Cosmetic dental surgeon Dr Krystyna Wilczynski discusses the considerations that need to be made by dentists to successfully incorporate non-surgical aesthetic treatments into a dental clinic
Many patients who regularly visit their dentist to improve the appearance of their teeth consider what’s next once their teeth have reached their aesthetic ideal. Often, they start to consider the surrounding external tissues to complete the entire cosmetic picture. This involves aspects of the lips, cheeks, chin structure, jaw position and the overall appearance and quality of the skin. This is the point where many dental clinics will lose their patients to other practices who can deal with these issues if they are not offering facial aesthetic services themselves.
In my opinion, dental clinics are ideally placed to offer such treatments. It seems a natural progression for dentists to offer facial aesthetic treatments due to the increased supply and demand from the patient in conjunction with facial anatomical knowledge and injection skills in this area. However, I have noticed that while some clinics are eager to keep their patients and introduce facial non-surgical aesthetic treatments, many find it hard to delve into this new market and struggle to go about doing so successfully. In this article, I will discuss how dental clinics can successfully fit facial aesthetic treatment procedures alongside others into their treatment portfolio.
Apart from keeping their current patients who are leaving them for other practices that specialise in non-surgical aesthetic treatments, there are a lot of reasons why dental clinics should add these treatments to their portfolio. Firstly, dental clinics will already be Care Quality Commission (CQC) registered.1 This means they have a clinical environment that is suitably equipped to perform non-surgical facial aesthetic procedures such as injectables. Secondly, dental clinics also already have a database full of loyal patients who already have their trust, so they are in a good position to o er these new medical treatments to their patients, should they request it. Thirdly, dentists working within a dental clinic have a variety of skills which are useful in the non-surgical medical aesthetic sector.
Dentists undergo extensive training in the anatomy, biochemistry and physiology of the head and neck in undergraduate dental training, which is crucial knowledge for administering any botulinum toxin and dermal filler products. Dentists tend to have highly accurate manual dexterity2 and are extremely familiar and comfortable administering fine- needle injections. Additionally, dentists are familiar with administering appropriate pain relief such as topical anaesthetic on the lips and intraoral anaesthesia. They are also knowledgeable in the management of adverse events such as post-operative pain, sensitivity, swelling and infection, as well as medical emergencies.
Dentists have well-practised communication skills between patient and professional, which are taught and developed from the early stages of their career. Excellent communication skills are essential in aesthetics to ensure the patient is aware of any treatment risks, complications and that they have realistic expectations of the results.
If you are a dentist who would like to introduce facial aesthetics into your dental practice, there are several key points you need to consider. I believe the greatest challenges lie in training, insurance and marketing, so have described these in more detail below.
Before you can even think about adding facial aesthetic treatments to your dental clinic’s portfolio, you must ensure that you have adequate training and experience. You must have completed formal training in each different procedure you wish to include in your practice, and obtained high-level qualifications from a recognised course, to ensure reliable results and appropriate knowledge of complication management. I believe that dentists new to facial aesthetics should be looking to start with a foundation botulinum toxin/dermal filler course that includes simpler treatments like the forehead and lips and then build upon this training thereafter.
As a minimum, I recommend that practitioners look for a training course that is led by a practitioner who is currently registered with the GMC/NMC/GDC and research that they have extensive experience in facial aesthetics training. To find a course that is right for you, ask like-minded colleagues for recommendations and do extensive research online. Also, determine whether the course offers support and mentoring following the completion of the training; I believe this is mandatory for safe practice and alleviates fear or uncertainty.
I actually find that the main hurdle within a dental practice is to ensure the new non-surgical facial aesthetic area is understood by all members of staff. You need to effectively train your team to incorporate the newly learned information into your existing systems. Some courses and training companies allow you bring your support staff for an extra fee so it’s a good idea to ask if they provide this service. You can also do your own in-house training to make sure the correct information is being relayed to your patients on the new treatment offerings.
It is vital that all your support staff are well accustomed to how the procedures work, their costs, time of appointments, materials used in the procedure and its downtime. This is because your patient’s first line of contact is the front of house and patients often ask questions upfront before booking a consultation. Also, ensure staff know the limit to the information they should give at the desk, for example, never instruct them to estimate how many mls of dermal filler a patient might need for a lip augmentation procedure, as this should be only discussed in the consultation after a full facial analysis with a qualified medical professional.
During training, I find that one way to engage your clinic staff and get them accustomed to your new treatment offering is by encouraging them to try the treatments. Should they consent, this form of ‘training’ will provide infinite knowledge and awareness of the treatment. This will also further encourage staff to endorse procedures and provide positive experiences to your current and perspective patients. I lastly advise to hold regular staff meetings so that you can identify any gaps in your staff’s knowledge and abilities and hold updated training once a year as a refresher and to build upon their understanding.
It is illegal to work in facial aesthetics without ensuring you are fully indemnified so get an appropriate policy.3 Dental clinics would already have insurance cover for dental procedures such as general dentistry/implant surgery. However, you will need to gain additional cover for your new facial aesthetic treatments and specify these new procedures for them to be covered. Do a lot of research and choose a reputable company that covers all the treatments your practice will offer. There will be an increase in your insurance costs with the addition of new treatments.
In my experience, this cost may depend on your level of training, how many hours you work a week, and how much revenue you believe to be turning over in your clinic. It is a good idea to firstly approach your current insurer to determine whether or not you can add your new facial aesthetic treatments to your policy. This is because it may be logistically easier to deal with one insurance company and may be more cost- efficient.
There are two main insurance bodies that dental professionals usually turn to in the UK, the Dental Defence Union or Dental Plans. Both will cover facial aesthetic treatments, so long as all procedures are performed in a dental practice by a dentist. Many dentists tend to have two separate insurances so that they are permitted to practice outside the dental clinic setting too. Reputable insurance providers who will insure clinics and individual dental practitioners wishing to perform facial aesthetics include Enhance Insurance, Hamilton Fraser and Cosmetic Insure.4,5,6
Introducing facial aesthetics is not a quick process and requires dedication and investment in promotion. Your current dental patients may be interested in undertaking a facial aesthetic or skin treatment, but are unaware that their dental clinic offers this. Obviously, the way you market your dental treatments will differ immensely to how you market your facial aesthetic procedures as general dentistry is marketed as health, whereas aesthetic dentistry is cosmetic. Be aware of the marketing laws and guidance surrounding such treatments, such as those from the Committees of Advertising Practice (CAP)7 and the GDC.8,9 For example, advertising botulinum toxin and other prescription-only medications are illegal, but you can use the words ‘anti-wrinkle’ or ‘muscle relaxant’.10 Also, use of the word ‘Botox’ is trademarked so should not be used.
Ensure you update your website to include information about each practitioner and the training they have received to provide such treatment, as well as your new list of treatment options available, with pricing. Although some clinics choose not to disclose their prices until after a consultation, I am always upfront with my costs as I find it affects patient’s decisions negatively if they do not have a preconceived idea of what their treatment may cost. You may want to consider separating your dental site from your facial aesthetics site so that it avoids confusion and allows you to target your patients more precisely. Note that this may involve a live demonstralve more cost, so assess your budget before making this decision.
Look to have a presence on social media, and introduce new signage and leaflets for your clinic. Word-of-mouth is an important part of practice building, so get everyone working at the clinic to talk about the new treatments available to your current patients, as well as their friends and family. Open days and launch events are also helpful as you can provide information to a larger number of interested people. To gain attendees, you can send email invitations to your current patients, press, as well as invite family and friends of your clinic staff . You might like to entice potential attendees with a free consultation, have your practitioners in attendance to discuss possible treatment options and promote discounted special offers and rates. I also find that training courses that o er a live demonstration of the treatment is helpful.
Dental clinics and dentists are in a very unique position in that they have the facilities and much of the clinical training available to them to be successful in providing facial aesthetic procedures. They must consider how they can successfully merge these new treatments into their practice. Any dental clinic or dental practitioner wanting to embark on facial aesthetics should take the time to find a reputable course to educate and support them. They should be insured and adhere to a high level of practice standards to avoid any unwanted incidences. Lastly, make sure current patients know about your new services through effective marketing.
1. CQC, Dentists: information for providers, 2018. <http://www.cqc.org.uk/guidance-providers/dentists>
2. Robinson, E. ‘Intrinsic And Extrinsic Factors of Aging’ The How To For Keeping Your Skin Looking Young And Beautiful’ (2011) Indiana University Bloomington ‘Manual Dexterity’ <http://hpplc. indiana.edu/ohp/d-md.shtml>
3. Guidance on indemnity, General Dental Council, <https://www. gdc-uk.org/api/files/Guidance%20on%20indemnity.pdf>
4. Enhance Insurance, Medical Professionals, <http://www.enhanceinsurance.co.uk/who-we-protect/medical-professionals/>
5. Hamilton Fraser, Private Application Form <http://www.cosmetic-insurance.com/wp-content/uploads/2017/02/HF-Private-Application-Form-8.9.16.pdf>
6. Cosmetic Insure, 2018 <https://www.cosmeticinsure.com/home.html>
7. CAP, Guidance on the marketing of surgical and non-surgical cosmetic procedures, 2016, <https://www.asa.org.uk/resource/cosmetic-interventions.html>
8. GDC Guidance on advertising, <https://www.gdc-uk.org/api/files/Guidance%20on%20advertising%20(Sept%202013).pdf>
9. GDC Guidance on ethical advertising, <http://dentalwebsitedesigners.co.uk/Ethical_advertising_statement.pdf>
10. AdvertisingStandardsAgency.OurPurpose&Strategy.2015. Available from: <https://www.asa. org.uk/About-ASA/Strategy. aspx>