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Dentistry is no longer just a case of filling and extracting teeth, as it was for many years. Nowadays many people turn to cosmetic dentistry, or ‘aesthetic dentistry', as a way of improving their appearance, much as they would use cosmetic surgery or even a new hairstyle. The treatments can be used to straighten, lighten, reshape and repair teeth. Cosmetic treatments include veneers, crowns, bridges, tooth-coloured fillings, implants and tooth whitening.
Veneers are thin slices of porcelain. These are precisely made to fit over the visible surface of your front teeth, like a false fingernail fits over a nail.
Veneers are an ideal way of treating discoloured or unsightly teeth, closing gaps between front teeth, or repairing chips and cracks.
A small amount of enamel is removed from the tooth, usually the same thickness as the veneer will be. An impression (mould) is taken by the dentist and sent to a dental technician for the veneer to be made in the laboratory. The veneer is then bonded to the tooth to form a strong and natural-looking repair.
For over 150 years standard fillings have been made out of a silvery-grey material called ‘amalgam'. This is considered one of the strongest and longest-lasting materials for fillings. However, many people find it unattractive and some are concerned about possible health risks.
White fillings are now a popular alternative to amalgam fillings. The new dental materials mean it is much easier to find a perfect match for the shade of a particular tooth. In most cases, it is quite impossible to see that the tooth even has a filling. Sometimes white filling material can be used to cover unsightly marks on teeth, in a similar way to veneers.
When a tooth is badly broken or heavily filled, the dentist may need to crown or ‘cap' it to restore its appearance and strength.
Fitting a crown usually involves shaping the tooth under local anaesthetic and then taking an impression using a rubber-like material. The impression is then sent to the laboratory along with the details of the shade to be used, and the technician makes the crown.
While your crown is being made, the prepared tooth can be protected with a temporary crown. This is easily removed just before fitting the permanent one. In most cases, the temporary crown is in place for about two weeks.
Crowns can be made of a variety of different materials, such as porcelain or porcelain bonded to gold or metal. New materials are being introduced all the time. It is a good idea to talk to your dentist about which crown would be best for you.
If a tooth is missing, or needs extracting, there are several ways to fill the gap that is left. In some cases it is important to try to replace any missing teeth to balance the way your jaw bites. If you have several missing teeth, the remaining teeth are under more pressure, which can lead to broken fillings or even jaw problems.
A partial denture is the simplest way of replacing missing teeth. However, some people find dentures uncomfortable and eventually decide to look at alternatives, such as bridges or implants.
Bridges are ideal for people who don't like dentures and only have one or two teeth missing. Bridges are usually made by crowning the teeth on either side of the gap and attaching a false tooth in the middle. They are fixed in the same way as crowns. These bridges are usually made of precious metal bonded to porcelain. Sometimes other non-precious metals are used in the base to give it extra strength.
Adhesive bridges or Maryland bridges are another way of bridging a gap, and less of the tooth needs removing. These bridges are made up of a false tooth with metal ‘wings' on either side. These wings are made to bond to the teeth on either side, with very little drilling involved. Instead, the teeth are roughened and the bridge is fitted using a very strong composite resin.
‘Implants' are an alternative to dentures or bridgework, but they are more expensive. Implants are titanium rods, which are surgically placed into the jawbone and act as anchors for fastening dentures or crowns onto.
Tooth whitening can be a highly effective way of lightening the natural colour of your teeth without removing any of the tooth surfaces. It cannot make a complete colour change, but it should lighten the existing shade.
Professional bleaching is the most common form of tooth whitening.
Your dentist will apply the whitening product to your teeth, using a specially made tray which fits into your mouth like a gum-shield.
The ‘active ingredient' in the product is usually hydrogen peroxide or carbamide peroxide. As the active ingredient is broken down, oxygen gets into the enamel on the teeth and the tooth colour is made lighter.
Once your dentist has started this treatment you may be given the trays to take home and continue the treatment, or you may need more appointments at the dentist's. This treatment can be done within 3 to 4 weeks, depending on how long you keep the trays in your mouth each time, and how much whiter you want your teeth to be.
There is now laser whitening or ‘power whitening'. During this treatment a light or laser is shone on the teeth to activate the chemical. The light speeds up the chemical reaction of the whitening product and the shade change can be achieved more quickly. Laser whitening can make teeth up to five or six shades lighter. This treatment usually takes about one hour and should be carried out by a qualified dentist. Under new European legislation the strength of peroxide used in most laser whitening has become illegal. So it is now much more common for you to take trays home to apply the whitening gel yourself.
Under European law, tooth whitening with peroxide can now only be carried out by or under the supervision of a dentist. Whitening kiosks are now therefore illegal, as is whitening by a beautician. Only a dentist is able to properly examine your teeth to see whether whitening is appropriate, and to make sure that it is done safely without damaging your teeth or other parts of your mouth such as your gums.
For the most up-to-date information on the regulations about tooth whitening and who can provide it, go to www.safetoothwhitening.org or call the Dental Helpline on 0845 063 1188.
This is when the teeth do not meet together properly, or are not in balance with the rest of the face, or if teeth are lost and not replaced.
If an incorrect bite is not treated the face can ‘collapse'. This can cause the face to sag, the chin to stick out or the smile to droop. It can even cause headaches, neck pain and pain in other parts of the body.
There are a number of treatments, including crowns, veneers and orthodontics (braces). Ask your dentist which treatment is most suitable for you. Ask for an estimate of the cost and a written treatment plan before you start.
Teeth can be straightened with orthodontics (braces). This is usually done during the teenage years, when the jaws are going through a period of growth. However, many adults also have treatment to straighten their crooked teeth or to improve their appearance. The treatment can take much longer in adults and is therefore more expensive.
For cosmetic reasons, clear or plastic braces can be used, which are hardly noticeable. If you are considering orthodontic treatment, first go along to your dentist and get their advice. Your dentist can talk to you about your treatment options and if necessary refer you to an orthodontist.
Cosmetic contouring can be used to improve the appearance of teeth. It is ideal if you have irregular-shaped or slightly crowded teeth.
However, in contouring the teeth a small amount of enamel would be lost. Contouring can also be used to improve the shape and appearance of your gums. These treatments are not recommended for young children.
Tooth jewellery involves sticking small jewels onto the teeth using dental cement. They should be fitted by a dentist, who can easily remove them if necessary. It is important to keep the area around the jewel clean, as plaque can easily build up around it and you will be more likely to get tooth decay.