Extreme Smile Makeovers

Hollywood teeth or bad for your teeth?

With TV programmes on almost every week showing dentists giving people the pearly-whites of their dreams, and newspapers touting the latest procedure to give you a “new smile in an hour”, the attraction of a quick-fix cosmetic smile makeover such as dental veneers, rather than prolonged improvement through natural alignment can seem a very attractive option for many busy professionals.

So, if we’re all unhappy with our teeth and searching for that elusive Hollywood smile, and there are enough qualified dentists out there to meet demand and provide the service; what’s the problem you might ask?

In this month’s feature article, Dr Raj Kumar looks at the worrying trend for unnecessary cosmetic dental veneers, carried out on healthy teeth for the sake of a smile makeover; and we look at the simple, natural alternative now available…Invisalign.

Veneers

Traditionally they have represented one of the best cosmetic dentistry options for people wanting whiter teeth than bleaching can achieve or who want to camouflage spaces between “gappy” teeth and/or overcrowded teeth. However, having veneers on your teeth is a permanent treatment and they will need to be replaced after a period of time.

Veneers involve removing the outer enamel by a minimum of 0.5mm to create space, otherwise the teeth will look bulky. If the teeth are misaligned and stick out by any degree, then we have to trim away healthy tooth tissue to get the veneers straight.

Some dentists routinely remove at least 1.5 mm to create space in order for the veneers to have some depth and natural translucency. 

This can lead to pulpitis, tooth fracture, veneer failure due to the loss of the enamel surface, gingivitis, ginigival recession etc.

Once you trim down a tooth you reduce its life expectancy. We only have 1 set of adult teeth, so why should we rush into irreversible treatment?

Some patients have an awful smile and have little confidence. They want to be more confident and feel a great smile is the answer. 

Some people are not happy with their face or body and feel that a visit to the dentist is the answer. If they spend £5000 on a set of pearly whites then it may be the beginning of the improvement?

Some people are going through a mid life crisis and feel that they want to turn back the clock.

Is cutting down your teeth the answer?

Traditionally they have represented one of the best cosmetic dentistry options for people wanting whiter teeth than bleaching can achieve or who want to camouflage spaces between “gappy” teeth and/or overcrowded teeth. However, having veneers on your teeth is a permanent treatment and they will need to be replaced after a period of time.

Veneers involve removing the outer enamel by a minimum of 0.5mm to create space, otherwise the teeth will look bulky. If the teeth are misaligned and stick out by any degree, then we have to trim away healthy tooth tissue to get the veneers straight.

Some dentists routinely remove at least 1.5 mm to create space in order for the veneers to have some depth and natural translucency. 

This can lead to pulpitis, tooth fracture, veneer failure due to the loss of the enamel surface, gingivitis, ginigival recession etc.

Once you trim down a tooth you reduce its life expectancy. We only have 1 set of adult teeth, so why should we rush into irreversible treatment?

Some patients have an awful smile and have little confidence. They want to be more confident and feel a great smile is the answer. 

Some people are not happy with their face or body and feel that a visit to the dentist is the answer. If they spend £5000 on a set of pearly whites then it may be the beginning of the improvement?

Some people are going through a mid life crisis and feel that they want to turn back the clock.

Is cutting down your teeth the answer?

Veneers are more lucrative for some dentists; they can charge top dollar, sometimes £1000 per tooth and up to 20 teeth in the smile. The treatment can be over within 3 weeks, so not bad for a months work.

Invisalign as an alternative to metal braces and veneers

I have been using Invisalign for 6 years to straighten teeth, without the need for metal braces. Using instead a series of clear, plastic “aligners” which slowly move teeth over time, according to an individual virtual 3D treatment.

Silicone dental impressions are scanned to create 3-D models of your teeth and gums. Technicians at the Align Tech are then able to isolate each tooth using the computer software and move them on screen according to the prescription from your dentist. The software then simulates this movement in stages, moving different teeth, slowly and at different times until the final result is achieved.

Virtual scans of an existing complex crowded case. No teeth were extracted.

Using special laser scanning technology, a laser beam follows the pattern and solidifies liquid resin layer by layer, to produce the set of plastic aligners which represent each tooth movement generated by the computer software for your personal prescription.

They are virtually invisible. They are removable so you can eat and drink, brush and floss your teeth with ease and due to the lack of metal components as often found with brace systems, they are considered more comfortable and less likely to cause abrasions such as mouth ulcers. 

Generally each aligner in a treatment sequence is worn for 2 weeks, meaning that as you change to the next one your teeth slowly move until they are straightened into their final position. Depending on your individual case, the total treatment time can take 9 – 15 months, with the number of aligners worn during treatment being approximately 18 – 30. At the end the teeth can be safely whitened if you so desire.

So what kind of result can you achieve in comparison to veneers?

Same case as above treated over 18 months, with no teeth extractions by Dr Kumar. No teeth were harmed during the creation of this smile

Dr Raj Kumar BDS LDSRCS MSc Implantology Cert Facial Aesthetics

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