Published by Bupa’s Health Information Team, September 2011.
This factsheet is for people who are having a cosmetic dental treatment, or who would like information about them.
Cosmetic dental treatments include any techniques that restore or improve the appearance of teeth.
You will meet the dentist carrying out your procedure to discuss your care. It may differ from what is described here as it will be designed to meet your individual needs.
Cosmetic dental treatments include techniques that restore, whiten or straighten your teeth. They are usually carried out by a dentist, but some require an orthodontist (a dentist who specialises in the prevention or correction of irregularities of the teeth).
If you have any tooth decay or gum disease, you will need to get this treated before you start cosmetic dental treatment.
Fillings, crowns and veneers can all be used to restore decayed, worn or broken 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 or general wear and tear. There are two types of fillings – amalgam (silver) and composite (tooth-coloured).
Amalgam fillings are made of a combination of metals including silver, tin, copper and mercury. Amalgam is extremely hard-wearing and can withstand the grinding and chewing action of your back teeth over long periods of time. 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, so aren't always recommended for the grinding and chewing surfaces of your back teeth.
Before you have a filling, your dentist will remove the decayed and weakened parts of your tooth using a small drill, and clean the cavity. With tooth-coloured fillings, your dentist may need to build the filling in layers, hardening each layer with a bright light before placing the next. This technique may take a bit longer than having an amalgam filling.
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 looks just like a natural tooth. It‘s made in a laboratory and then glued 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 need to have two appointments to have a crown fitted. At the first, your dentist will place a temporary crown over your tooth while you wait for the new crown to be made. 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, damaged or discoloured, a thin layer (veneer), usually made of porcelain, can be made to fit over it. Sometimes, if you have one or more teeth that are slightly crooked, veneers of varying thicknesses can be fitted to help them appear straighter.
You will usually need two visits to the dentist. At the first, your dentist will take a mould of your tooth, which is then sent to a laboratory for the veneer to be made. He or she will also remove a small amount of the top layer of your tooth (enamel). On the second visit, your dentist will cement the veneer onto the front of 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 lighten the surfaces of your teeth. There are a number of different bleaching methods available to lighten the natural shade of your teeth. Some you can buy and use at home, whereas others require a visit to your dentist.
Whitening toothpastes are slightly abrasive, which may help to remove surface staining, but don't change the natural shade of your teeth. Experts are currently reviewing how effective whitening toothpastes are.
Over-the-counter tooth whitening kits are sold in most major 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 in the gel is usually hydrogen peroxide. The kits will only contain weak hydrogen peroxide, so may not be as effective as the stronger products used by your dentist.
Always speak to your dentist before using an over-the-counter tooth whitening kit.
Professional bleaching is carried out by your dentist. It’s the most common type of tooth whitening and can be external or internal. If you have external bleaching, the gel is placed on the outer surfaces of your teeth. Internal bleaching involves your dentist putting the bleaching product inside your tooth. External bleaching is more common, as internal bleaching can only be used if you have had root canal treatment, making access to the inside of your tooth easier.
Power or laser bleaching can also be done by your dentist. He or she will place a rubber seal around your teeth to protect your gums. Then the bleaching gel is put onto your teeth and a special, bright light is used to speed up the whitening process. This treatment usually takes about an hour.
Possible side-effects of bleaching include tooth sensitivity and gum irritation. The long-term effects of using these techniques aren't known. All the bleaching techniques only whiten your teeth temporarily, so you will need to have more treatment if you want to maintain the colour.
Orthodontic treatment is used to straighten or move your teeth to improve their appearance or function. It can also help to keep your teeth and gums healthy by spreading the pressure of your bite out evenly. Straight teeth are easier to clean and are less vulnerable to tooth decay and gum disease.
Orthodontic treatment usually involves wearing a brace on your teeth. This puts gentle pressure on specific 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.
Removable braces are made of plastic and usually have wire clips and springs to move specific teeth. They are most 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 mealtimes and at night.
Fixed braces (sometimes called 'train tracks') can't be removed from your teeth – except by your orthodontist when your treatment is finished. They are made of small brackets that are glued to your teeth with filling material and are joined together with a wire. Fixed braces are usually made of metal, but can also be made of plastic or ceramic. You may need to have small elastic bands attached to your brace – these are used to keep the wires in place and are often available in different colours. Fixed braces can be used on both your upper and lower teeth.
Once the treatment is finished, your dentist will remove the brackets and clean the filling material off your teeth.
Orthodontic treatment isn’t always suitable for everyone. Ask your dentist to explain the options available to you.
For answers to frequently asked questions on this topic, see Common questions.
For sources and links to further information, see Resources.
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This information was published by Bupa's Health Information Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition. The content is intended only for general information and does not replace the need for personal advice from a qualified health professional. For more details on how we produce our content and its sources, visit the About our Health Information page.
Publication date: September 2011
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