How many of you take aesthetics patients’ dental history as part of your consultation? From what we see among new aesthetics practitioners, we’re guessing you might not…
We understand that when you first start out in aesthetic medicine, you just want to get to the injecting part. However, in order to get the best possible results from your injectable treatments, you need to conduct a thorough consultation first.
Dr Kalpna Pindolia is a highly experienced facial aesthetics expert and Harley Academy’s director of education.
She explains, “One significant part of the consultation, which can be overlooked by trainees, is past and current dental history and examination.”
Whilst it’s good practice to take all aesthetics patients’ dental history, the ramifications generally only apply to fillers. The reason for this is because fillers act as a foreign implant as long as they’re present in facial tissue. This is a potential nidus for infection.
Here she outlines why injectors must take aesthetics patients’ dental history, and why it’s so important…
Perioral and cosmetic dental work
“If a patient is to have dental work, it’s sensible to have this completed first,” advises Dr Kal.
“This can affect the aesthetic of the lips and lower face, and may mean amending a filler plan.”
Dr Kal’s recommendations for the timeline between dental work and filler treatment is outlined later in this article.
Complications from dental work and filler treatments
“The concern is dental infection and inflammation leading to abscess or delayed onset nodules (DONS) with filler treatments,” clarifies Dr Kal.
“Cheek filler in particular seems to be an issue. It’s been suggested that, as maxillary bone is more porous, bacterial spread is more likely.”
She notes, “Prolonged infection can cause tissue scarring and potential unpleasant long-term aesthetic sequelae. DONS can also be resistant to treatment. This is why dental history is so important in preventing complications.”
What about if your filler patient expresses dental pain concerns post-treatment? “Advise them to seek dental care early to avoid filler involvement,” Dr Kal states.
“Abscess will need early treatment. Aspirate sent for microbiological tests before antibiotics are commenced is ideal. This is so that antibiotic treatment can be tailored later, with the results. Although it’s worth noting that most results are negative.”
“Dissolving filler early, in the brewing abscess scenario, seems a rational approach,” she says. “Remember, perpetual infection around the implant will set up further tissue destruction.”
Prevention is better than cure
“If there’s any concern with dental pain pre-treatment, do not treat until they have seen a dentist,” instructs Dr Kal. “Only treat once it’s been confirmed that their diagnosis excludes infection.”
“If there is infection, that should be treated first. I personally wait at least 4-6 weeks before considering filler treatment after the infection has been managed.”
“Where patients have had recent dental procedures, I personally wait for 4 weeks before treatment,” she says. Further noting that “this includes hygienist appointments”.
Ensure you communicate clearly and compassionately with your patients. Take time to explain the situation. Many patients won’t understand why their aesthetic treatments have anything to do with their dental situation.
“Managing these patients may need shared care with a dentist,” notes Dr Kal. “As well as needing your support and advice”.
Delivering first-class patient care is not just your duty as an ethical aesthetics practitioner. It’s also a highly effective marketing tool.
Going above and beyond for your patients is a great way to generate goodwill, good reviews and excellent word-of-mouth recommendations.
Remembering to take aesthetics patients’ dental history during consultation
“There’s a lot to cover during your patient consultations so to make it easier, give yourself some prompts,” suggests Dr Kal.
“These can take whatever format works best for you. A checklist, or Post-Its hidden inside a cabinet that you review before each appointment, for example.”
“Include each aspect you need to cover during your consultation, then physically – or at least mentally – check them off.”
The more patients you see, the easier this process will become. Soon it’ll become second nature, but don’t be afraid to use reminders for as long as you need.
Conducting in-depth consultations is part of our eLearning modules. These interactive, self-paced online aesthetics training tools are invaluable educational resources.
They’re included in all our injectables courses and can be used as reference material throughout your career. Doctors, dentists, nurses and midwives are also welcome to purchase these separately.
For more advice on this topic, check out our article Perfect Your Aesthetic Patient Consultations.