Cosmetic Dental Treatments

Cosmetic dentistry uses a number of ways to enhance the appearance of your teeth. Treatments are available to make crooked teeth look straighter, to improve the appearance of teeth and to make discoloured teeth look whiter.

Cosmetic treatments tend to look better and last longer if you have healthy teeth and gums. If you have tooth decay or gum disease, this should be treated before any cosmetic dentistry is started.

Tooth-coloured fillings

Fillings are used to fill holes (cavities) that have formed, usually as a result of decay or tooth wear. There are many types of filling, each suitable for different cavities.

Tooth-coloured fillings can now be used instead of amalgam (silver) fillings, making them a natural-looking alternative. They are often used in teeth that show during smiling or talking. They are not as durable as amalgam, and so they aren't always suitable for the grinding and chewing surfaces of the back teeth.

Most people have a local anaesthetic injection to completely numb the area while the filling is being done.

The decayed and weakened parts of the tooth are removed using small drills and the hole is washed. The filling material is then packed in.

Tooth-coloured fillings must be kept completely dry until they have set, so the dentist will take special precautions to keep saliva away from the area. This may include placing a sheet of rubber over the tooth (called a rubber dam).

Tooth whitening

There are a number of different bleaching methods available to lighten the natural shade of your teeth. Some you can buy and use yourself, while others require a visit to the dentist.

Whitening toothpastes are lightly abrasive, which may help to remove surface staining. However, they do not alter the natural shade of your teeth.

Over-the-counter (OTC) kits are sold in most major chemists throughout the UK. In general, they contain rubber mouthguards (moulds that are approximately the same shape as your teeth) and tubes of bleaching gel. After squeezing some of the gel into the mouthguards, you place them over your teeth, usually for about 30 minutes at a time.

The bleaching ingredient in the gel is called hydrogen peroxide. OTC kits only contain weak hydrogen peroxide, and tend not to be as effective as stronger products that may be used by your dentist.

Home bleaching is similar to the OTC kit method, but with two main differences. Firstly, your dentist makes the rubber mouthguards so that they fit your teeth precisely, and secondly, the bleaching gel is stronger so it tends to be more effective. Your dentist will give you tubes of bleaching gel and detailed instructions.

"Power" or "laser" bleaching is done in the surgery. Your dentist will put a rubber seal around your teeth to protect your gums. Then, the bleaching gel is painted onto your teeth and a special, bright light is pointed at them. This light speeds up the whitening process.

Internal bleaching involves placing a bleaching product inside the tooth. It can only be done on teeth that have been successfully root-treated. This means that the blood vessels and nerves inside the tooth have been replaced with a rubber filling.

To bleach a tooth in this way, the dentist will drill a hole and put the bleaching product into the hole. The hole will be sealed with a temporary filling, leaving the bleach inside the tooth. You will have to go back to your dentist about a week later to have the temporary filling and bleach taken out. If you are satisfied with the new shade, your dentist will fill the hole with a tooth-coloured filling.

It's important to bear in mind that bleaching doesn't always result in the whiteness that you expected. The results vary from person to person and depend on the shade of your teeth before bleaching. The whitening effects of different bleaching methods can last for a few years, but this also varies from person to person.

Veneers

If a front tooth is chipped, damaged or discoloured, a thin layer (veneer) of ceramic material, eg porcelain, can be made to fit over it, or tooth-coloured composite material can be placed on the tooth. In some cases, if you have one or more teeth that are crooked, veneers of varying thicknesses can be fitted to help them appear straighter.

On the first visit, you may have a local anaesthetic injection to numb the tooth, but this isn't always necessary. The surface of the tooth may be filed down slightly to allow for the small added thickness of the veneer. The dentist will also take a mould of the tooth in a putty-like material. This is sent to a laboratory where the veneer is made. The laboratory work often takes a week or two so, while the veneer is being made, you may have a slightly roughened, sensitive tooth.

On the second visit, the dentist cements the veneer onto the front of the tooth.

Veneers can last for several years but they can be damaged just like normal teeth due to an accident, break or chip.4 The edge of a veneer may be fragile, so you should try not to bite your nails or tear sticky tape with your teeth.

Crowns, inlays and onlays

If a tooth has been broken, or weakened by a lot of decay or a large filling, a crown (or cap) can be fitted. Crowns are shaped like natural teeth. For teeth near the front of the mouth crowns are usually made of porcelain-like materials. Crowns on back teeth may be made of porcelain or gold.

Inlays and onlays are similar to fillings. However, like crowns, they are made in a laboratory and then cemented to the tooth with special adhesive. The process of fitting crowns, inlays and onlays requires two visits to the dentist.

Inlays and onlays are very strong and, in some circumstances, may be more durable than ordinary fillings. They are suitable for the grinding surfaces of the back teeth and can be made out of gold, porcelain or composite material.