Many cosmetic dental treatments can be used to repair your teeth. Your dentist will be able to advise you which treatments are most suitable.
Fillings are used to fill holes (cavities) that have formed in your teeth, usually as a result of decay.
There are two types of fillings – amalgam (silver) and composite (tooth-coloured).
Before your filling is fitted, your dentist will remove the decayed parts of your tooth and clean the cavity. Amalgam fillings are made of a combination of metals including silver, tin, copper and mercury. Amalgam is extremely hard-wearing and can last for 15 to 20 years. Composite fillings can be used instead of amalgam as a natural-looking alternative. They are often used in teeth that show when you smile or talk. However, they don't tend to last as long as amalgam fillings. Your dentist will be able to advise you on which type of filling is best for you.
If your tooth has been broken or weakened by a lot of decay or a large filling, your dentist may recommend fitting a crown. A crown is shaped like a natural tooth. It’s fitted over the top of your damaged tooth to disguise it. Crowns can be made of porcelain, gold or a combination of metal covered with tooth-coloured porcelain.
You will usually need to have at least two appointments to have a crown fitted. At the first, your dentist will prepare your tooth and place a temporary crown over your tooth. Then at the second appointment, your dentist will remove the temporary crown and fit the permanent one.
If one of your front teeth is chipped or discoloured, a thin layer (veneer), can be made to fit over it. These are usually made of porcelain. Sometimes, if you have a small gap between your teeth, or if they are slightly crooked, veneers can be fitted to help them appear straighter.
You will usually need at least two visits to the dentist. At the first, your dentist will take a mould of your tooth, which is then used to make the veneer. He or she will also remove a small amount of the top layer of your tooth (enamel). On the second visit, your dentist will fix the veneer onto your tooth.
Veneers can last for several years, but they can be damaged just like normal teeth because of an accident, break or chip.
Whitening can be used to make your teeth look whiter. There are a number of different bleaching methods available to lighten the shade of your teeth. Some you can buy and use at home; others you will need to have done by your dentist.
Your dentist will discuss your options with you and advise you which treatment is the most suitable.
Some whitening toothpastes gently polish your teeth and can help to remove stains from your teeth. However, these don't change the natural shade of your teeth. Experts are currently looking into how well these toothpastes work.
Over-the-counter teeth whitening kits
Over-the-counter teeth whitening kits are sold in most pharmacies throughout the UK. They usually contain rubber mouth trays (moulds that are approximately the same shape as your teeth) and tubes of bleaching gel. The bleaching ingredient is usually hydrogen peroxide or carbamide peroxide. The kits will only contain a weak bleaching agent, so may not be very effective.
Always speak to your dentist before using an over-the-counter teeth whitening kit.
Professional teeth whitening
You may be able to whiten your teeth at home. If this treatment is suitable for you, your dentist will give you a specially made mouth tray and some whitening gel. Usually, you can wear the mouth tray for around eight hours each day, over a period of about two weeks. However, this will vary from person to person and may differ from what is described here, so make sure you follow your dentists advice.
You can also have your teeth whitened at your dental practice, where your treatment will be supervised by your dentist. Power bleaching is one type of treatment that can help to make your teeth whiter. Firstly, your dentist will place a rubber seal around your teeth to protect your gums. Then he or she will put the bleaching gel onto your teeth and use a bright light to speed up the whitening process. This treatment usually takes one or two hours.
Possible side-effects of bleaching include tooth sensitivity and gum irritation. The long-term effects of using these techniques aren't known. These bleaching techniques can keep your teeth whitened for up to three years, although this will be different for everyone. Speak to your dentist to get an idea of how long the effects will last.
Orthodontic treatment is used to straighten or move your teeth to improve their appearance or function. Straight teeth are easier to clean and less vulnerable to tooth decay and gum disease.
Orthodontic treatment usually involves wearing a brace on your teeth. This puts gentle pressure on your teeth to move them into the right place. You will usually need to wear a brace for between six months and two years. During this time, your orthodontist will monitor your teeth closely and make adjustments to the brace. Orthodontic treatment is usually carried out during childhood, but adults can have it as well.
There are several different types of brace. Some can be removed whereas others are fixed in place.
You can take removable braces out of your mouth at any time. They are made of plastic and usually have wires and springs to move specific teeth. Removable braces are commonly used to move your upper teeth. You will need to take your brace out to clean it, but otherwise you should wear it at all other times, including during mealtimes.
Fixed braces (sometimes called 'train tracks') aren’t removed from your teeth until your treatment is finished. Fixed braces are usually made of metal, but can also be made of ceramic. They are glued to your teeth with filling material and joined together with a wire. You may need to have small elastic bands attached to your braces. These are used to keep the wires in place and are often available in different colours. Fixed braces can usually be used on both your upper and lower teeth.
Orthodontic treatment isn’t suitable for everyone. Ask your dentist or orthodontist to explain the options available to you.
Can I have my silver fillings replaced with white ones?
Yes, it's usually possible to replace a silver (amalgam) filling with a tooth-coloured (composite) alternative. But often it’s best to wait until your dentist tells you a filling needs replacing.
If you have an amalgam filling that’s very noticeable when you talk or smile, you may wish to replace it with a tooth-coloured one. However, if you have good quality amalgam fillings, your dentist may encourage you to wait until they need replacing.
Amalgam fillings are very hard-wearing, so are often used for the chewing and grinding surfaces of your back teeth (molars). Although composite fillings are strong, they are less hard-wearing than amalgam ones. Therefore, your dentist may recommend not using white fillings in places like your back teeth.
However, dentists can now use new materials to make tooth-coloured fillings that may last almost as long as amalgam ones. Speak to your dentist if you would like more information about white fillings. They will be able to advise you on which type of filling is the most suitable for you.
Can anything be done about the gap between my front teeth?
Yes – there are a number of options available to disguise or reduce the gap between your front teeth. Your dentist will be able to recommend the most appropriate treatment for you.
The technical name for a gap between your front teeth is a diastema. A diastema can occur if you have small teeth and a slightly larger jaw. It can be disguised by reshaping your front teeth with fillings or veneers, or it can be closed using orthodontic treatment.
Veneers are coverings made of porcelain. They can be fixed onto your teeth to close the gap. First, your dentist will remove a small amount of the top layer of your tooth (enamel). He or she will then attach the veneers to your existing teeth.
It may be possible to use orthodontic treatment to close the space. Orthodontic treatment isn’t suitable for everyone, so ask your dentist or orthodontist for advice.
Closing up a gap can make a big difference to your overall appearance. Speak to your dentist if you’d like to know more about your treatment options.
I'm getting a veneer fitted. Will my tooth look odd between appointments?
If you’re having a veneer fitted, it’s unlikely that your tooth will look any different between appointments.
Your dentist will remove a thin layer of enamel from the surface of your tooth to prepare it for a veneer. This is to make sure the veneer can be fixed into place later. Your tooth shouldn’t look very different to usual but it may feel a bit rougher than before.
It’s unlikely, but your dentist may offer you a temporary veneer in some situations. For example, if your tooth feels more sensitive than usual, your dentist may make a temporary veneer for you to wear until the second appointment.
Talk to your dentist before starting the treatment if you have any concerns.
- Cosmetic treatments. White fillings. Treatment and brace types. British Dental Health Foundation. Different filling materials. www.dentalhealth.org, accessed 27 March 2014
- Why orthodontics. Removable appliances. Conventional removable appliances. British Orthodontic Association. www.bos.org.uk, accessed 27 March 2014
- Crowns. British Dental Health Foundation. www.dentalhealth.org, accessed 20 March 2014
- Dental decay. British Dental Health Foundation. www.dentalhealth.org, accessed 28 March 2014
- Different filling materials. British Dental Health Foundation. www.dentalhealth.org, accessed 27 March 2013
- Mitchell D, Mitcheel L, Brunton P. Oxford handbook of clinical dentistry. 4th ed. Oxford: Oxford University Press; 2005:84−5, 132, 158, 182−8, 266−7, 313, 316−7
- Veneers. British Dental Health Foundation. www.dentalhealth.org, accessed 30 March 2014
- Statement on the safety and effectiveness of tooth whitening products. American Dental Association. www.ada.org, published April 2012
- Tooth discoloration. Medscape. www.emedicine.medscape.com, published 21 June 2013
- Tooth whitening. British Dental Health Foundation. www.dentalhealth.org, accessed 26 March 2014
- Hasson H, Ismail AI, Neiva G. Home-based chemically-induced whitening of teeth in adults. Cochrane Database of Systematic Reviews 2006, Issue 4. doi:10.1002/14651858.CD006202
- The justiﬁcation for orthodontic treatment. British Orthodontic Association. www.bos.org.uk, published 2008
- Conventional fixed appliances. British Orthodontic Association. www.bos.org.uk, accessed 20 March 2014
- Ireland R. Oxford dictionary of dentistry. Oxford: Oxford University Press; 2010: 111
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