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Dental health: how to upgrade your smile

upgrade your_smile_23_04_12Want brighter, whiter, straighter teeth? Here’s the ultimate guide to cosmetic dentistry – and the lowdown on the most popular treatments. If your oral hygiene includes a swift brush before bed, consider this an intervention. And if you lust after a straight set of gnashers, new technology can make it happen. Start your perfect pearlies pilgrimage here.

Take 10 years off your smile

When you think about the signs of ageing, your teeth are probably pretty low on the list. But having yellow or chipped teeth can actually age you just as much as wrinkles and lines. And everyone’s doing it these days – seeing a dentist for cosmetic purposes. Many people seek out the services of a cosmetic dentist to improve their teeth, jawline and smile in the hope that it will significantly enhance their appearance.

From carrying out the smallest of dental procedures like tooth whitening to more involved and complex treatments like crowns, bridges, veneers, multiple dental implants and a host of other treatments, good cosmetic dentistry can make a great difference when it comes to building up confidence and boosting lifestyle. If you have cracked or broken, stained or crooked teeth, unseemly gaps where teeth are missing, unsightly fillings, gum decay problems, an uneven bite, chipped or even rough teeth – a good cosmetic dentist can sort you out, for a fee of course.

Keep in mind that cosmetic dentistry is truly a specialised field and is practised by highly trained professionals who aren’t shy when it comes to billing you. Consequently, treatment can be quite an expensive undertaking. Ensure that you only consult a registered professional. Also, research clinics abroad, which offer treatment at affordable prices. Flights, hotels and treatment costs are sometimes cheaper than a UK option.


Braces are used to help teeth to move into a better functional or cosmetic position. They can also influence jaw growth if timed early. Malocclusion is the dental term for teeth that don’t fit together properly – and orthodontics is the branch of dentistry that corrects these malocclusions. The size of someone’s teeth and how they fit into a person’s jaw are inherited traits. Some people are lucky and naturally have straight teeth. Others unfortunately aren’t so lucky. Also, habits like thumb-sucking can put extra pressure on teeth and cause a malocclusion. Missing teeth can mean that a bad bite develops, as well; the teeth around a space will shift, throwing off the entire bite and meaning braces may have to be worn to correct the damage. Any malocclusion that isn’t corrected can affect a person’s profile and appearance. It also contributes to tooth decay, bone destruction, jaw joint issues, and headaches.

The procedure:

Correcting your bite through orthodontic braces can improve your dental health as well as your smile. The side-effects and complications of wearing braces are usually related to oral hygiene – unless you can already clean teeth well to a high standard, then most orthodontists and dentists will sometimes decide to refuse treatment with braces. This is because the braces will inevitably trap more food, plaque and debris around them, making for a dirtier mouth. This will always cause more decay and cavities so there is no point in having straight, rotten teeth that may then need extensive treatment, even extractions, after years of brace–work.

Good cleaning habits and diet are essential.

Other potential problems involved are pain initially as the teeth start to move position – but only rarely is this so severe that it causes treatment to be abandoned. Also, some teeth can become non-vital and need root canal treatment later or the roots can dissolve away a bit due to being moved through the bone. These risks increase the older the patient is, in general. However, fortunately these complications are rare and the vast majority of orthodontic brace treatment is successful. Aligners A great, discreet, alternative to braces are aligners – this method uses a series of clear aligners that are custom-moulded to fit your mouth. The virtually invisible aligners gradually reposition your teeth into a smile you’ll be proud to show off. And there are no metal wires or bands to feel shy about.


Veneers, porcelain or plastic, are placed over the front teeth to change the colour and or shape of the teeth. Veneers are ideal for teeth that are too small, too big, or have uneven surfaces. It is very common for people to have imperfect teeth – either oddly shaped, chipped, crooked, teeth with small holes in them, or an inappropriate sized tooth or teeth that have an odd appearance in contrast to the rest of your mouth. Veneers can solve such irregularities and create a durable and pleasing smile. Often an alternative to crowns, veneers are very thin pieces of specially-shaped porcelain or plastic that are glued over the front of your teeth with little or no anaesthesia needed. Unlike crowns, veneers won’t require the dentist to remove much of the tooth itself in most cases. It is important to ask your cosmetic dentist how much tooth will be removed. In some cases more will need to be removed, which may increase the risk of trauma to the tooth.

The procedure:

Veneers are created from an impression taken in your cosmetic dentist’s office. Your custom veneer is then glued directly onto your tooth. Typically costing less than crowns, veneers won’t stain, making them a very popular solution for many people seeking that perfect smile. Strong and very durable, veneers last from 10 to 15 years, and come in colours that will brighten dark teeth without the worry of them changing colour.


Grinding your teeth (bruxism), an improper bite, age, fillings and tooth decay can all be contributing factors in the wearing down, cracking or breakage of your teeth. Dental crowns will cover the entire visible surface of your affected tooth and provide added strength, durability and stability.

Your cosmetic dentist will usually be able to spot early problem areas in your mouth that might lead to tooth damage and a need for crowns. Chewing patterns play an important role as well. By selectively grinding the tips of your middle and back teeth you can alter your bite to reduce the stress on at-risk teeth. In other instances, crowns are used to replace an actual missing tooth.

The procedure:

Crowns are anchored to the teeth on either side of a missing tooth, with a bridge section connecting the two, or instead of bridges, single tooth dental implants may be used that eliminate the need for supporting the crowns. Your cosmetic dentist will make an impression of the tooth and a dental laboratory will create the crown. You will typically leave the office with a temporary crown to wear while the permanent crown is being created – this takes about two weeks. The permanent crown is then cemented onto your tooth. Typically, only two visits are required for this part of the procedure. Often, a preliminary restoration of your tooth may be needed before a crown can be placed. To stabilise your tooth, a filling must first be put in place prior to placing a crown due to the loss of the original tooth structure. Tooth crowns usually last 10 to 15 years. Be sure to confirm with your cosmetic dentist that the cement colour used for your permanent crown will be the same as what is used for your temporary one. A try-in paste is used for this purpose, but the pigment in the cement does affect the overall colour of a permanent porcelain crown, so this needs to be discussed long before your temporary crown is placed.


If you have missing teeth and have good oral hygiene practices, you should discuss this procedure with your cosmetic dentist. If spaces are left unfilled, they may cause the surrounding teeth to drift out of their position. Additionally, spaces from missing teeth can cause your other teeth and your gums to become far more susceptible to tooth decay and gum disease. If you have a space from a missing tooth, a bridge will be custom-made to fill in the space with a false tooth. The false tooth is attached by the bridge to the two other teeth around the space – bridging them together.

The procedure:

Your cosmetic dentist will prepare your teeth on either side of the empty space so they are ready for the false tooth. You will be given a mild anaesthetic to numb the surrounding teeth and gums, and the cosmetic dentist will then remove an area of each abutment (teeth on either side of the space) to accommodate for the thickness of the crown. When these teeth already have fillings, part of the filling may be left in place to help act as a foundation to anchor the new crown. The dentist will then make an impression, which will serve as the model from which the bridge, porcelain false tooth and crowns will be created by a dental laboratory. A temporary bridge will be placed for you to wear while your bridge is being made until your next visit. This temporary bridge will serve to protect your teeth and gums.

upgrade your_smile2_23_04_12Solutions to smile about

Here’s our round-up of the best dental fixes for a total mouth makeover. Whether it’s a quick brightening and whitening you’re after or if it’s all about getting those problem teeth straightened out, we’ve got the answers…

Ageing teeth problem: Yellow or stained

Dental fix: Bleaching

What is it? An in-clinic whitening technique that breaks down stains using a photosensitive bleaching solution combined with high-intensity light. Any tooth decay should be dealt with first.

Is it painful? Some people experience a tingly sensitive feeling in their teeth and gums during or after treatment. How long does it take? About an hour.

How long does it last? One to two years if you look after them, but less if you smoke or drink lots of coffee or red wine.

Cost? Between £500 and £1,000.

Ageing teeth problem: Jagged edges or unsightly chipped teeth

Dental fix: Cosmetic bonding

What is it? Composite filling (white porcelain filling) is bonded directly onto the teeth. It is useful for filling gaps between teeth in particular, the gap between the two front teeth known as the central diastema; re-shaping teeth that may be pointed or twisted, or building up teeth that have broken. The whole procedure is minimally invasive as no tooth is removed. It’s also completely reversible, so if you don’t like the end results, change back.

Is it painful? Expect no pain at all. How long does it take? 30 to 60 minutes.

How long does it last? Up to seven years.

Cost? Between £200 and £700 per tooth.

Ageing teeth problem: A mouth full of cracked and damaged teeth

Dental fix: Veneers What is it? Finger-nail thin slivers of porcelain or composite that are attached with resin cement to the front surface of your teeth.

Is it painful? You’ll receive a local anaesthetic before, but your mouth may feel sore afterwards as your teeth need to be reshaped. There’s also a nearly pain-free version called lumineers, which doesn’t always require filing down the actual tooth before use.

How long does it take? One hour to file off a thin layer of enamel and to make an impression of each tooth. Once the veneer is ready (usually around a week or two later), it takes roughly another hour to have them fitted permanently in place. How long does it last? 10 to 15 years.

Cost? Between £750 and £1,000 per tooth.

Ageing teeth problem: Crooked teeth (teeth that shift over the years)

Dental fix: Invisible aligners

What is it? Custom-made clear plastic aligner trays that look like retainers and work much like removable invisible braces do.

Is it painful? Only a slight sensitivity as your teeth shift position.

How long does it take? A one-hour appointment to have moulds taken and your teeth digitally photographed (these images are then used to create your aligners). Then you’ll wear the series of aligners – which are swapped approximately every two weeks – for months or years while they gradually straighten your teeth.

How long does it last? Results will be permanent provided that you follow up with a retainer.

Cost? Between £3,500 and £5,000.

Photograph: Getty Images 

This article was first published in at home’s ’Ask the Doctor’ with Dr Christian Jessen in March 2012. [Read the digital edition here]


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