Suzanne Valance discusses changes in cosmetic dentistry, and which treatments are most suitable for a range of dental concerns
Before undergoing cosmetic dental treatment many patients report being self-conscious about their appearance and the impact of this low confidence on personal and professional lives is surprising. A 2016 study by the British Dental Association revealed that 77% of respondents felt that visibly decayed teeth, missing teeth or bad breath would hinder a candidate’s chances of securing employment in public or client-facing roles, and six in 10 believe tooth decay could impede their promotion prospects. These views were reported alongside the overall belief of that white teeth increases attractiveness by 20%.
In the face of this dental anxiety, cosmetic dentistry has never been so popular. With a variety of treatments available, it’s important that the correct choice for each patient’s individual needs are met. The most effective cosmetic treatments available are changing as technology advances, so it’s vital that dental practices are moving with technology to create an improved clinical environment for patients.
Cosmetic dentistry varies from small treatments that will improve a patient’s oral health and make their mouth look clean and well cared for, to improving tooth alignment and enhancing the appearance of their smile. These cosmetic procedures can make a huge difference to a patient’s appearance, although every mouth requires different treatment and there is no one size fits all answer when it comes to dental solutions.
For those who have concerns about the way their teeth look, whether it is chipping, colouring, or straightness, there are varying dental treatments available that can make them feel more confident about their appearance. Cosmetic treatments vary and any professional dentist generally provide the following cosmetic treatments:
• Teeth whitening
• Dental implants
• Teeth straightening (Invisalign)
• Inman aligner orthodontics
A simple clean may be all that’s needed in order to lift the colour of some patients teeth. Regular professional cleaning removes plaque and tartar by using tools to remove this from above and below where the tooth and gums meet.
Teeth whitening is a great next step for patients who are looking to restore their smile without surgery. The whitening product is applied to the teeth using a specially fitted mouth guard. As the active ingredient—typically hydrogen peroxide or carbamide peroxide—is broken down, oxygen gets into the enamel on the teeth and the tooth colour lightens. The treatment typically takes around 30 minutes to one hour
Teeth whitening is only legal if carried out by a dentist, dental hygienist, dental therapist, or using an at home kit containing less that 0 .1% hydrogen peroxide, according to EU legislation. Although tooth whitening at home is increasing in popularity, a dental professional is highly trained to understand the complex ways in which the mouth works and the way the treatment will affect it—plus can recognise problems such as cancer of the mouth and gum disease, which would contraindicate treatment.
Research is showing that one third of teenagers and adults suffer from tooth discolouration and that this is causing them to feel less confident about there appearance when meeting new people, smiling and interacting with their peers. This may be having a psychosocial impact on society that goes beyond vanity as patients will do almost anything to achieve the whitest shade of teeth possible.
Sourcing products from a reputable supplier is vital for practitioners reputation and patient safety. It’s been reported that in Warwickshire, the LGA seized more than 15,000 “dangerous”‘ teeth whitening products between May 2015 and February 2016. These kits contained up to 33% hydrogen peroxide, which is shockingly high in comparison to the legal limits of 0.1% for public use, or 6% for professionals.
Patients should be advised that The British Dental Association warns against buying whitening kits over-the-counter or on the internet. Home kits are not the best option for teeth whitening as they may not fit the patients mouth exactly and bleaching isn’t always advised for patients with gum disease or crowns.
Crowns and veneers
Dental porcelains are used to create replicas of natural looking teeth for both veneers and crown fabrication. The tooth is prepared by removing a layer of the outer surface using a chamfer bur on a hand piece drill, this can also be done with another preferred bur.
Once the tooth is prepared, the dental team will begin to take an impression. The impressions are then transferred over to the dental technician, along with personal information about the patients shade of teeth.
By putting the patient under local anaesthetic this procedure should feel no different from a filling for the patient, however, in some cases if the tooth does not have a nerve, and a post crown is being prepared, a local anaesthetic may be unnecessary.
Veneers and crowns are perfect for a patient who wants a subtle change made to their mouth. The secret to fitting the perfect crowns and veneers is that the work should be imperceptible.
The dental implant debate
Dental implants are ideal for patients who have lost teeth to injury or oral disease. This treatment is beneficial as implants can be fitted either individually or as a whole set.
Dental experts at Berkeley Clinic recommend that dental implants should be safe, strong and durable for them to be more effective than dentures. Dental implants are made from titanium—a biocompatible material that the body will not reject and that provides a strong foundation for replacement teeth. The natural bone fuses to the implant—in the process of osseointegration. These new teeth could last a lifetime if they are looked after appropriately.
Media coverage of celebrity culture has boosted the attractiveness of dental implants as superstar patients are looking for first class dental care from trusted physicians.
Dental implants vs dentures
In recent years the popularity of dental implants over dentures has grown increasingly, though dentists should consider a variety of personal preferences before advising a cosmetic treatment for their patient.
Dental implants are applied to patients while they are under general anaesthetic. To secure the implant into the patient’s jawbone they are drilled in. The titanium implant then acts as a new tooth root whereas partial dentures are secured with wings to adjacent teeth.
Many denture wearers complain about the comfort of the appliance and how it affects eating and drinking. Dental implants are fixed firmly to the gums which eliminates any risk of slippage, as the implants are attached. Partial denture appliances can loosen and slip out of place, which may cause the user distress.
Impact on oral health
Partial dentures depend on adjacent teeth for support and in many cases this can damage the lining of the patient’s natural teeth. Dental implants do not rely on adjacent teeth.
As the more modern treatment, dental implants are stronger and are the most reliable and comfortable form of tooth replacement.
The future of cosmetic dentistry
With technology comes choice and the last 15 years has seen the world of cosmetic dentistry full of new options for patients, including CADCAM dentistry that allows single visit crowns, veneers and ceramic reconstructions.
Computer Aided Design and Computer Aided Manufacturing are now used to assist with dental restoration—specifically dental crowns, veneers and dental implants. This modern technique allows dentists to treat heavily broken teeth in as little as one visit and in reduced appointment times. This has benefits both dentists in the form of higher patient volumes and for patients who can be seen sooner.
With the rise of clear brace applications like Invisalign that only take a matter of months to straighten teeth, it appears that, in the future, state of the art technology will enable dentists to fix teeth without an impression, without temporaries, and without metal.
Suzanne Valance is an industry writer for cosmetic dentistry, she represents the Glasgow Dental Clinic, Berkeley Clinic, an award winning practice in Glasgow, Scotland.