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Dentistry: Winning smile

30 Apr 2014 by BusinessTraveller
Great-smile

The days of an Austin Powers-style grin being considered a charming British quirk are long gone. According to a King’s College London study, bad teeth can even hold you back career-wise. Tim Newton, professor of dental psychology at King’s, says: “Research shows that we assume people with healthy-looking, attractive smiles are clever, popular and well-adjusted. One study we did found people with whiter teeth were rated as being more intelligent, so your teeth may even make the difference between getting a job or not.”ave you become adept at smiling without opening your mouth? You’re not the only one – according to an NHS survey, about one in seven people in the UK are so unhappy with their teeth that they feel self-conscious about smiling.

About 27 per cent of 45- to 54-year-olds have opted for cosmetic work, according to a recent survey by the British Academy of Cosmetic Dentistry. Dr Tif Qureshi, an academy spokesman, says: “It’s no longer socially acceptable to have poor teeth, especially if you work in countries such as America and Germany, where there are high standards of dentistry. Bad teeth are also incredibly ageing.”

Men now make up 50 per cent of patients and, to meet demand, many dental surgeries have introduced flexible appointment schemes with more evening and weekend slots.

Cosmetic dentistry is rarely available on the NHS, unless there is a “clinical” need for it – if a missing tooth is causing a misaligned bite, for example. Prices in Eastern Europe are cheaper – a full set of veneers that would cost £10,000-£20,000 in the UK are £2,500-£4,000 in Hungary. But it’s not for the faint-hearted – to keep visits to a minimum, you could spend up to eight hours in the chair rather than spreading the work over several sessions.

“I have seen good results from abroad but the issue I have, especially in more complex cases such as implants, is what happens if something goes wrong?” Qureshi says. “In the UK, you have recourse to the General Dental Council, which investigates every complaint. If you go abroad, you’re on your own.”

Still, treatment doesn’t necessarily have to be expensive. Dr Uchenna Okoye, clinical director of the London Smiling Dental Group (londonsmiling.com) says: “It’s true that you can spend £15,000 on a full smile makeover. But you can make a significant improvement to the way your teeth look for under £1,000.”

White fillings

“Changing your fillings from metal to white instantly brightens your whole mouth,” Okoye says. “If you can’t afford to get them all done, do your bottom teeth first as these are most visible.” White fillings are made from a composite material (powdered glass quartz, silica or other ceramic particles added to a resin base) that is as long-lasting as metal (amalgam) fillings. The material will also be matched to the colour and surface of your own teeth.

Cost Front teeth available on the NHS, otherwise £30-£150 per filling depending on the work involved.

Clinic time Usually one visit. “You’ll need a local anaesthetic in the gums, so if there’s a lot to do, opt for two visits and do one side at a time,” Okoye says.

Where to go Available at most dentists.

Worth the investment? “A large metal filling can cast a grey shadow over the whole tooth, so it only takes three or four to darken your smile,” Okoye says.

Hygienist clean

The hygienist’s clean has evolved over the past decade, which means as well as removing plaque, it can also leave teeth looking whiter. “Most hygienists use ultrasonic scalers that can remove stains in hard-to-reach places,” says hygienist Michaela ONeill, from the British Society of Dental Hygiene and Therapy. “Many use air-polishing systems, which fire a powerful jet of minute sodium bicarbonate crystals.”

Cost £17-£47 on NHS, up to £85 privately.

Clinic time About 45 minutes. Depending on your eating and drinking habits, results last about six months.

Where to go Ask your dentist for a referral to an NHS hygienist. The High Gloss Diamond Polish treatment (£89) is available at the UK’s first walk-in hygienists, Smilepod (smilepod.co.uk).

Worth the investment? “If you’re thinking of having your teeth whitened, have a hygienist clean first. It’s cheaper,” ONeill says.

At-home whitening

Over the years, the protective enamel thins, so teeth become more prone to stains – professional tooth whitening can take your teeth up to eight shades lighter. A custom-made home kit from your dentist costs less than half the price of having laser whitening. It can also be more effective, Qureshi says, as “it penetrates the tooth surface so gives a longer-lasting lift in colour”.

The key is in the trays – as they’re made to fit your teeth, the active ingredient (a peroxide gel) has maximum contact with tooth surfaces but minimum contact with gums, reducing sensitivity.

Qureshi adds: “Getting a custom-made kit from your dentist ensures you’re whitening safely. Beauticians are not licensed to use hydrogen peroxide so they often use chlorine dioxide instead, which can burn the teeth and leave them pitted and stained.”

Cost About £250-£350 (not available on NHS), which usually includes enough whitening gel for a top-up treatment (extra syringes of whitener cost about £50). The effects last 12 to 24 months, depending on your lifestyle (smoking is considered the biggest tooth stainer, with tea and coffee a close second).

Clinic time Two visits – one to take an impression of your teeth, and a second to check that the tray fits. You’re then sent home with gel to use once or twice a day for two to three weeks.

Where to go Most dentists offer it.

Worth the investment? “I’d advise anyone who’s unhappy with their teeth to have them whitened first before considering any other cosmetic procedure – it’s amazing what a difference it can make,” Qureshi says.

Fix a chip

Advances in dental materials over the past five years mean it’s now possible to fix a chipped tooth with cosmetic bonding rather than a veneer. Okoye says: “It’s a cheaper solution and doesn’t involve removing any of the tooth’s surface.” A small amount of dental composite, a mouldable paste made from acrylic resin, is applied to the surface and shaped, then set with a bright light. It can also be used to fill in small gaps and to lengthen teeth.

Cost About £150. It’s not available on the NHS.

Clinic time One visit.

Where to go As the bonding is shaped by hand, a dentist with an artistic eye will get the most natural result. Visit bacd.com for a list of cosmetic dentists.

Worth the investment? A quick and easy way to even out a crooked smile.

Veneers

A veneer is a thin piece of porcelain that fits over your tooth after part of the surface has been removed. They’re good for permanently stained, chipped or pitted teeth, particularly the most noticeable ones at the front, or for lengthening short teeth. They are hard-wearing and long-lasting. Early veneers often looked a bit “tombstone” but the latest ones look natural.

Cost £500-£800 per veneer. Not available on the NHS.

Clinic time Two visits – one to prepare the teeth and design the veneers, one to have them fitted.

Where to go Choose a dentist who does a lot of cosmetic work.

Worth the investment? It’s not for everyone but it can make a difference to stained or pitted teeth.

Fill in a gap

A single implant can eliminate a noticeable gap caused by a lost tooth. Dr Gary Moynes, clinical director of the New Tooth Company, says: “Until recently, your options were wearing a denture, or having a bridge fitted, which involves the teeth either side of the gap being filed down and fitted with crowns. But now you can have a single implant that looks, feels and functions like a normal tooth.” The treatment involves screwing a titanium post into the jaw, allowing it to heal, then bonding a crown on to it.

Cost Generally £1,500-£2,000 per implant, but they’re available for about £995 per tooth at the New Tooth Company. “We do nothing but implants and because we treat a high volume of patients we can keep our costs competitive,” Moynes says. Not available on the NHS.

Clinic time Not a quick fix. Treatment involves about four visits, but there may be a gap of three to six months between the post being fitted into the jaw and the tooth being attached, depending on how quickly you heal (you’re fitted with a denture in the meantime to disguise it).

Where to go Make sure you see a dentist who specialises in implants. “Ask what qualifications they have and how many implants they have carried out. They should show you before and after pictures,” Moynes says. The New Tooth Company is based in Maidstone, Kent (thenewtooth.co), or see the website of the British Academy of Dental Implantology (badi.org.uk) or the Association of Dental Implantology (adi.org.uk).

Worth the investment? Worth considering if you’ve got a noticeable gap.

Gum reshaping

Sometimes it’s your gums that need work rather than your teeth, says Dr Maurice Johannes, from the Harley Street Smile Clinic (harleystreetsmileclinic.co.uk). “If there’s too much gum on show, it can detract from even nice, straight teeth. Or sometimes the gum levels are uneven – higher on one tooth than another, creating an imbalance. Gum sculpting can give a more symmetrical look.” Done with a laser, which seals the wounds naturally, there is no need for an anaesthetic and results are instant.

Cost £85 per tooth.

Clinic time Usually one visit. “There is little or no downtime as the gums heal very quickly,” Johannes says. Not available on the NHS.

Where to go Choose a dentist who concentrates on cosmetic work and ask to see before and after pictures or patient testimonials.

Worth the investment? If an uneven gum line is your main issue, it can make a big difference.

Invisible brace

Overcrowded teeth can trigger health problems such as jaw or neck pain and headaches. “If your bite is misaligned, you will clench or grind as a reflex response, which can cause the deep facial muscle controlling the jaw to go into spasm and the muscles around the neck to overwork to compensate,” Okoye says.

Adult orthodontics has become one of the biggest growth areas in dentistry since the introduction of “invisible braces” such as Invisalign or the Inman Aligner. Instead of a traditional ceramic bracket, which is held in place by a fine metal wire, a clear plastic mould is used to apply pressure on the teeth.

Okoye says: “Apart from being aesthetically more pleasing, you also take it off when you eat or clean your teeth, so it’s better for teeth health. It’s also fine to take it out for the odd party.” Invisalign is best for mild to moderately quirky teeth. For more complex problems, you can now opt for fixed lingual braces behind the teeth that aren’t visible. For the full works, opt for an ABB (align, bleach, bond) – teeth are straightened and whitened, and any chips evened out by bonding.

Cost £1,500-£6,000

Clinic time An ongoing commitment -– you will need to visit regularly to have your appliance adjusted as your teeth move, usually every six weeks. Complex cases can take up to two years.

Where to go To find an orthodontist near you, contact the British Orthodontic Society (bos.org.uk).

Worth the investment? “Slight crookedness that you tolerated at 30 may be far more noticeable by the time you’re 45,” Okoye says.

Man-smile

CASE STUDIES

Alexander Adams, 45, opted for a full smile makeover in 2013. “I was given tetracycline, an antibiotic, for a childhood illness in the days before they knew it permanently damaged teeth developing in the gums. My adult teeth grew with yellow-grey staining, and were soft and prone to decay.

“In 2011, I went for a couple of hospitality jobs and got turned down. I asked for feedback from one, and they said it was my teeth that let me down.

“I went to Uchenna Okoye, opting for a full set of veneers on my top teeth. The impact on my confidence has been enormous – I smile more, I’m no longer self-conscious and my body language has become more open. So far I’ve spent about £16,000 (including other treatments) but it’s already paying off – I’m now earning twice as much as I was two years ago.” londonsmiling.com

Business Traveller’s Rose Dykins underwent sodium perborate and laser teeth whitening earlier this year. “This method doesn’t use peroxide and is designed to bring back the natural whiteness of your teeth without damaging the enamel. I attended Aesthetics of London’s clinic in the Strand [the company also has branches in Fenchurch Street, Stratford and Croydon], where sessions cost from £249. Gel was applied to my teeth, then a laser lamp was positioned over them for three 15-minute sessions. Immediately afterwards, I couldn’t see a difference, but days later, my teeth looked about two shades whiter.” aestheticsoflondon.com

Business Traveller’s JENNY SOUTHAN visited the Soho outpost of London’s Smilepod to get set up for a two-week course of home whitening (£299). “First, there was a free consultation. Then I had to have custom moulds of my upper and lower teeth made, returning a week or so later when they arrived to check they fitted. After, I was sent away with a pack of Philips Zoom whitening gel syringes (the product has 16 per cent carbamide peroxide) after being shown how to apply a small dot to each of the tooth imprints in the trays.

“I was also advised to begin using sensitive toothpaste and to avoid red wine, coffee, tea and curry, which can stain. As I had to wear the (discreet) clear trays for two to three hours a day, I chose to do it at my desk at work. Although my teeth were already in good condition, I immediately noticed the whitening effect, which gradually intensified over the days. I did experience a couple of painful ‘zings’ and some mild gum irritation, and while it was quite an inconvenient treatment, it did have the desired effect, whitening my teeth several shades.” smilepod.co.uk

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