Online clinical course for clinicians
Gum Filler for Black Triangles
Learn to close black triangles with hyaluronic acid filler, and to know when not to.
The only UK course on it, taught by the dentist who has done it since 2017.
Online, at your own pace. One hour of verifiable CPD. The opening price is £500 for the first week, Monday 9 to Sunday 15 November, or two monthly payments of £250. From Monday 16 November the course is £750.
You already have this patient
Beautiful smile, straight white teeth, and one small dark gap between two front teeth that they see every time they look in the mirror. Bonding could make the teeth look chubby. Orthodontics could be a year. Surgery to rebuild a papilla is rarely on offer. So they live with it, or they ask you and you have nothing to offer.
Hyaluronic acid gum filler gives you an answer that takes minutes in the chair. I trained in it in the States in 2017 and it has been part of my cosmetic practice ever since. This course is everything I know about it, including the cases I turn away.
What gum filler does
Three of my own patients, before and after hyaluronic acid filler in the papilla. Nothing else was done to the teeth.
Patients of Dr Manrina Rhode at DRMR London, shown with their consent. Results vary with the papilla, and the course teaches you which cases will take filler and which will not.
What is inside
Short video lessons, watched whenever suits you.
Before you start
- Welcome, the aims and what you will be able to do by the end
- Where gum filler sits legally in the UK as at launch, researched and sourced, and the one phone call to make before you treat anyone
Section 1: Assessment and case selection
- Patient mindset and setting expectations
- Assessing tight papillae: the fingertip test that tells you in seconds
- When gum filler works and when it doesn't
- Gum filler and bridges: the limitations
- Choosing the right cases, with the classification periodontists use
- Cases gum filler can't fix
- Why patients want black triangles treated
- The psychology behind the request, and the red flags
- What causes black triangles, including the 5 mm rule
- Managing expectations with visuals
- Alternative treatment options: composite, orthodontics, frenum, gingival dentures
- Before and after: reading your results honestly
- Choosing the right filler, and why temporary hyaluronic acid
Section 2: The procedure
- Preparation and consent
- The application protocol: a full case filmed in my surgery, syringe to needle to the last cotton bud
- A second case, start to finish, at double speed
- Aftercare, complications and maintenance
- What to charge: my clinic's current fee list and how to set your own
Your first-case pack, ready to print
- Consent form, with the off-label wording already in it
- Patient aftercare sheet
- Protocol card for the surgery wall: every step, the numbers and the stop signs on one page
- Pricing guide, with a worksheet to set your own fee
Section 3: Assessment and certificate
- A ten-question end of course assessment
- Your certificate of verifiable CPD, issued in your name with the hours and the GDC outcomes on it
A real case, start to finish
Not slides. A patient in my chair, retractor in, and me talking you through it. Then the aftercare I give the patient.
Who it is for
Registered clinicians: dentists, therapists, hygienists, doctors and nurses. You will be asked for your professional registration number at enrolment and it is held on our course register.
You do not need to have used filler before. Whatever your experience, we suggest you check with your indemnity provider before you start.
Outside the UK? Please check the rules on injecting filler where you practise.
One hour of verifiable CPD
Aims, objectives and learning outcomes are published before you start, mapped to GDC development outcomes A, C and D. Complete the lessons and pass a short assessment and your completion certificate is issued straight away. Within a few working days the Academy team emails your certificate of verifiable CPD, with your professional registration number, the hour and the outcomes covered on it, so it can be verified if you are ever audited.
Taught by Dr Manrina Rhode
Cosmetic dentist, founder of DRMR Clinic and Academy in Knightsbridge, London. Over 15,000 veneers placed. Dentist of the Year 2022 and in Dentistry's Top 50 every year since 2019. Manrina has used gum filler in her own practice since 2017 and teaches dentists through her mentorship programme, the Designing Smiles veneer course and AI for Dentists.
Join the course
The opening price is £500 for the first week, or two monthly payments of £250. On Monday 16 November the opening price ends and the course is £750. Immediate access to every lesson, the filmed case, and the first-case pack: consent form, aftercare sheet, protocol card and pricing guide. Online and self-paced, so you can watch it before your next black triangle patient walks in.
Questions dentists ask
Is gum filler regulated in the UK?
Hyaluronic acid fillers are regulated as medical devices. No filler carries an indication for the gum, so this is off-label use, which is lawful but your responsibility. The course gives you the position as at launch, with sources, and tells you exactly what to document.
Do I need a prescriber?
Not for the filler itself. The course covers what does need a prescriber and what to have in the surgery before you treat.
Will my indemnity cover it?
We can't speak for indemnity providers, so we suggest everyone checks with theirs, in writing, before starting. The course tells you what to ask.
I've never used filler. Can I join?
Yes. We would assume you can learn it without having used filler before. As with everyone, check with your indemnity provider before you start.
I'm a therapist or hygienist. Can I join?
Yes. The course is open to dentists, therapists, hygienists, doctors and nurses who are registered with the GDC, GMC or NMC. As with everyone, check with your indemnity provider before you start.
I'm not UK registered. Can I join?
Yes. The course is open to clinicians outside the UK, and you get the same certificate as UK delegates: one hour of verifiable CPD, with the aims, learning outcomes and quality assurance on it. Whether it counts towards your own CPD or CE is up to your regulator, so please check with them first. The certificate is not ADA CERP or AGD PACE approved. The lesson on the legal position covers the UK, so please also check the rules on injecting filler where you practise.
Will I be able to do this on Monday?
That is the point of the course. You watch a full case from syringe to cotton bud, and you leave with the consent form, the aftercare sheet, a one-page protocol card for the surgery and a pricing guide. Everything for your first case is in the pack.
What about vascular occlusion? The mouth is so vascular.
Lesson 16 deals with it straight: what the published studies report, where the risk sits in the anatomy, where to inject and where not to, and what to have in the surgery.
Does it work on every gum type?
No. A thin phenotype or a papilla that is flat and tight will not take filler. Lesson 2 teaches the fingertip test and lesson 5 the classification, so you pick the cases that work and send the rest elsewhere.
How long does the result last, and what happens when it wears off?
Tell patients six months. In practice it often lasts much longer because the gum does not move. When it does wear off the gum goes back to how it was, and the treatment is repeated to maintain the result. The course covers review timing and maintenance.
How much should I charge?
The course gives you my clinic's current fee list and a worksheet to set a fee for your own practice.
Does the price go up?
Yes. £500 is the opening price, for the first week only: Monday 9 to Sunday 15 November, or two monthly payments of £250. From Monday 16 November it is £750. The course is the same either side of that date. Only the price changes.
Which filler do you use?
A temporary cross-linked hyaluronic acid with lidocaine in it. Lesson 13 explains why, and why not a permanent filler.
Can I watch it on my phone?
Yes. Everything is in the DRMR Academy member area and works on any device.