Treatment options

The choice of cosmetic dentistry treatments is wide and varied, from veneers, bridges, crowns and white fillings to computerised smile analyses that evaluate the harmony between lips, gums and teeth.

Crowns, bridges and fillings

Common methods for correcting slight aesthetic discrepancies or issues of tooth quality are crowns, bridges and fillings. Crowns or caps are used to restore chipped teeth or replace broken teeth. An impression of the tooth is taken and the crown - made from metal or porcelain - is built in a laboratory to individual prescription, using a gold alloy covered with bonded porcelain. The old tooth is then cut down a millimetre or so to make room for the crown. The crown is then cemented to the tooth. It takes two two-hour appointments and results are permanent.

Bridges cover the gap where a tooth is missing or a gap is present.
It entails a metal unit of three crowns and is fashioned from porcelain to blend with existing teeth, which is cemented to the teeth either side of the gap. These teeth are drilled down to attach the bridge either side of the gap. The middle crown is solid to mimic a tooth, the other two are hollow in order to fit over the teeth. Generally a couple of appointments are required and the results last from three years to fifteen years, if maintained properly.

White fillings are for people with smaller gaps, chipped teeth or filling the edge of a tooth. They are made of a composite of resin and glass particles, cemented onto the existing tooth using a bonding agent. One appointment is required and, while they are less resilient than veneers, results should last for around 15 years if cleaned properly.

Chipped, broken, discoloured or decayed teeth may be repaired or have their appearance corrected using a procedure called composite bonding. A dental composite material with the look of enamel is applied into the cavity or onto the surface of a tooth, where it is then sculpted into shape, contoured and hardened with a high-intensity light. The result is a restoration that blends invisibly with the remainder of the surrounding tooth structure and the rest of the natural teeth.

Teeth Whitening

In the blossoming world of cosmetic dentistry, teeth whitening reigns supreme as arguably the most commonly recommended procedure. Teeth are often stained from poor oral hygiene or smoking, food, coffee, tea or red wine. Bleaching the teeth can enhance the appearance of a smile.

Universally valued by men and women alike, whitening (or bleaching) treatments are available to appeal to every budget and time frame. Whether in the form of one-hour bleaching sessions at a dentist's office, or home-use bleaching kits purchased at a chemist, teeth whitening solutions are widely available. Virtually everyone who opts for this cosmetic treatment will see moderate to substantial improvement in the brightness and whiteness of their smile. However, teeth whitening is not a permanent solution and requires maintenance and repeat treatments for a prolonged effect.

There are three types of teeth whitening techniques to choose from: pure laser, kick-start laser and at-home kits.

The pure laser technique is a quick fix to whiten teeth. It involves laser beams - or the more updated light emitting wavelengths - to provide an intense light that activates a whitening agent made from carbamide peroxide or hydrogen peroxide pasted onto the enamel of the tooth. This chemical reaction lifts the stain out of the enamel and is then washed away by the dentist. It takes about one-and-a-half hours and needs topping up once every three to six months.

With the second method, a mould of the teeth is taken and a mouth guard made to exact specifications. The patient wears the mouthguard filled with a whitening gel made from carbamide peroxide or hydrogen peroxide. Often kick-start laser beams, or a light emitting wavelengths, activate the gel pasted onto the enamel of the tooth. Two appointments, two weeks apart offer results of three to six months.

Where the laser methods tend to be more costly, home kits are very affordable and see the patient is fitted with a tailor-made mouth guard at their dentist and they wear the mouthguard filled with whitening gel each night for around three weeks. This does not harm the teeth but slightly changes the composition of the dentine - the part of a tooth that is hard, contains calcium and lies underneath the enamel - making it appear whiter. Results last between three and six months.

Dental Veneers

Dental veneers are custom-designed shells of tooth-like material that, when applied over the surface of a tooth, can cover worn tooth enamel, uneven tooth alignment or spacing, crowding, staining and chips or cracks. Veneers can also increase the dimension of the tooth, thicken them, make them squarer or longer. Regardless of what causes unattractive teeth, dental veneers may solve most or even all cosmetic dental issues.

Second to this, the translucent quality of today's veneers provides a more natural look than what has been available in the past.

The veneer is bonded onto the front surface of the tooth using a chemical bonding agent, with some minimal drilling to curve the contours of the veneers. The two most common materials used in the manufacture of dental veneers are composite resin and porcelain veneers. Both porcelain veneers and composite veneers can be fabricated by a dental technician in a dental laboratory and are bonded to the tooth with resin cement, but composite veneers can also be directly fabricated inside the mouth at the dentist. Of the two, porcelain veneers are longer lasting and more expensive.

Veneers can be maintained in the same way as regular teeth: with proper brushing, flossing and regular dental checkups.

Dental Implants

Dental implants are artificial tooth root replacements that are used as a part of prosthetic (artificial replacement) dentistry to compensate for tooth loss. Often the result is not only an enhanced smile, but also a more youthful appearance, since missing teeth cause the face to collapse, which can make a face look older.

Teeth can be lost because of tooth decay, root canal failure, gum disease (Periodontitis), trauma to the mouth, excessive wear and tear and congenital defects. People who have lost teeth might feel self-conscious when smiling or talking or can experience functional problems with eating.

Dental implants are stronger and more durable than their restorative counterparts (bridges or dentures). Implants may be used in conjunction with other procedures, for example, a single implant can serve to support a crown replacing a single missing tooth. Implants can also be used to support a dental bridge for the replacement of multiple missing teeth. Because implants can also help maintain bone, they can help prevent additional tooth loss and a sunken facial appearance.

Today implants are a common procedure, and they are virtually indistinguishable from other teeth. Once the implant, usually made from titanium, is surgically placed in the bone, it takes four to six months for it to become integrated into the jaw (a process called osseointegration). A ceramic porcelain tooth restoration is then matched to the original tooth colour and attached to the implant. These feel more natural than conventional replacement bridges or dentures.

Usually implants can be placed with the patient awake, however anaesthesia can be used upon request. If necessary, pain medications can be prescribed.

Like natural teeth, implant restorations require regular daily oral care and professional dental hygiene appointments. Provided they are well cared for and the patient remains healthy, dental implants can last indefinitely.

Teeth straightening

There are two ways to straighten teeth, either cosmetically or with orthodontics - the area of dentistry concerned with the prevention and correction of irregularities of the teeth. For people with crowded, crooked or tilting teeth, this is a viable solution.

Cosmetic teeth straightening happens under a local anaesthetic whereby the dentist uses an electrosurge unit (a surgical device which uses heat to remove fragments of gum) to reshape the gum and suit the shape of new veneers. The teeth are drilled ready to receive the new veneers. Each veneer is then bonded to the front of the tooth. It takes several visits and lasts between two and five years.

Orthodontics using metal or tooth-coloured braces or clear aligners are fitted inside the mouth. These are usually on for one to three years, with follow up appointments every four to eight weeks depending on the individual. Patients will be advised to wear a retainer after they are removed.

Gum lift

The health and appearance of the gums play an important role in the general aesthetics of a smile. A ‘gummy smile' describes a smile where there is too much exposure of the gum above the upper front teeth, which makes the teeth appear shorter. If this is the case, a gum lift may be required.

A gum lift is a surgical procedure where the gums are lifted to improve not only their appearance, but also the size and shape of the teeth. The position and shape of the gum is surgically modified to show more of the natural teeth and less of the gum when smiling.

Removal of excessive gum and reshaping of the gum line can give a fuller, more aesthetically pleasing smile. Alternatively, a gum lift may only be required for one or two teeth to create harmony and symmetry. It can be performed in combination with other cosmetic dentistry procedures or on its own.

The procedure is performed in one visit. It is minimally invasive with mild post-operative discomfort. Maturity of the gums to their final position takes approximately 12 weeks.

Smile Makeover

Smile makeovers involve a comprehensive assessment of a person's smile aesthetics in order to improve its overall appearance. Typically one or more cosmetic dentistry procedures, such as dental veneers, dental implants, gingival sculpting and teeth whitening, will be required for teeth in both the upper and lower arches in order to achieve the right look.

Full mouth reconstruction: During the consultation about a smile makeover, the dentist may discover a need to treat or correct functional problems with the patient's bite, muscles, teeth and bone structure. If the patient needs full mouth reconstruction, the materials available today make it possible for the dentist to provide durable, functional and clinically sound treatments that also look natural.