Last Updated On: February 29, 2024
The orofacial complex is a dynamic system where even the slightest change can result in a noticeable difference. In pursuing a radiant smile and a youthful appearance, many turn to cosmetic procedures such as Botox and veneers.
Although veneers are an elective and almost exclusively aesthetic procedure, their success is significantly dependent on the stable balance of harmony between the masticatory system and orofacial soft tissues.
Veneers and Botox offer a comprehensive solution for those seeking a flawless smile and a youthful look.
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With time, the utility of Botox has extended beyond cosmetic needs. A neurotoxic protein, Botox, is derived from Clostridium botulinum, an anaerobic bacteria. It inhibits the neuromuscular transmission of acetylcholine9, a neurotransmitter that sends signals to muscle cells.
By blocking these signals, Botox reduces muscle action or lack of muscle contraction, which can help treat various medical conditions. The applications of Botox include both cosmetic and therapeutic aspects. The cosmetic applications are explored in a later section.
Therapeutic Applications of Dental Botox:
Botox is typically available in 7 serotypes (A to G)2, but only types A and B are FDA-approved for therapeutic use. It takes around 2 weeks for Botox to show its clinical effects.
When replicating the natural tooth appearance, dental veneers are the go-to option for their excellent aesthetics. The need for minimal tooth preparation and color stability attracts patients to rejuvenate their smiles. In the hands of a trained cosmetic dentist, well-planned and placed veneers can effectively reduce a person’s age by almost 10 years. The results are quick and provide an instant boost to the patient’s confidence.
Like thin shells, a dental veneer, usually made from porcelain or composite resin, is bonded to a tooth’s front (labial/buccal) surface to cover generalized and localized defects3, including:
Veneers are long-lasting and have a survival probability of 91%4. Moreover, they are resistant to stains, which is a significant advantage over natural enamel. They can be customized to match the individual’s facial features and preferences, making them a good choice for aesthetic enhancement while preserving the integrity of the dental hard tissue.
Patients seeking esthetic dental treatments prioritize the appearance of the “social six” anterior teeth over functional concerns. Research by Wazani et al. found that 59% sought treatment due to dissatisfaction with looks rather than functional issues.
Therefore, evaluating and correcting posterior occlusion before addressing cosmetic concerns in the front teeth is crucial to achieving lasting positive outcomes.
The perfect smile is incomplete without the harmony of the hard and soft tissues. One thing that dentists across the world unanimously experience is trepidation regarding the stability and longevity of aesthetic procedures like veneers. Factors such as temporomandibular disorders (TMDs), parafunctional habits, irregular muscle activity, and unforeseen healing patterns can lead to undesired outcomes.
Mitigating these issues can result in the need for more invasive treatments, which can be psychologically and financially draining for the patient. This is where Botox and dermal fillers can provide drastic benefits without going beyond a few millimeters of soft tissue.
The therapeutic effects of Botox help address the following cosmetic concerns1:
This is often a result of hyperkinetic lip depressor or elevator muscles, resulting in an imbalance in lip positioning.
Excessive maxillary gingival display1,5 (>2mm), or a gummy smile result from multiple etiologies. It can be hard to treat this condition because some muscles in the lip and cheek are overactive. These muscles include the levator anguli oris, levator labii superioris, levator labii superioris alaeque nasii, zygomaticus, and the depressor septi.
Many people in dentistry fear “black triangles,” which are the result of interdental spaces that allow food particles to accumulate. Injecting Botox or dermal fillers into the interdental papilla closes these gaps. The results of such treatments typically last for about eight months or longer, necessitating periodic reapplications.
Interestingly, a dose of Botox to the masticatory muscles can mitigate abnormal forces generated in bruxers. Evidence6 suggests that dental implants are more prone to micro-fractures at the bone-implant junction owing to excessive functional force. Administering Botox (Type A) injections into these muscles can relax and weaken muscle activity for approximately three to four months, giving a much-needed window for promoting osseointegration.
The appearance of drooping mouth corners and Marionette lines is caused by age-related changes in the skin and hyperactivity of the depressor anguli oris (triangularis muscle) muscles.
Age, exposure to the sun, smoking, and strawing make vertical lip lines worse because they result from repetitive orbicularis oris muscle contractions.
Masseteric hypertrophy is a condition where the masseter muscles in the jaw become enlarged due to various reasons, such as genetics, chronic clenching habits, and TMJ dysfunction. This can impart a squarish appearance to the face.
Botox effectively addresses perioral wrinkles, gummy smiles6,10,11, marionette lines, smoker’s lines, and masseteric hypertrophy by relaxing targeted muscles, diminishing wrinkles, and enhancing overall facial appearance.
While planning Botox after veneers, the latter should fully settle before injecting Botox. This usually takes a few weeks, allowing the gingiva and teeth to adjust to the new veneers. The waiting ensures that the Botox treatment does not interfere with the bonding of the veneers or cause any complications.
Establishing the proper function of the masticatory system is critical to ensuring optimal outcomes and patient satisfaction while planning veneers.
It involves a comprehensive examination and diagnosis to restore the worn dentition while prioritizing functional aspects. A thorough treatment plan includes reviewing the patient’s history, overall health, oro-facial structures, and functional examinations.
The ‘5P’ approach7 can help tackle complex cases through various phases, including,
Overall, evaluating these factors meticulously is vital to ensuring patient comfort and optimal aesthetic results.
The combination of Botox and dentistry offers safe and effective cosmetic enhancement and delivers quick results. Coupled with veneers or fillers, it rejuvenates smiles by addressing issues like black triangles, gummy smiles, and high lip lines.
Although costly and repetitive, Botox’s popularity lies in its non-invasive, fast results, especially among patients apprehensive of invasive procedures. Dentists, with their expertise in the orofacial region, can administer Botox. However, proper training and expertise are vital for minimizing risks and ensuring optimal outcomes.
Yes, one can get Botox after veneers. However, waiting at least two weeks to 15 days post-veneer cementation is essential to evaluating the need for additional changes.
Dentists are well-known for their expertise in dealing with problems concerning the head and neck region. Their dexterity in complex dental and oro-facial procedures makes them the perfect candidate to administer Botox. However, the scope of this particular service may vary in different places. Therefore, it is best to have a licensed professional perform the procedure.
After administering Botox, it is crucial not to allow its spread to other areas of the face, as it can lead to potential side effects. Avoiding the following can help improve the benefits of treatment:
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