Cosmetic dentistry

What is cosmetic dentistry?
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 and tooth-coloured fillings.

What is a veneer?
Veneers are thin slices of porcelain. These are precisely made to fit over the visible surface of front teeth, like a false fingernail fits over a nail.

Why might I have a veneer?
Veneers are an ideal way of treating discoloured or unsightly teeth, closing gaps between front teeth, or repairing chips and cracks.

How are veneers made?
They are made by a dental technician, using impressions taken by the dentist. The veneers are made in the laboratory and bonded to the tooth to form a strong and natural-looking repair. Sometimes a natural colour ‘composite’ material is used instead of porcelain. Composite veneers can be completed in one visit and involve bonding tooth-coloured filling material to the front of the tooth. Although these veneers are slightly more prone to staining and have a shorter life, they are easily replaced.

Can I use veneers to close the gaps between my front teeth?
Yes. Again, using tooth-coloured material or porcelain, the dentist can change the shape or size of the tooth very slightly, closing the gap between the teeth.

How much will a veneer cost?
In some cases veneers can be available on the NHS. However, this type of treatment is usually classed as cosmetic and would therefore only be available privately. Costs will vary from practice to practice and from region to region. It is therefore important to discuss treatment options and charges with your dentist and it is always recommended that you get a written estimate before starting treatment.

Can I have white fillings?
For over 150 years standard fillings have been made out of a silvery-grey material called ‘amalgam’. This is still one of the strongest and longest-lasting materials available for fillings. However, many people find it unattractive and some are concerned about possible health risks.

White fillings are now becoming 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.

Are there any other alternatives to silver fillings?
In some cases, the cavity that needs filling is quite large, but the surrounding tooth is healthy. A composite filling may not be strong enough, but it would seem pointless to remove more of the healthy tooth in order to make a crown. In these cases an inlay may be the answer.

The dentist can make an inlay by preparing the cavity in much the same way as they would for a filling. But instead of putting in a filling, the dentist takes an impression of the tooth. The impression is then sent to the laboratory where the technician makes an ‘inlay’ using porcelain, resin-material or gold. The dentist then bonds this into place.

My tooth is badly broken – what can I do?
When a tooth is badly broken or heavily filled, the dentist may need to crown or ‘cap’ it to restore its appearance and strength

How does the dentist make a crown?
The usual procedure for fitting a crown 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, where the technician makes the crown.

What happens to my teeth while the crown is being made?
While your crown is being made, the prepared tooth can be protected with a temporary crown, which is easily removed just before fitting the permanent one. In most cases, the temporary crown is in place for about two weeks.

What is a crown made of?
Crowns can be made of a variety of different materials, such as porcelain or porcelain bonded to gold. New materials are continually being introduced. There are different crowns for different situations and it is a good idea to discuss with your dentist which crown would be best for you.

How much will a crown cost?
On the NHS, tooth-coloured crowns are available on teeth near the front of the mouth (from the first pre-molar tooth forwards). Many people want to have tooth-coloured or gold crowns for teeth that are further back, but these are only available privately. Costs for these vary from practice to practice and region to region. Always get an estimate of the cost and discuss all possible treatment options with your dentist before starting treatment.

I have a gap – should I have it closed?
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 in order 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.

How can my dentist fill the gap?
A partial denture is the simplest way of replacing missing teeth. However, some people find dentures uncomfortable and eventually decide to have a bridge made.

What is a bridge?
Bridges are ideal for people who don’t like dentures or only have one or two teeth missing. Conventional bridges are 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 for strength.

What if I don’t want my remaining teeth drilled?
Adhesive 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 of these teeth. The teeth are roughened and the bridge is fitted using a very strong composite resin.

How much will a bridge cost?
Bridge work is expensive because of the time, materials and expertise involved. Even bridges covered by the NHS cost more than most other treatments. It is important to get a written estimate of the costs involved before starting.

Can I have teeth screwed in?
‘Implants’ are an alternative to dentures or bridgework, but they are more expensive. Implants are titanium rods, which are surgically placed into the jawbone, leaving parts sticking out through the gum. These act as anchors for fastening dentures or crowns onto.