Esthetic dentistry has been an absolute boom over the last 30 years especially when it comes to such innovative techniques as teeth whitening and minimally invasive veneers. If the teeth look good but we ignore the rest of the face, then we have really limited what we have done in esthetic dentistry. It is time to seriously give serious consideration to extending the oral-systemic connection to the esthetic realms and facial pain areas of the face which dentists are more familiar than any other healthcare practitioner.
Botox is a trade name for botulinum toxin, which comes in the form of a purified protein. The mechanism of action for Botox is really quite simple. Botox is injected into the facial muscles but really doesn't affect the muscle at all. Botulinum toxin affects and blocks the transmitters between the motor nerves that innervate the muscle. There is no loss of sensory feeling in the muscles. Once the motor nerve endings are interrupted, the muscle cannot contract. When that muscle does not contract, the dynamic motion that causes wrinkles in the skin will stop. The skin then starts to smooth out, and in approximately 3 to 10 days after treatment, the skin above those muscles becomes nice and smooth. The effects of Botox last for approximately 3 to 4 months, at which time the patient needs retreatment.
The Areas that Botox is Commonly Used for:
- Smoothing of facial wrinkles at the forehead, between the eyes (Glabellar Region) and around the corners of the eyes (Crow's Feet) and around the lips.
- Botox has important clinical uses as an adjunct in TMJ and bruxism cases and for patients with chronic TMJ and facial pain.
- Botox is also used to complement esthetic dentistry cases, as a minimally invasive alternative to surgically treating high lip line cases, denture patients who have trouble adjusting to new dentures, lip augmentation and has uses in orthodontic cases where retraining of the facial muscles is necessary.
Dermal fillers, such as hyaluronic acid (Juvederm, Restylane) and calcium hydroxylapatite fillers (Radiesse), are commonly used to add volume to the face in the nasolabial folds, oral commissures, lips and marionette lines. As we age, collagen is lost in these facial areas and these lines start to deepen. These dermal fillers are injected right under the skin into to plump up these areas so that these lines are much less noticeable. Dermal fillers are also used for lip augmentation and are used by dentists for high lip line cases, uneven lips and to make the peri-oral area more esthetic. The face looks more youthful and is the perfect complement to any esthetic dentistry case.