Look Great, Feel Great, Sleep Great
It is truly an honor to be asked to be the guest editor for this edition of the Alpha Omegan journal. My personal thanks to my good friend and an outstanding prosthodontist and dental clinician Dr. Steven Spitz, who is the international editor for Alpha Omega, for allowing myself and the American Academy of Facial Esthetics (AAFE) this opportunity to contribute and share our knowledge with the readers.
As president of the AAFE representing more than 9,000 dentist members (in addition to medical healthcare members), I am excited to share new and innovative evidence based diagnostic and treatment options that will enable you to offer your patients better esthetic and treatment outcomes than ever before.
I am joined by some of our outstanding faculty members, all practicing clinicians with successful practices, as we demonstrate the best ways to integrate the areas of facial pain, facial esthetics, and bruxism/ dental sleep medicine into every dental practice.
It is important to note that all dental esthetics is truly facial esthetics; all dental pain is facial pain and vice versa. There is no differentiation between the two, as you will see in the articles in this journal, they are truly all one and the same.
As an example, in the past, dental professionals would give lip service (pun intended) to the soft tissue structure around the mouth while often having to go to dramatic and highly invasive surgical lengths to correct smile and lip lines. With 85% of TMJ and orofacial pain coming from the head and neck muscles, trigger point muscle therapy is the best place to start before any irreversible dentistry is accomplished. Often, these muscle trigger points will refer pain to the teeth resulting in phantom dental pain on virgin teeth which frustrates those dental clinicians who have not been trained to treat trigger points.
Botulinum toxin (Xeomin®, Botox®) and dermal fillers have now been routinely used by dental professionals for the last 8 years. These pharmaceutical agents are not procedures in themselves; they are simply tools for dental clinicians to use for treating patients. In addition to the nearly 200 live patient training courses the AAFE teaches in the United States and worldwide, the AAFE also has partnered with the ADA Annual Meeting, the Hinman Dental Meeting, and other universities and dental societies to bring the latest highly successful techniques for treating facial esthetics, facial pain, trigger point therapy, and bruxism/dental sleep medicine.
The Most Common Dental Disease
It is well known that a third of patients exhibit some kind of bruxism, making it one of the most common dental diseases. Yet it is the only one that we have not been able to quantify in any kind of meaningful way that could help patients. The frustration every dentist has when recently placed dentistry fails due to breakage is something we all share and truly dislike.
Replacing the dentistry then results in failure again – many dentists like to blame the laboratory or the dental materials when in truth, even when the occlusion is impeccable, the destructive forces caused by bruxism is the unseen and untested disease that in the past we could not identify or control. New technology is now available so that every single dentist can monitor the patient’s bruxism by establishing the patient’s Bruxism Episodes Index (BEI) to create a treatment plan. To quote my mentor Dr. Gordon Christensen, “Bruxism monitoring is one of the most important concepts in dentistry today.”
I often hear from dentists that we are only then treating the symptoms, not the cause. Where does this bruxism come from? Here is where the well-established link to obstructive sleep apnea (OSA) is the primary reason why every dental practice needs to incorporate dental sleep medicine. As an example, with 40 million patients in the United States having OSA and 90% of those largely undiagnosed, this is the direct link to dental bruxism which will determine the prognosis of dental treatment performed on these patients. OSA is a medical condition that requires a physician’s diagnosis. Dentists should never be testing a patient only for OSA as this falls outside of the dental scope of practice. Combining bruxism and dental sleep testing is the best way to integrating this into every dental practice and staying with the dental scope of practice. This type of training is an AAFE exclusive and is demonstrated in this journal.
Circle of Treatment
The AAFE Circle of Treatment is made up of the areas of facial pain, facial esthetics, and bruxism/dental sleep medicine (Figure 1). If you think about this circle, every single patient that comes into your practice is really coming for treatment in one of these areas, whether it is for esthetics, pain, bruxism or sleep related issues in the oral and maxillofacial areas. Once a patient enters into this treatment circle, they should be evaluated for all of these areas as part of their initial examination and evaluation as most of the time, all of these areas are completely inter-related. It is for this reason that the AAFE frequently uses the adage that we make patients “look great, feel great, and sleep great!” It is often not necessarily in that order but once a patient has been evaluated properly, they will get improvement in all three areas.
We Are Not Teeth Mechanics
It is high time for dentists to stop being “teeth mechanics” and start being the oral physicians that we truly are. Stop being afraid of bruxism and TMJ patients. The AAFE has trained more than 10,000 dental professionals to treat these areas of facial esthetics and facial pain with botulinum toxin, dermal fillers trigger point therapy, bruxism monitoring, and oral sleep appliances. These are all minimally invasive, non-surgical, and highly productive techniques that every dentist has the skill set to learn.
Today, with more control and better results, every dentist has the capacity to deliver much better care for their patients than ever before with procedures that are much more cost effective for patients. Start practicing total dental and facial esthetics and give your patients the best possible esthetic and therapeutic treatment outcomes. Skill based, live patient training is the best investment you can make with the highest possible ROI as you then have these skills for the rest of your career.
It is my hope that this outstanding journal will motivate you to make the best investment a dental professional can make – invest in yourself and your dental practice. Get trained today!