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Irish Examiner
2 days ago
- Health
- Irish Examiner
The wild west of beauty: why Ireland's cosmetic treatment craze needs taming
Type 'botox party' into your search engine and watch as almost two million results pop up. Among the items there to grab your attention are card designs for invites to such a party, videos on how to 'experience the excitement of botox parties', tips on how to run such an event, and a 'what you need to know' guide for those just starting out on such an adventure. Botox, fillers, and other cosmetic procedures are now as normal as booking in for a hair appointment, a chin wax, or a dental scale and polish. More traditionally associated with a select number of providers, the offering open to people now who are looking for cosmetic improvements is wide, with people also considering travelling abroad for procedures, or simply getting together with 'the girls' for a laugh, a drink, and a shot of botulinum toxin (botox) in the comfort of their own home. This week's Irish Examiner Women's Health Report shows that a growing number of women, particularly in the under 34 age profile, feel positive towards cosmetic treatments and plastic surgery procedures including brow lifts, 'nose jobs', and breast augmentation. For example, 44% of those in the 25 to 34 age bracket felt positively about cosmetic treatments compared with just 17% of the over 65 category. While there is slightly more reticence about plastic surgery procedures among all age cohorts, the age differential remains. Over a third, 35%, of those in the 25-34 age category felt positively about plastic surgery compared with just 10% in the over 65 category. Overall, 12% of the 1,078 women interviewed for the Ipsos B&A survey conducted over a two-week period had undergone a procedure involving botox or fillers. For the vast majority of respondents, the experience was positive. Of those who had undergone botox or anti-wrinkle injections, 82% would consider doing it again. Why do people do it? So why do people do it? Almost half of women who opted for cosmetic treatments such as botox or anti-wrinkle injections did it to boost their confidence. The desire to roll back the years was also evident in the responses with 50% saying they had undergone lip fillers/injections for anti-ageing purposes, compared with 66% who said they had done botox or anti-wrinkle injections for anti-ageing reasons. In recent years, dental practices across the country began offering cosmetic procedures including botox and dermal fillers, with the Dental Council having its own code of conduct for the area, which was updated in 2023. The Irish Examiner survey shows that while one in seven of the surveyed women were aware of dentists offering cosmetic procedures, just one in 10 knew GPs also offered such services. Dublin-based aesthetic medicine practitioner Eithne Brenner has been a doctor for 36 years, including 25 years as a GP. She diverted her focus to aesthetic medicine in 2007 and says that her clients are mainly women in the over 45 category, who are looking for cosmetic work to tackle signs of ageing. 'I do work with lasers improving people's ruddy complexions, doing work that can be very subtle and very effective,' said Dr Brenner. 'The filler side of it is one of the areas where there is still a lot of bad work out there. I don't see the younger girls at all because they are looking for a bargain in somebody's kitchen. "I tend to see people 45 or 50 plus who want subtle changes and they are terrified of looking different but they want something. My work is more restorative. The younger girls are going to beauticians and people who are cheaper. They take more risks. 'I have colleagues who do amazing breast reconstruction for somebody who has very heavy, very droopy boobs and pain. In the right hands, surgery can be transformative. But it is about doing research. These are very serious medical procedures.' Dr Brenner accepts that there is more awareness now of the dangers of unscrupulous people carrying out cosmetic procedures but said: 'There is still a drive for plastic surgery and there is an issue of how do we raise our younger generation to be really careful and know they don't need these things.' Currently, botox is supposed to be only available through prescription, under the administration of qualified doctors and dentists. However, as seizures conducted by the Health Products Regulatory Authority show, there is a thriving market for counterfeit and illegal versions in Ireland. Last year, 1,709 units of fake or illegal products claiming to contain botulinum toxin were seized, compared with just 26 in 2020. Unlike botox, dermal filler is not yet subjected to stringent regulations, meaning that it can be administered in unsafe settings and environments. Legislation delayed Legislation mooted in 2016 still has not been enacted for governing the area of cosmetic procedures. The Patient Safety (Licensing) Bill was approved by the then government in 2017 and subsequently underwent pre-legislative scrutiny. It was then referred to the Office of the Attorney General for drafting. In March, in answer to a parliamentary question, health minister Jennifer Carroll MacNeill said the legislation remained with the AG's office and that her department continues to work on it. She said it will, for the first time, 'introduce a licensing requirement for all hospitals, public and private, and certain designated high-risk activities in the community'. The general scheme of the bill outlines that 'designated activities are likely to initially relate to cosmetic surgery services but other services may be added over time as the licensing system becomes embedded in the health system'. Social Democrats health spokesman Pádraig Rice called the delay in progressing the bill unacceptable. 'It's almost eight years since the draft legislation received government approval, and yet there is no sign of the final bill,' said Mr Rice. 'In that time, there has been an exponential increase in demand for unregulated cosmetic procedures. Until Hiqa has the necessary accreditation, inspection, and enforcement powers, patients will continue to fall into the hands of unqualified practitioners.' Almost half of women who opted for cosmetic treatments such as botox or anti-wrinkle injections did it to boost their confidence, and the desire to roll back the years was also evident in the responses, the IPsos B&A survey found. Last week in the UK, the Health Security Agency (UKHSA) revealed that 14 people from Co Durham and Darlington had experienced 'adverse reactions' including eye drooping and double vision following a procedure involving 'botulinum toxin' injections. Of those, 10 people required treatment as a result. The County Durham and Darlington NHS Foundation Trust said that investigations were ongoing 'but evidence so far does not suggest that the product used has been contaminated' and that 'symptoms are being reported a few weeks after injection'. It added: 'UKHSA has issued advice to clinicians to ensure that they look out for botulism in people who may have had a recent aesthetic procedure in order to provide them appropriate treatment which includes giving anti-toxin.' Meanwhile, a public health notice was issued in the past 10 days by the UKHSA asking clients of an aesthetics company in Wolverhampton who received 'vampire facials' to contact it to arrange free blood tests, due to concerns about the risk of bloodborne viruses including hepatitis. The notice said that 'inadequate cleaning of equipment used for this treatment at the clinic' had been identified as 'a risk to health'. Dr Brenner is adamant that progress needs to be made on the planned Irish legislation and cites the recent UK cases as examples of why there needs to be regulation of the sector. 'Botox is a prescription-only medicine so you have to see a doctor or dentist for a consultation to make sure you are suitable,' she said. 'But there is absolute widespread fraud and illegal use among non-medical staff and we do know there is illegal product coming into the country. When we get into fillers, it is even more Wild West. They are not counted as a medicine at all, they are counted as a medical device, a bit like a bandage. "So you could legally go onto any website, buy filler, and inject one of your friends and you are technically not breaking the law. There are good quality products but there is also a tonne of cheap stuff.' She said that people opting to buy bargain filler products online have no concept of 'cleanliness, hygiene, safety, anatomy'. Unscrupulous use of filler products can lead to strokes or other health implications such as scarring and loss of tissue, she added. 'It has been really trivialised. It has become like a commodity like getting your hair done. I do think in the 40 plus age group, they are more cautious and more nervous of looking overdone and they are the people who come to a medical person. "But the younger ones are very bargain-led, which you can understand, but that is where there is a safety issue. And you have people doing what are major surgical procedures and all that kinds of crazy things in filthy conditions. 'There was a death last year of a mum of five in the UK who died from having a litre of filler injected into each buttock.' Dr Brenner said that botox parties are not the right location for such a procedure. People could be on medications that they might not disclose in a public setting at a party. It is not conducive to cleanliness or confidentiality.' A spokesperson for the Department of Health told the Irish Examiner: 'The general scheme of the Patient Safety (Licensing) Bill was approved by government on December 12, 2017. It underwent pre-legislative scrutiny at the Oireachtas joint committee of health on June 13, 2018, was subsequently referred to the Attorney General's Office for drafting. 'Legislative priority was given to the Patient Safety (Notifiable Incidents and Open Disclosure) Act 2023 which was commenced in September 2024. 'A decision is now being sought from the Government to recommence drafting of the Patient Safety (Licensing) Bill. A memo for Government will be considered at Cabinet shortly.'
Irish Daily Mirror
31-05-2025
- Health
- Irish Daily Mirror
Banned UK dentist now practicing in Ireland using different name
A man branded 'Britain's rudest dentist' and struck off in the UK due to the risk he posed to patient safety is continuing to practice in Ireland using a different name, the Irish Mirror can exclusively reveal. Dr Rajesh Narendranath was barred from practice in the UK in 2013 after a patient who had cancer and multiple sclerosis claimed that he had deliberately damaged her mouth during a procedure. The patient accused him of making rude comments and being unprofessional, but it was his repeated refusal to apologise or comply with the recommendations of professional bodies that resulted in him being struck off. In June 2011, the Parliamentary and Health Services Ombudsman (PHSO) took the highly unusual step of laying her report on the complaint against Dr Narendranath before the UK Parliament. However, the Irish Mirror can reveal that the 50-year-old dentist is now operating his own practice in Loughrea, Co Galway, and has been working at a dental surgery in Cork, where he featured on its website under the name 'Dr Raj Nair'. He registered the business name of his practice, Lakeshore Dental, in 2013 – the same year that he was struck off the dental register in the UK. Dr Narendranath has also given talks at conferences and featured in the Irish Dental Association's official journal as Dr Raj Nair. Dentists are legally required to practice under the name stated on the Dental Council's Register of Dentists, which lists him as 'Rajesh Narendranath'. After the Dental Council was alerted to Dr Narendranath's use of an alternative name by the Irish Mirror, the regulatory body launched an investigation into the matter, which is currently underway. As part of its inquiries, the Council contacted the dental practice in Cork where Dr Narendranath was working under the name Raj Nair. His photograph and name were removed from the practice's website the following day. The Cork practice did not respond to queries from the Irish Mirror. The Dental Council was previously made aware of the proceedings against Dr Narendranath and his subsequent removal from the register of dentists in Britain. It considered the matter and decided that he was fit to practice dentistry in Ireland. 'I was already practising in Ireland before I was struck off back in 2013 and it was disclosed to the Dental Council in Ireland, as per the requirements,' confirmed Dr Narendranath. 'After investigation, there was no action by the Irish Dental Council, there is [a] long documentary trail for that. I bet you won't print that,' he added. Referring to his use of the name 'Raj Nair', he said 'thousands of patients' that he treats in Ireland 'could barely pronounce my full name', so he decided to shorten it. 'Nair is my clan name and religious patronymic, which I am entitled to use,' he claimed. However, the Dental Council explained that practitioners are obliged to practice under their registered name, although some may shorten their names – but the body's 'main concern' is that they are clearly identifiable. 'I want to confirm that the Dental Council are now investigating this matter with a view to ensuring that relevant provisions of the Dentists Act 1985 are being complied with,' said its registrar, David O'Flynn. Dr Narendranath qualified from the University of Kerala in India in 1997 and moved to the UK in 1999. He subsequently obtained a masters degree in restorative dentistry from Leeds Dental Institute. He worked in a number of locations including Belfast before acquiring a dental practice in Staffordshire in January 2006. The incident that led to a protracted disciplinary process and his ultimate removal from the UK dental register occurred the following year, when he refused to treat a patient with cancer and MS, and told her to leave the premises. When the local Primary Care Trust (PCT) investigated her complaint the following month, Dr Narendranath replied: 'She has complained about me to the PCT!! Who shall I complain to against this patient?' An independent review of the complaint was conducted by a healthcare commission, which recommended that the dentist write to the patient and apologise in relation to five specific issues, as well as providing reassurances on future care. He wrote to the patient, but did not say sorry, and told her that he was still waiting for an apology for her rude and insulting behaviour. He also told the healthcare commission that no apology was due, except to himself. The matter was referred to the General Dental Council, which was 'very concerned' that the patient was yet to receive a letter of apology. In July 2010, she complained to the PHSO, which conducted an investigation. Dr Narendranath maintained in the course of this inquiry that a letter sent by his advisers had constituted an apology, and he stated that he would not pay the woman any compensation. The PHSO upheld the complaint of maladministration and recommended that he should provide the patient with a full acknowledgement and apology, as well as paying her £500 for the 'shock and offence' suffered. The ombudsman said Dr Narendranath's unwillingness to comply with the recommendations of professional bodies raised concerns about his fitness to practice to the extent that it constituted a risk to the health and safety of patients. In June 2011, the ombudsman took the unprecedented step of laying the report before the UK Parliament, allowing Dr Narendranath to be named, noting that it was very unusual for someone providing a health service to ignore her recommendations. This led to widespread coverage of the case in the UK media, which branded Dr Narendranath 'Britain's rudest dentist'. He appealed the decision to remove him from the register to a first-tier tribunal, and said the report being laid before parliament and the attendant publicity had been the 'turning point' at which he realised that he had been at fault. The tribunal endorsed a behavioural assessment of the dentist, which found there were indications that he sometimes made statements that were 'not substantiated by evidence'. It also said he was 'not a reliable historian and witness', and the tribunal was 'unable' to accept that he had fundamentally changed or was 'currently able to change'. It came to the 'clear conclusion' that he was unsuitable to be included on the register of dentists in the UK, and that his attitude posed 'a clear risk to the public interest… [particularly] patient safety and well being'. 'It is necessary to protect patients from exposure to a practitioner who even now lacks true insight into the impact of his behaviour and his failure to take responsibility,' the tribunal said, dismissing his appeal.
RNZ News
12-05-2025
- Health
- RNZ News
Dentist ignored woman's 'thrashing about' in pain during wisdom tooth extraction
By Tracy Neal, Open Justice reporter of Photo: 123rf A woman in agony during the extraction of a wisdom tooth was ignored by the dentist as she "thrashed about" in pain. The procedure left her with nerve damage that took months to heal, with the dentist agreeing she had had "a terrible experience". The dentist also described the procedure as a "highly difficult extraction on a nervous patient", which was a struggle for both him and her. Now, the Health and Disability Commissioner has found the dentist breached the woman's health consumer rights because he did not discuss the force required in the procedure or explain the potential risks, including nerve damage. The dentist believed he had explained the procedure, but did not record this in his notes. Deputy Health and Disability Commissioner Vanessa Caldwell said in her decision released today that a further breach had occurred in that the dental surgeon's skill was below the standard expected. The dentist was a subcontractor at the dental practice, but has since retired and asked to be removed from the Dental Council register. In her complaint to the HDC, the patient said she usually had treatment at a university dental practice, where she had been seen earlier about an infected impacted wisdom tooth. She was prescribed antibiotics and told that the tooth needed to come out. She then sought an emergency appointment at a different practice to have her lower right wisdom tooth removed because of the pain and distress she was in. The woman said she emailed her dental X-rays from the university dental practice, but before the extraction, she was not provided with any information on the procedure and was not asked to sign any consent forms. There was no discussion about side effects or potential risks, Caldwell said. The dental surgeon said he would normally assess a patient for extraction, but he felt under pressure to relieve the woman's pain and distress. In her complaint, the woman described the procedure as very painful despite receiving three numbing injections. She stated that she "thrashed out in pain many times", but the dentist ignored her and continued with the procedure. He later said he needed to remove more bone than expected and that removal of the tooth required a "greater level of force on the tooth and the jaw than he had expected". Afterwards, she was given no aftercare or safety-netting advice, but soon experienced ongoing pain, numbness of her tongue, and inflammation of the extraction site. When she first raised her concerns with the practice, she was given pain medication, and then antibiotics when the pain continued, but was not told what they were for. She was also provided with "dry socket" treatment, but was not told how to use it and what to expect. Dry socket was described by the HDC as a painful condition that could occur after tooth extraction, when the blood clot that covered the wound became dislodged or did not form fully. She then asked for a copy of her dental records, and was told by the practice owner that she had suffered nerve damage and that it would take months to heal. After further investigation by her usual dental practice, she was diagnosed with possible lingual nerve damage, and the dental wound was "debrided" (removal of bone debris). The woman was then referred to an oral and maxillofacial surgeon for further analysis and treatment. The dentist who extracted the tooth completed an ACC claim for nerve injury, refunded the woman's fees and sent her a written apology. Caldwell was pleased to note that the dental practice accepted the findings of an independent adviser's report and acknowledged the recommendations made, which included continued education for all staff at the dental practice about the importance of full consultation, informed consent, and thorough note-taking. Caldwell also recommended that if the dentist returned to practice, he was to familiarise himself with the clinical technique for wisdom teeth removal, the complications of altered nerve sensation following removal, and the appropriate postoperative care. *This story originally appeared in the New Zealand Herald. Photo: Open Justice
South China Morning Post
15-04-2025
- Health
- South China Morning Post
Overseas dentists can help bridge shortage in Hong Kong
The northbound quest for medical treatment among Hongkongers in recent years has not just been driven by comparable and cheaper services on the other side of the border. It is also a symptom of the city's worsening shortages of medical professionals. Advertisement Thankfully, the authorities have gradually come to realise that they must open the door wider for overseas practitioners to fill the gaps. In another timely reinforcement, the health authorities have issued job offers to 12 non-locally trained dentists, including three who started working last month. The rest are expected to have their limited registration approved by the Dental Council in the coming two months. The recruitment followed the Legislative Council's approval of amendments to the Dentist Registration Ordinance, allowing non-locally trained dentists to work in Hong Kong without having to pass the city's licensing exams. Advertisement A two-month global recruitment push last July received 90 applications, a response authorities described as enthusiastic.
