We all want that perfect smile. We’re bombarded with images of beautiful people with straight pearly whites and as a dentist, I get daily requests to make teeth whiter and straighter. And why not? One of the first things we notice about a person is the sparkle in their smile.
We have all seen the emotional smile makeovers on TV and although this often means drilling away good tooth tissue compared to going under the knife, it doesn’t seem like such a big deal. Many celebrities have sought quick fixes to dramatically improve their smiles using veneers. These are thin porcelain facings stuck to your natural teeth to mask the colour, shape and overall look of your current smile. Done well, they significantly improve the appearance of your teeth in a matter of weeks. Having said that, veneers come with serious risks that could cause permanent damage to your teeth, smile and health so before you jump on that bandwagon, let’s discuss the good, the bad and the downright ugly.
So what are the risks? In order to create space for the porcelain, a certain thickness of enamel is shaved off. The drilling process creates immense heat which can damage the teeth, causing irreversible inflammation of the nerves resulting in nerve death. When this happens, the dead tissue turns to pus and an infection develops. This can appear as a small abscess or can spread to your eyes, your throat and even your lungs, and in extreme situations cause death. In less extreme situations, the outcome of nerve death would be a lengthy root canal treatment. Ultimately, the tooth becomes a dark grey or black colour which can sometimes show through a veneer. Research has shown that one in five teeth that undergo this treatment will undergo nerve death.
Treatment cost is high, with a typical veneer smile makeover costing £5000+. Veneers are at risk of fracture and may even pop off unexpectedly. They need replacement every 10-15 years, which leads to accumulating costs. In addition, decay can form around the edges, which means they need replacement and further drilling of what was once healthy tissue. Veneers are categorised as an irreversible treatment. Once they are on, there is no going back. So what’s the alternative?
Patients often turn to veneers because they have crowding, overlapping, sticking out or ‘yellow’ teeth. The option of wearing braces can be unappealing as they don’t want to have the metal in their mouth for several years as adults. However there are simple, rapid and safe alternatives including treatment with the Inman Aligner that can straighten crooked front teeth in as little as 6-16 weeks. This is a removable orthodontic appliance worn for 16 hours a day to gently move teeth into the correct position. Significant changes can be seen, and combined with teeth whitening, patients can now achieve rapid, progressive smile makeovers in a safe and cost effective way with much fewer risks than treatment with the drill. 9 week cases: Bonding is another option, or the use of composite veneers, where white filling material is layered on top of the existing tooth to create the shape and colour desired. These require much less thickness than porcelain and therefore are often reversible. The downside is they may chip and discolour faster than their porcelain counterparts.
Other short-term orthodontic treatment options include Fastbraces, Six months Smiles, CFast and many more that come in a clear brace to straighten teeth without the traditional metal brackets. Martin Kelleher, a dentist acutely aware of the dangers of aggressive veneers wrote an article entitled ‘The daughter test’ in the Dental Update Journal, 2010 stating “This test asks the question, whenever one is contemplating elective intervention that involves tooth destruction: ‘Knowing what I know about dentistry and the effects of this elective treatment on the health and structure of the teeth in the long term, would I carry out this treatment on my own daughter?’ I don’t know of any sensible, experienced, ethical dentist who would elect to do invasive and destructive treatment on anyone they cared about if there were reasonable alternatives.” So whilst there are certain indications for veneers, there are often alternatives for those are seeking a rapid smile makeover to fix crowding.
Ultimately, your dentist should place your long-term health and safety first. Knowing about these safe alternatives and discussing them in detail with your dentist will ensure that you make the right decision to achieve the smile you’ve always wanted.
About The Author Yusra Al-Mukhtar BDS (Hons) BSc (Hons) MFDS RCS Ed MJDF RCS Eng. Yusra qualified as a dentist from Kings College London in 2010 and completed her BSc in Medical Science and Management at Imperial College London in 2008. She is an active member of the dental community and holds a Diploma for Membership of the Faculty of Dental Surgeons and the Faculty of General Dental Practitioners at the Royal College of Surgeons of Edinburgh and England. She works in private practice, NHS practice and teaches oral surgery in a trauma unit in a leading London hospital. Yusra has an interest in simple orthodontics and aesthetic dentistry. She is involved in ongoing research with the Saving Faces charity. She is a keen supporter of the Safety in Beauty Campaign.