News & Media

Beyond the mouth – a duty of care

AADFA_ADMIN - Dec,18 ago
Skin , SPF


By Dr Myles Holt


With a heat-wave gripping parts of Australia this summer, never has it been more important for all dental practitioners to be asking every single patient that sits in their chair, one very important question that has nothing to do with teeth: “Do you wear sunscreen on your face every day?”

Many years ago, when AADFA opened the door for dental practitioners to be able to train in and offer skin rejuvenation services in their practices, treatments like Botox and Dermal Fillers were only ever one small aspect of the overall concept. The broader notion was to develop a training pathway through which dental practices could fill the current void for patients in relation to caring for the health of their largest organ – the skin. Never has that goal and the AADFA training pathway been more important than it is right now!

Australia has the world’s highest incidence of skin cancer (3-4 times the rates in Canada, the US and the UK). With more than 2,500 people dying from skin cancer each year, it is the most common form of cancer in Australia, accounting for around 80% of all newly diagnosed cancers each year, with 95 – 99% of these skin cancers being caused by exposure to the sun, the majority of which are found on the head and neck.

Fortunately skin cancer is largely preventable, meaning regular, recurring, concise and correct patient education, similar to oral hygiene instruction, is an effective tool in combating these statistics. Furthermore, 99% of skin cancer patients survive; with metastasis and mortality, as well as surgical scarring and morbidity, being drastically reduced; thanks to early detection.

This scenario parallels very closely with dental pathology and when compared to what dental practitioners routinely screen for in regular examinations, questions are now being asked as to whether our profession is failing to see the bigger picture and utilize our position to the best of our ability.

Oral cancer examinations have been the standard of regular care in dentistry for many decades and yet only 1 in every 325 Australians will develop oral cancer – about 74,000 people based on current population figures. More and more dentists are now focusing on sleep disorders and airway issues at each recall appointment, thereby addressing an issue for about 1 in every 4 Australians (about 6 million people). Compared to skin cancer, these problems pale in comparison, with every 2 in 3 Australians being diagnosed with some form of skin cancer by the age of 70–a whopping 16 million people! Quite simply, our profession is missing something that is literally staring us in the face and for which we have a duty to play a major role.










But it’s not my job and they’ve heard it all before ...

It’s a sad state of affairs that many dental practitioners still believe their role ends with teeth and gums and that other health practitioners are better trained or better suited to be addressing issues such as skin cancer. Nothing could be further from the truth and this approach does a dis- service not only to our patients but to our profession.

Dental practitioners are perfectly poised to take a primary preventative screening and patient education role when it comes to many general health concerns, including skin health. Dental practitioners see more patients, more regularly than any other health practitioner, when the patient generally thinks they are fit and healthy. This affords us the unique opportunity to offer our patients a better general health screening service and focused health education, all while diversifying and strengthening our own businesses.

The fact is that patients do not see medical doctors or dermatologists routinely and early signs of skin cancer will largely go unnoticed or unchecked for prolonged periods. While skin cancer awareness campaigns have been prolific, skin cancer rates have not been decreasing. This is in large part due to a failure of people to be properly educated and to fully understand the intricacies of sunscreen use and general sun care (see the box: “Sun care myths exposed”).

More than any other health service, dental practices are geared towards prevention of such conditions and are already well-versed in efficiently and effectively delivering high levels of patient education, as well as being very familiar with providing regular screening services. Dental practices are also able to utilise highly trained auxiliary team members well for such purposes, making the process more cost effective.

What can we do?

As mentioned, dental practitioners can have a massive impact in the lives of their patients by training to provide focused, quality, practical information on the specifics of skin care and by also including a skin screening of the head and neck with every examination, for every patient, every time, allowing for changes to be tracked routinely and caught early.

At no stage do dental practices need or want to become specialists in skin, but we can provide a vital missing link by simply expanding our extra-oral examinations and health education, utilising our support staff well.

The Australian Cancer Council has some excellent resources for use in dental practice education and they actively encourage our profession to step into this screening role. Patients should be counselled to avoid excessive sun exposure, corrected on the intricacies of sun care and develop a routine when in the sun that follows the principles of:

  • Slip on some sun-protective clothing
  • Slop on broad spectrum (UVA & UVB)
  • SPF 30 sunscreen & lip balm – reapply every 2 hours
  • Slap on a hat
  • Seek shade
  • Slide on some sunglasses

Dental practitioners should pay close attention to the patients’ skin condition as a part of their routine extra-oral examination, looking for any suspicious lesions, such as atypical moles, scaly red patches, open sores or growths that appear or change over time. Photographs can be used to track these areas over time and referrals given to a qualified dermatologist should concerns arise.

A small change to our routine extra- oral examinations could have a major impact in the lives of our patients!


Beyond the aesthetic

As many of you know, my clinical practice as a dentist consists almost entirely of dento-facial aesthetic procedures, from teeth whitening and Botox, to facial thread lifting, dermal fillers and everything in between. The one question I get asked more than any is: “What’s the one product I should be using on my face to maintain the appearance of my skin?” The answer is always the same: SUNSCREEN!

Solar damage can be as simple as fine lines associated with a deterioration of collagen, or it can be more severe, resulting in hyperpigmentation, actinic keratosis and superficial or invasive skin cancers. One thing is for sure, I can’t begin to help patients with their aesthetic concerns, through treatments like Botox and Dermal Fillers, unless they are first protecting the health of their skin. It does not matter what treatments a patient receives, or how much they spend, if they are still being exposed to excessive UV radiation, they will never achieve the aesthetic results they are looking for or expect and they run the real risk of more serious issues arising.

It is for this reason that AADFA’s facial aesthetic training pathway has a strong focus on health first and has been developed to teach dental practitioners more than just how to deliver simple Botox injections, but rather to have a complete understanding of how to address the facial needs of patients in their entirety.

The interesting thing is, incorporating skin care education and skin health screening into your practice is also a positive business growth strategy. Patients really appreciate the extra level of care and service, driving word of mouth buzz and an approach to skin allows us to diversify and differentiate our business – all while helping patients in a more thorough and meaningful way.

It’s time we all started to see what is staring us in the face!

Incorporate skin care education and skin health screening into your practice...

AADFA’s philosophy and training pathway has a strong focus on health first and the approaches taught during the FACE program are designed to improve the health and quality of the skin and get it healing itself, thereby reducing the need for artificial therapies like Botox and Dermal Fillers.

Just like maintaining the health of the teeth and gums, what the patient does at home is more than half the battle – you can use all the fancy treatments and technologies you like, but none of it will last or look as good as it could if the patient isn’t doing their part at home each day. FACE helps dental practitioners to cut through the marketing hype behind much of today’s skincare industry and counsel patients on the best, scientifically proven products and methods to maintain healthy, vibrant and attractive skin. Just like teeth and gums, if we get the skin functioning optimally, healthy and well-maintained, then improved aesthetics will naturally follow.

Join us at The AADFA "FACE" Module re-launch to learn all things SKIN!

In 2020 AADFA will be re-launching our NEW and IMPROVED, updated "FACE" module! Which will include even more practical training from Australia's leading Dermal Therapists based on solid science research and proven BEST practice! Open to the entire Dental Team. Learn from the LEADERS AND INNOVATORS in Aesthetic & Facial Rejuvenation Dentistry!