Botox and Dermal Fillers

The next big thing in dentistry? By Dr. Shailly Luthra

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Since, being first discovered by the German physician Justinus Kerner (1786-1862), Botulinum toxin- commonly known to us as Botox has come a long way.

Most of us primarily believe that Botox is used only as a cosmetic treatment for decreasing fine lines and wrinkles on the face. However, the toxin botulinum from which Botox is derived from has a lengthy history of medically beneficial uses for treatment of cervical dystonia, hyperhidrosis, strabismus and blepharospasm.

Botox has now been increasingly used in dentistry also as it is therapeutically beneficial for treatment of  specific oral conditions.

Botulinum toxin (Botox) is a protein and neurotoxin produced by the bacterium Clostridium botulinum. Presently, seven botulinum neurotoxin serotypes (A, B, C1, D, E, F, and G) produced by Clostridium botulinum, are recognized. Although botulinum toxin is a lethal, naturally occurring substance, it can be used as a successful and potent medical remedy.

Toxin A, however, has been the most extensively studied. Three forms of botulinum toxin type A (Botox, Dysport and Xeomin) and one form of botulinum toxin type B (MyoBloc) are available commercially to be used for different medical and cosmetic practices.

The toxin’ mechanism of action is inhibition of  the release of acetylcholine (ACH), a neurotransmitter responsible for the activation of muscle contraction and glandular secretion, and its injection results in reduction of tone in the injected muscle.

Botulinum toxin type A can be used  primarily for the dental conditions namely:-

  • Dentofacial aesthetics.
  • Temporomandibular joint disorders
  • Bruxism
  • Dental implant and surgery
  • Gummy smile
  • Masseteric hypertrophy
  • Oromandibular dystonia
  • Mandibular spasm

However, other uses for it also include conditions like-

  • Sialorrhea,
  • Trigeminal neuralgia,
  • Prevention of relapse during orthodontic treatment.
  • Botox can be used while giving a new set of dentures to patients with decreased vertical dimensions, and a long history of edentulism .
  • Prior to resetting or during rehabilitation after fracture of a facial bone (fractured mandibular condyle) high dosage of botulinum toxin type A can be potentially used as a therapeutic splint, limiting muscle contraction.
  • In cases of complex tooth ache Botox can help verify the nature of the pain; as to being muscular or pulpal in origin. In certain instances muscular pain from the anterior temporalis is referred to the teeth. This should be treated first, then only any dental treatment should be performed if needed. In this situation, botulinum toxin type A is both a prophylactic as well as a diagnostic agent.

Seeing there is an upcoming role of Botox and dermal fillers in Dentofacial aesthetics; the question that arises at the end is -what is the difference between Botox and dermal fillers?

Here is the answer : Botox is the common trade name for the substance which is scientifically known as botulinum toxin.

Dermal fillers are also known as Facial fillers . Just like Botox, they also prevent or eliminate signs of aging in the face like wrinkles. The primary difference between the two being that- Botox reduces the activity of muscles in the face that cause wrinkles whereas, Facial fillers fill the trouble areas with collagen, which helps to stimulate collagen growth in the face as well as plump and lift the skin to replace collagen loss. This helps your skin achieve a youthful look, as well as eliminates the signs of aging that occur as a result of collagen depletion.

How  to choose between the two needs some consideration.

The primary point to be kept in view when choosing between Botox and facial fillers is what kind of wrinkles do you want to get rid of and how? Botox is the better choice for dynamic wrinkles as it reduces their visibility and motion. These wrinkles occur when making expressions or when there is facial movement. They are usually area of the forehead and around the eyebrows. Facial fillers are the best choice for static wrinkles, which are visible even when you are making no expression or even when your face is relaxed. The areas of the face which are depleted or sunken in benefit from the fullness given by dermal fillers.

Even though more research is needed to find further uses of Botox to aid in dental therapy, the role of Botox cosmetic is much more than what meets the eye.

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