I recently attended the 5th European Congress in Aesthetic Dermatology and Surgery in Anti-Aging Medicine, hosted by the European Masters in Aesthetic & Anti-Aging Medicine (or EMAA) in Paris, France. The conference focused on a plethora of anti-aging information and news in the field, but what I found interesting were the procedures tailored toward dental medicine. Botox, or Botulinum toxin, is a neurotoxic protein that is in fact one of the most poisonous substances known to man! Despite the dramatic definition, the use of very small amounts of this toxin to treat muscle spasms in anti-aging medicine is widespread. Botox relaxes muscle spasms in a way that can reduce wrinkles, by training specific muscle groups to relax and lower tension.  Botox effects wear off between three and six months, and will need to be re-administered to maintain results.

From the dental aspect, Botox can be used to control a gummy smile. Botox relaxes the muscles in a person’s upper lip – known as hyperactive upper lip – which contributes to a gummy smile. When Botox is injected into the muscle group in a person’s lip, the toxin actually relaxes the muscles and restricts the muscle’s ability to overly contract upward thus showing excessive gum tissue . Botox can also be used to control facial muscle spasms that contribute not only to wrinkles and frown lines, but to headaches as well. By undergoing Botox therapy, the muscles in the lips and face can be trained to eventually relax on their own.

Although Botox may sound like a miracle drug for reducing the appearance of gummy smiles, fine lines and even headaches, one must remember that any anti-aging treatment plan is dual-fold: the patient must be committed to their health in order to achieve long-lasting results. Patient compliance is key in any medical treatment plan, but when it comes to anti-aging, a healthy lifestyle can make all the difference in the world. Diet is one of the most important factors in patient compliance. Everyone has heard the age-old saying “you are what you eat,” – it is absolutely true.

A patient who is concerned with his or her physical health and appearance – and is willing to go through Botox therapy to achieve anti-aging results – must realize that his or her diet is vital to achieving long-lasting results. Vegetables, lean proteins and minerals are all vital in achieving healthy skin, bones and organ function. A poor diet high in refined sugars, fat and carbohydrates with poor habits (like alcohol consumption and smoking, staying up late and no exercise) all will contribute to a faster aging process. We all wishto be young and healthy forever – it all starts with healthy choices.

If you are planning on having any elective cosmetic work done, make sure your physician is familiar with different cosmetic options and has a good training background. The most common cosmetic dentistry problems can be prevented if you do your homework, including unsatisfactory cosmetic outcomes or clinical and technical shortcomings! These problems can lead to a not so happy nor healthy smile, altered speech, gum irritation, increased tooth sensitivity , chipping, loose teeth and even breakage of porcelain (from insufficient bonds between natural teeth and porcelain veneers from an overly trimmed tooth structure or bite issue). These errors end up needing additional work (like crowns, root canals or gum surgery) and can be painful and infuriating.

It is important when considering any kind of cosmetic work – dentistry or otherwise – that you evaluate your own needs, and knowing your own health as a foundation for your own future.  The consequences of only looking at cosmetic dental procedures without the health side can put your long term oral health at risk.  If you have a fairly healthy mouth with well-aligned teeth, it may be easier to get satisfactory cosmetic results with the average cosmetic dentist . If you have seriously mis-aligned teeth, gum disease or lots of dental work / TMJ problems (or are prone to cavities), you have a much more sensitive oral cavity and must be very careful with who you choose to be your cosmetic dentist. Also, you may require multiple steps in order to attain a healthy, long lasting result.

It is also important to have a well thought-out plan before the procedures starts as good communication with your cosmetic dentist and technician is key. Not only is it necessary to be able to convey your desires clearly, but it is also best to go through the proper diagnostic steps to analyze the problem, plan the treatment scientifically with a mock-up or wax-up procedure and set up the detailed 3-D blueprint of your smile makeover before proceeding with dental reconstruction work. Make sure your dentist and ceramist are well experienced by asking other patients what kind of work you can expect and by checking into his or her credentials, education and training background (www.aacd.com is a good reference site).  Look at pictures of past cases the dentist has worked on, and get a feel of what kind of sincerity and caring attitude the dental team will be able to provide you, in order to help make your important decision. Make sure you ask questions about what will make the procedure a long term success before proceeding the work.

It is a wonderful thing to have a great smile, but maintaining it will be just important. Proper home care and regular professional check-ups are musts – proper diet and healthy habits will keep your smile beautiful for a long time! Finally, wear a night guard if you are prone to bruxism as they can help maintain the structure of your oral system.

Especially when traveling to remote destinations or developing regions of the world, it can be difficult to find adequate or specialized dental care depending on what needs you may have, or what dental emergencies may arise during your trip. In the most extreme places, dental treatment can be both painful and dangerous, depending on the tools and medicines available to the dentists on staff – dental qualification standards are also frequently much lower abroad than those in the western world.

Many Americans wishing to avoid expensive dental care by voyaging outside the borders of the United States travel to Mexico or Eastern Europe every year, and while this may be a way to save money, it is important to be aware that all American dentists hold a Doctor of Dental Surgery (DDS) degree from an accredited dental school, and hold practicing licenses which are issued only after rigorous examination periods which must be renewed every year. These strict practicing guidelines do not always exist abroad. Guidelines for strict sanitation and hygiene in dental offices are regulated by the Center for Disease Control (CDC), another safety precaution which developing nations often are lacking.

If you choose to go abroad to a remote or developing location to seek dental treatment, be sure to check with that country’s health ministry to inquire about health and safety standards for practicing dentists. Call local health offices and get a feel of what you can expect. If possible, research and find a specific doctor you will visit, and check up on his or her qualifications and practicing history. Once you arrive, your eyes will be your best tool to determine the state of his or her practice! Make sure hands are being washed, instruments are coming from sterilized packaging, and “get a feel” of the place. If you are suspicious, do not proceed!

The Organization for Safety and Asepsis Procedures (OSAP) has published a Traveler’s Guide to Safe Dental Care, which should be read by any and all persons traveling abroad to receive dental treatment – www.osap.org. Finally, dental referrals may be available from the consolate of the country you are a citizen of! Be sure to call the embassy once arriving in your destination country and get all available information. Make sure to be healthy, be prepared, and have a fun and safe trip.

Local anesthetic is effective in most situations, however approximately 15% of dental patients experience a partial or total lack of numbness after receiving anesthesia injections. This phenomenon usually occurs in the lower jaw, when mandibular bone is too dense for infiltrated anesthetic injections to take, unlike the upper jaw which can receive the anesthetic solution easily. The dental nerve within the lower jaw is essentially buried within the dense bone itself,  so it requires a mandibular block injection for proper numbing (numbing which includes the teeth, tongue and lips in the same quadrant).

Variations in the anatomy of the “entry window location” (where the mandibular injection deposits its solution) makes it difficult for some people to receive proper numbing, even when the dentist follows the usual landmarks – don’t blame the dentist right away if your anesthesia doesn’t work! The physiology of each individual varies besides the anatomy, which will lead to different thresholds or reactions to various dental injections. Different dental injection solutions also gives different numbing effects – your dental professional should choose what is most applicable to your situation, usually epinephrine (the blood vessel constrictor) is added to give a better local numbing effect.

Speedy injections or anxious patients can cause a racy heart beat, which could be very uncomfortable. If you’ve had too many cups of coffee or if your blood sugar is low from having not eaten, you may feel uncomfortable after receive the dental injection. The wine from last night can also alter the effectiveness of the numbing. This all makes anesthesia a very delicate science. The technique of the operator (the dental professional) can occasionally be at fault for improper anesthesia, but more likely than not it is a complication with a patient variable. It is important for you to communicate with your dental professionals if you’ve had a history of difficulty with dental anesthetics.

Special oral local anesthetic techniques, such as intraosseous anesthesia, which can enhance deep pulpal anesthesia, may help to increase the numbing sensation. This process injects novocaine directly into the bone marrow – because the needle penetrates the hard cortex of the bone, it penetrates to the jaw’s deepest level and can adequately numb the site. It is important to remember that every mouth can be anesthetized, however because intraosseous anesthesia is considered a specialized procedure, it is important to find a dental professional who is experienced with such techniques.

Root canal therapy (also known as endodontic therapy) is a procedure of treatment for the pulp of a tooth once it has become infected – the inner pulpal material  must be removed, in order to protect and decontaminate the tooth from future microbial invasion to the jaw bone. Once a root canal procedure is performed, however, the lack of nutritional supply in the tooth (once the organic tissue is removed from the tooth during the procedure) will render the tooth brittle, the weakened tooth should be reinforced and restored properly, with a post and crown.

Root canal treatment does have a bad reputation due to the pain and the stigma associated with the procedure. Often times, a patient will have a root canal performed and think the procedure was a success, only to have pain and infection return several years down the line. The complexity of the anatomic root variation could be an obstacle and techniques can often be tedious, which is why specialized service is usually performed by a highly trained dentist or endodontist. Special tools like microscopes are also often necessary for a successful procedure. Advanced instrumentation and technique will ensure long-term success.

Regular dental checkups are vital to properly maintain your dental health. If the unhealthy dental condition requires a root canal treatment or an extraction, have your dental professional explain the pros and cons of each option, then make an educated decision. If there is a mystery pain, a 3-D image (Morita Survey of CT scan) would be invaluable for proper diagnosis. Regular dental x-rays are not capable of capturing images of a cracked tooth nor accessory root canals (which are small and difficult to see). These tiny cracks or canal issues can lead to prolonged discomfort, which you may have thought was a figment of your imagination! If the prognosis was poor, or a tooth has broken down so much that it has become unrestorable, extraction and a dental implant might be a more sustainable investment to you dental health.  Prevention is always the best treatment! Brush and floss your teeth twice daily and after meals. If you have any dental pain, schedule an appointment with your dentist sooner rather than later.