Cosmetics Dentistry

A partial denture is the simplest way to replace missing teeth. However, some people find dentures uncomfortable and eventually decide to look at alternatives, such as bridges or implants.

What is a bridge?

Bridges are ideal for people who don’t like dentures and only have a few teeth missing. Bridges are usually made by putting a crown on the teeth on either side of the gap and attaching a false tooth in the middle.

The bridge is permanent and can’t be removed. 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.

What if I don’t want my remaining teeth drilled?

Adhesive bridges are another way of bridging a gap, and not as much of the tooth is removed. 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 needed. Instead, the teeth are roughened and the bridge is fitted using a very strong composite resin.

Can implants be used to replace missing teeth?

Implants are an alternative to dentures and bridges, 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.

Can I lighten the color of my teeth?

Yes. Tooth whitening can be a highly effective way of lightening the natural color of your teeth without removing any of the tooth surfaces.  It cannot make a complete color change, but it should lighten the existing shade.

What does tooth whitening involve?

Professional bleaching is the most common form of tooth whitening.

Your dental team will apply the whitening product to your teeth, using a specially made tray which fits into your mouth like a mouthguard.

The ‘active ingredient’ in the product is usually hydrogen peroxide or carbamide peroxide. As the active ingredient breaks down, oxygen gets into the enamel on the teeth and the tooth color becomes lighter.

Once your dental team has started this treatment, you may be given the trays to take home and continue the treatment, or you may need more appointments with the team. This treatment can take around 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.

It is important to remember that only natural teeth will be whitened, and that any crowns, bridges or dentures you have will stay their current shade.

What other tooth-whitening methods are there?

There is now laser whitening or ‘power whitening.’  During this treatment a light or laser is focused 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 you must be seen by a qualified dentist before starting treatment.

How safe are whitening kiosks and beauticians?

Under European law, tooth whitening can 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 and other parts of your mouth such as your gums.

What is an ‘incorrect bite’?

This occurs 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.

What can happen if it is not treated?

If an incorrect bite is not treated,  the face can ‘collapse.’ This can cause the face to sag, the chin to protrude , or the smile to droop. It can even cause headaches, neck pain,  and pain in other parts of the body.

How can it be treated?

There are a number of treatments, including crowns, veneers and  orthodontics (braces). Ask your dental team which treatment is most suitable for you. Also ask for an estimate of the cost and a written treatment plan before you start.

Can my crooked or twisted teeth be straightened?

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.

Some people have clear or plastic braces which are hardly noticeable. If you are considering orthodontic treatment, first see your dental team to get their advice. They can talk to you about your treatment options and, if necessary, refer you to an orthodontist, a dentist who specialises in straightening teeth.

There are also now ‘invisible’ braces. Your dentist will make a series of clear plastic shields (like a mouthguard) which need to be worn all day and gradually move your teeth into the new desired position.

Are there any alternatives to orthodontics?

Cosmetic contouring can be used to improve the appearance of teeth.  It is ideal if you have irregularly 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.

What is tooth jewelry?

Tooth jewelry 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.

What is tooth whitening?

Tooth whitening can be a very effective way of lightening the natural color of your teeth without removing any of the tooth surface. It cannot make a complete color change, but it may lighten the existing shade.

Why would I need my teeth whitened?

There are a number of reasons why you might get your teeth whitened. Everyone is different; and just as our hair and skin color vary, so do our teeth. Very few people have brilliant-white teeth, and our teeth can also become more discolored as we get older.

Your teeth can also be stained on the surface by food and drinks such as tea, coffee, red wine, and black currant. Smoking can also stain teeth.

‘Calculus’ or tartar can also affect the color of your teeth. Some people may have staining under the surface, which can be caused by certain antibiotics or by tiny cracks in the teeth which take up stains.

What does tooth whitening involve?

Professional bleaching is the most common method of tooth whitening. Your dental team will be able to tell you if you are suitable for the treatment, and will supervise it if you are. First the dental team will put a rubber shield or a gel on your gums to protect them. They will then apply the whitening product to your teeth, using a specially made tray which fits into your mouth like a mouthguard.

The ‘active ingredient’ in the product is usually hydrogen peroxide or carbamide peroxide. As the active ingredient breaks down, oxygen gets into the enamel on the teeth and the tooth color is made lighter.

How long does this take?

The total treatment can usually be done within three to four weeks. First, you will need two or three visits to the dentist. Your dental team will need to make a mouthguard and will take impressions for it at the first appointment. Once your dental team has started the treatment, you will need to continue the treatment at home. This means regularly applying the whitening product over two to four weeks, for 30 minutes to one hour at a time.

However, there are now some new products which can be applied for up to eight hours at a time. This means you can get a satisfactory result in as little as one week.

What other procedures are there?

There is now laser whitening or ‘power whitening.’  During this procedure a rubber dam is put over your teeth to protect the gums, and a bleaching product is painted onto your teeth. Then a light or laser is focused on the tooth to activate the chemical. The light speeds up the reaction of the whitening product and the color change can be achieved more quickly. Laser whitening is said to make teeth up to five or six shades lighter.

How long does chair-side power whitening take?

Your dentist will need to assess your teeth to make sure that you are suitable for the treatment. Once in agreement, this procedure usually takes about one hour.

How long will my teeth stay whiter?

The effects of whitening are thought to last up to three years. However, this will vary from person to person. The effect is less likely to last as long if you smoke, or eat or drink products that can stain your teeth. Ask your dental team for their opinion before you start the treatment.

What are the side effects?

Some people may find that their teeth become sensitive to cold during or after the treatment. Others may have discomfort in the gums, a sore throat, or white patches on the gum line. These symptoms are usually temporary and should disappear within a few days after finishing the treatment.

If any of these side effects continue,  you should contact or see your dentist.

What about home whitening kits?

There are many home whitening kits available, including paint-on whiteners and strips. How effective these are depends upon the amount of whitening agent they contain.

Home kits are cheaper but they are not always assessed for safety and tend to be more acidic. So there is a chance that these products could damage your teeth and gums. Because tooth whitening is a complicated procedure, we advise that you always talk to your dentist before starting the treatment.

Regulations covering home kits vary from country to country. Kits sold in Europe cannot legally contain more than 0.1% peroxide, and this is too little to be effective. In other countries where stronger peroxide is allowed, home whitening is more common. But you need to be careful as some kits sold over the internet may contain mild acids and abrasives.

How safe are beauty kiosks and beauticians?

In Europe and in some other countries, whitening can only legally be carried out by a dentist. So tooth whitening by beauticians and in whitening kiosks is illegal. In Europe, it is illegal to supply bleaching material containing more than 0.1% peroxide (or the equivalent in carbamide peroxide) to anyone other than a dentist, or direct to the public.

These regulations are to protect the public. They make sure that anyone carrying out whitening is properly trained and has the right skills and knowledge to carry out the procedure without risking permanent damage to the teeth or gums.

What about whitening toothpastes?

There are several whitening toothpastes on the market. Although they do not affect the natural color of your teeth, they may be effective at removing staining. Therefore, they may improve the overall appearance of your teeth. Whitening toothpastes may also achieve a more lasting effect once your teeth have been professionally whitened.

Can a single tooth which has been root filled be whitened?

Yes. Sometimes dead teeth will become discolored after a root filling. If the tooth has had root treatment,  the canal (which contained the nerve) may be reopened. The whitening product is applied from the inside to whiten the tooth.

When might tooth whitening not work?

Tooth whitening can only lighten your existing tooth color. Also it only works on natural teeth. It will not work on any types of ‘false’ teeth such as dentures, crowns and veneers.

If your dentures are stained or discolored, visit your dental team and request they be cleaned.

How can I look after my teeth once they have been whitened?

You can help keep your teeth white by cutting down on the amount of food and drinks you have that can stain teeth. Don’t forget, stopping smoking can also help prevent discoloration and staining.

We recommend the following tips to take care of your teeth:

• Brush your teeth last thing at night and at least one other time during the day, with a fluoride toothpaste.
• Cut down on how often you have sugary foods and drinks.
• Visit your dental team regularly and as often as they recommend.