Rapid growth in demand for facial aesthetics treatments, such as botulinum toxin injections and dermal fillers, has led a rising number of dental practitioners to offer these services. With the UK non-surgical cosmetic industry currently worth over £3 billion, expanding into this field to complement traditional dental services can offer a commercial boost to many practices.
Dentists are well placed to provide these treatments safely and effectively, given their extensive training, technical skills and Care Quality Commission (CQC)-registered premises. However, complications leading to complaints and claims can occur, so it is essential to be aware of the dento-legal issues and to maintain appropriate indemnity cover.
Facial aesthetics is a largely unregulated field. Anyone can administer non-surgical cosmetic treatments and many untrained practitioners are marketing these at attractive prices. The ease of access raises concerns about patient safety, and dental practitioners have a role to play in helping patients to make safer choices when seeking facial aesthetic treatments.
Key regulations to be aware of are:
- Botulinum toxin is available by prescription only. It can be administered by appropriately-trained dentists, dental hygienists and dental therapists (not by dental nurses), but a dentist must always assess the patient and provide the prescription. Dermal fillers are classed as devices and do not need a prescription.
- Since 1 October 2021 it has been illegal to administer botulinum toxin or a dermal filler for cosmetic purposes to under 18s. Dental practitioners must always verify age prior to booking and performing the procedure.
Reduce the risks: be trained, competent and indemnified
To protect patients from harm and dental professionals from litigation, the General Dental Council (GDC) provides guidance:
“If you choose to offer Botox or other non-surgical cosmetic procedures the GDC expects the same high standards of you, whatever the type of treatment you are carrying out. In particular, you will need to ensure that you only work within your knowledge and professional competence, adhere to the Council’s standards at all times, and be prepared to back up the decisions you make.”
“You need to also ensure that you have appropriate indemnity cover. Careful thought also needs to be given to maintaining professional standards in relation to advertising these services.”
Dental professionals providing facial aesthetic treatments should meet the qualification requirements set by Health Education England. Accredited training providers can be found through the Joint Council for Cosmetic Practitioners (JCCP) ‘Register of Approved Education and Training Providers’.
Patients can identify suitably-qualified practitioners by searching voluntary, Professional Standards Authority (PSA)-accredited registers such as those provided by JCCP and SaveFace. Dental professionals are allowed to enter these registers with a Level 7 qualification in aesthetic medicine.
Work in the best interest of patients
The GDC expects dental professionals to communicate effectively with their patients, obtain valid consent, and work with colleagues in the best interest of patients.
The process of obtaining valid consent is especially important when patients seek non-surgical cosmetic treatment. They may have high expectations and any dissatisfaction with the outcome could trigger a complaint if the patient has not been fully informed about the range of possible outcomes and potential risks and costs.
Patient assessment is also crucial. Dentists should be vigilant for signs of psychological vulnerabilities that indicate a need for caution in providing cosmetic treatment, and decline treatment if it is not clinically appropriate and in the patient’s best interest.
Be prepared for complications
Facial aesthetic treatments can have good results when performed by a trained health professional but there is always a risk of side effects and complications. Fortunately, patients can be confident that registered dental professionals are trained to avoid, recognise and manage any adverse effects.
As always, documentation of patient assessments, treatment plans and follow-up care is crucial in case something goes wrong and the patient makes a complaint. At discharge, patients should be given details of who to contact if there is a problem.
Marketing facial aesthetic services
It is imperative that any marketing is done responsibly, to enhance patient trust and avoid falling foul of GDC rules on advertising. Since compliance with those rules is often poor, practitioners may need to enhance their knowledge in this area. All advertising and promotional material must be accurate, not misleading, and backed up with facts; promotional tactics should be avoided that could prompt patients to make an ill-considered decision. Importantly, prescription-only medicines, including botulinum toxin, cannot be advertised directly to the general public.
However, in a market where unregistered, sometimes rogue, practitioners are advertising cut-price treatments, appropriately-trained and registered dental professionals can offer patients a safer choice, with the skills to provide ethical facial aesthetic treatment in a well-equipped environment.
If you offer facial aesthetic treatments, or plan to in the future, please keep us informed at Dental Defence Society so that we can make sure you have appropriate indemnity cover.