Cosmetic surgeons bare teeth

Dr Myles Holt
Dr Myles Holt says some doctors are illegally offering tooth whitening services.

The latest step in what appears to be an escalating war between Cosmetic Physicians Society of Australasia (CPSA) and Dr Myles Holt took place last week, with Dr Holt naming a number of non-dentist CPSA members offering tooth-whitening services in contravention of Dental Board guidelines.

Following a press release last Friday, all references to the services offered by the named GPs were removed from the CPSA website. Dr Holt’s complaint follows the dismissal of a complaint Dr Holt made to the Medical Board in February. In that complaint he alleged that CPSA members had engaged in “a smear campaign of lies, intimidation and scare mongering” and also claimed that members had colluded with pharmaceutical companies to restrict supplies of Schedule 4 drugs. The Medical Board dismissed the complaint.

The complaint was made after the CPSA notified health authorities that Dr Holt was delivering courses on cosmetic injections outside his field of practice as a dentist, in conflict with the Dental Board of Australia’s interim policy.

Now Dr Holt has claimed “Many GP doctors, with often only a basic medical degree, which does not afford the appropriate levels of training in procedures around the mouth, are flaunting regulations and offering everything from tooth whitening to lip enhancements, shunning the coughs and colds of Medicare in an attempt to capture a slice of the lucrative private cosmetic dental market.”

The core of Dr Holt’s complaint against the CPSA is that its members are offering services they are not trained for—the same accusation the CPSA leveled against Dr Holt back in February. Back then, the President of the CPSA, Dr Gabrielle Caswell, said, “Our objection to Dr Holt’s behaviour is that he is intending to run training modules based on the use of Schedule 4 cosmetic injectables for non‐dental purposes, which dentists are not legally able to administer in Australia. The law is quite clear on this issue.

“We believe his training modules, as proposed, present a potential threat to patient safety and breach existing state and commonwealth regulations, showing continue disrespect for the current Australian legislative framework.”

At the time, Dr Caswell rejected the accusation that doctors were fighting a “turf war” with dentists on the issue.

“This is about patient safety and legal responsibility. Most dentists recognise that they do not have the training or expertise to safely administer cosmetic procedures and handle adverse reactions if they occur.”


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  1. There we have it-“This is about patient safety and legal responsibility. Most dentists recognize that they do not have the training or expertise to safely administer cosmetic procedures and handle adverse reactions if they occur.”-get real- many of these injectable procedures are done by ‘cosmetic nurses’ in such reputable establishments as hairdressing salons and beautician shops.
    Usually, the nurse has undertaken a 2 day course run by ‘Allergen’, the ‘Botox’ manufacturer.
    It is an insult to ALL dentists to fall into the pecking order below these ‘experts’. That’s right- 2 days of training outscores the average dentist’s knowledge on injection technique, facial anatomy and patient management and care. Not only are dentists expertly trained in injection delivery and correctly dealing with any adverse drug reactions, but have world best practice standard sterilization protocols in place. Dental Authorities must stand up for and represent the people they are charged to help in running their small businesses, rather than be bullied by Medical groups. Now that tooth whitening has been railroaded by the same groups -namely, hairdressers, beauticians, pharmacists and doctors, we dentists are left languishing as the Medical authorities treat us as fools. Do I need to become a nurse to make a living- and add 2 days to make me an injectables ‘expert’? Please, Dental Board, help us.

  2. I agree Damian its B.S. I am an Oral Health Therapist who holds a Bacholar degree in Oral Health. My degree was the same as the dentist ie same exams same ciriculum with exception to pediatric and perio. Who else know the facial muscles and facial nerves better than us. It makes me laugh… I spend all day doing irreversiable proceedures on patients (especially children) and inject anesthetic into deep facial tissues. And do you know what is even funnier I can’t even be issued by the government with a provider number!!!!! lol what a joke!!!!! However the guy down the road can practice massages and be issued with a health provider number. So my profession can practice dentistry til the cows come home but I am not allowed to provide it. So whythe hell did I spend all that money going to university to become a dental practitioner who is registered as such with AHPRA and I can’t get a provider number or inject botox either. I agree with you.. I should of done a government funded nurses course plus the 2 day company course on botox. Then I might be reconnised as a worthy health professional. The Dental professional bodies that we finance really need to start fighting for our rights. As a dental professional it is frustrating to realize that we are still really in the dark ages and as a profession we still go unsupported.

  3. Dentistry in Australia is disgusting, no wonder so many Australian Dentists now choose to work overseas! Why exactly do all Dentists choose to freely hand over $$ every year for the ADA to ride our ars#s and in turn never support us?! They are a disgusting organization and it is about time all of the Dentists in Australia stand up for their rights and not let the ADA belittle our profession!! What are we puppy dogs!!??
    Dr Holt seems to be the only Dentist in Australia helping our profession, he has my full support..

    Cheryll you could not have put it better , we finance those professional Dental bodies and all they do is take our money and give us grief!! I am disgusted!

  4. And to further look at the other issue, HOW CAN GP’S DO TEETH WHITENING? Does the CPSA think it is ok for its members perform procedures well outside their field? I have trained alongside medical practitioners and they would not have a clue if the patient has caries or how to use gingival barrier systems or what a curing light is? is that not just abusing the patients trust in their GPs to make a bit of cash on the side? …..what a joke especially when the CPSA condemns dentists doing what they do every day, use injections within their field of expertise i.e. head and neck! and to hear a dentist who can cut gum , drill bone, stitch, use a variety of drugs and materials that can cause adverse reactions are deemed unsafe to handle these reactions by the CPSA by uneducated and pure idiotic quotes like “This is about patient safety and legal responsibility. Most dentists recognise that they do not have the training or expertise to safely administer cosmetic procedures and handle adverse reactions if they occur.” !!!!! Well next time you go to your dentist Dr Gabrielle Caswell make sure you take your back up emergency team as you don’t think that dentist can look after you if you had an adverse reaction!!! what a pathetic joke of a President!!

  5. The thing we should be asking is where is our “ELECTED” professional body in all of this? Why does the ADA not defend the Dental profession against such outrageous comments that transcend the Botox issue and amount to direct attacks on the abilities of professionalism of Dentists in general? Why must is be left to a single strong willed Dentist to have to take on another professional association? It is about time all Dentists started showing support for our pioneering colleagues, rather than being led like sheep by ineffectual self serving has beens!

  6. Despite the whole turf-war issue. If a “laser clinic” franchise is allowing nurses with no training or understanding of the facial anatomy to perform facial injection treatments, it would seem that the regulation by AHPRA on restricting dentists ignorant and ill-informed. If CPSA is using a flawed interim policy to restrict dentists on the practice of facial enhancement, Botox and Dysport were medically developed for other medical treatments, and cosmetic enhancement was an “off-label” use. The idea behind letting nurses doing injections and not dentists who work with extreme fine medical materials concerns me greatly, both as a patient and as a health professional. The argument behind the interim policy is also poor thought through. The policy aims to regulate dentists with “appropriate” training to administer Btx-A to Masseter and Temporalis. Before AADFA came around, there was no “appropriate” training, to top that off, the dosage that is required to reduce the muscle tone in these muscles are significantly higher than those required for wrinkle reductions. Why limit a well-organised problem, and why allow dentists to use higher concentration on 2 major muscle groups and restrict the provision of Btx-A on other minor muscle groups that requires significantly lower concentration. Toxicology and patient safety were not taken into consideration and such policy is flawed in every way possible.

  7. “The lucrative private cosmetic market” seems to overide the professional ethical niceties of yesteryear ,What else must be sacrificed on the altar of the almighty dollar? Only the ability to demonstrate that best interests of our patients will over-ride the necessary business interests can maintain an honourable future for dentistry.

  8. In an ideal world Neil you may be right – I assume then from your comments that you offer treatment to patients at cost price or only charge enough so that you can sustain a modest roof over your head; basic clothing for your back; and enough bland food to ensure you sustain life for your family.

    While it might be nice to make the world a simpler and less superficial place, the fact is fashion magazines, TV, celebrity and heartless financial institutions drive todays society, their views and their interests.

    I think you’ve missed the point by trying to be too “man of the people”. The point is not whether the provision of Botox, tooth whitening or a myriad of other “lucrative” services is moral or right – they are already established and you do not have to chose to provide them – that is your personal choice.

    The point is – why should equally if not better trained health professionals be denied the right to offer these services to their patients instead of being discriminated against because other practitioners are trying to protect their bottom line? No one is forcing patients to take up these treatments either – it just makes no scientific sense to prohibit Dentists.

    People need to focus on the facts of the matter and stop mudding the waters with irrelevant commentary such as your previous statement.

    • Thankyou Kimberley , firstly for your assumptions on my gross income , my ability to provide for my family and my taste in food. Secondly for your quite extreme level of cynicism on the extent to which todays society is dominated by the media. Muddying the waters by the sexist comment of my supposed “trying to be too “man of the people” , I believe, does you no credit. Did I once infer that it does make “scientific sense to prohibit Dentists”? Your aggression is unacceptable and the relevance of my comment is obviously in the eye of the beholder.

  9. I am also a registered dental health professional and am totally frustrated with the archaic management of the profession. As a hygienist I have found support and representation with the DHAA, Dental Hygienist Association of Australia, who also realise the short comings of the scope of practice and are actively campaigning for change.


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