is released and believes there is a mood for change.2
Again, we are not suggesting anything outrageous. Botox therapy is recognised and utilised by dentists in the USA, UK and many European countries leading in dentistry. The Brisbane Courier Mail newspaper reports that the Gold and Sunshine coasts are leading the way at home, as Queensland accounts for almost half the dentists nationally who have undergone training with advocate Dr Myles Holt.3
Overall, there is still the question of whether it would become a ‘turf war’ between dentists and doctors. Originally it was the dermatologists and the plastic surgeons that could provide Botox therapy. Then it spread into more mainstream medical practice with GPs and now nurse practitioners, under the guidance of a medical practitioner, can also use Botox and dermal fillers. There is much overlap with allied health care these days, which is a wonderful thing and this needs to be embraced by all health practitioners for the benefit of their patients. After all, that’s what it is all about isn’t it?
References:
- Pranav Nayyar et al. ‘BOTOX: Broadening the Horizon of Dentistry’, J Clin Diagn Res. 2014 Dec; 8(12): Published online PMCID: PMC4316364
- Skates, Linda. ‘Dentists look to use Botox for cosmetic purposes as board pulls interim policy to review it’, ABC News, 2014 Dec 6. Published online: http://www.abc.net.au/news/2014-12-06/dentists-look-to-use-botox-for-cosmetic-purposes/5947576
- ‘Botox grows in popularity in Queensland’, Bite Magazine. 2012 June. Published online: http://bitemagazine.com.au/botox-grows-in-popularity-in-queensland/