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Cosmetic dental treatmentsPublished by BUPA's health information team, healthinfo@bupa.com, August 2007. This factsheet is for people who would like information about different treatments that can be used to straighten, whiten and re-shape teeth.
What are cosmetic dental treatments?Cosmetic dental treatments can improve the appearance of your teeth. 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 begins. Tooth coloured fillingsFillings 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 tough 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 whiteningThere 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 toothpastesThis type of toothpaste is slightly abrasive, which may help to remove surface staining. However, it doesn't alter the natural shade of your teeth. Over-the-counter (OTC) kitsOTC kits are sold in most major chemists throughout the UK. In general, they contain rubber mouth trays (moulds that are approximately the same shape as your teeth) and tubes of bleaching gel. After squeezing some of the gel into the mouth trays, you place them over your teeth, usually for about 30 minutes at a time, but this does vary between products. 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 bleachingThis is similar to the OTC kit method, but with two main differences. Firstly, your dentist makes rubber mouth trays 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" bleachingThis is done in the dentist's surgery. Your dentist may 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 treatment may be used in combination with the home bleaching method for some people. Internal bleachingInternal 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 make a hole in the tooth and put the bleaching product into this 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. VeneersIf a front tooth is chipped, damaged or discoloured, a thin layer (veneer) of ceramic material, such as 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 one or two weeks 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 a break or chip. The edge of a veneer may be fragile, so you should try not to bite your nails or tear sticky tape with your teeth. Orthodontic treatmentThe way that our teeth bite together is called the occlusion, and people who have crooked or crowded teeth have a malocclusion. The branch of dentistry that specialises in aligning teeth is called orthodontics. Orthodontic treatment usually involves wearing a brace (appliance). This puts gentle pressure on specific teeth to move them into the right place. At the initial appointment, your orthodontist will do a very detailed dental examination. If you have any decayed teeth, these will need to be treated by your dentist before orthodontic treatment starts. Orthodontic treatment usually takes between one and two years, depending on the severity of the problem. There are different kinds of braces. Some can be removed while others are fixed in place. Removable braces are made of plastic and usually have wire clips and springs to move specific teeth. In most cases, they are used to move upper teeth. A removable brace must be taken out to be cleaned, but it should be worn at all other times, including mealtimes and at night. Fixed braces (sometimes known as "train tracks") can't be removed. They are made of small brackets that are glued to the teeth and joined together with a wire. Fixed braces can be used on upper and lower teeth. Once the treatment is finished, the brackets and glue are cleaned off the teeth. A relatively new type of orthodontic treatment allows teeth to be straightened using removable, see-through, plastic aligners (eg Invisalign). This treatment is not suitable for everyone. Further information
Sources
Related topicsThis information was published by BUPA's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Dr Brian Franks BDS (U. Lond) LDS RCS (Eng) MFGDP (UK) FPFA ACIArb, clinical director (dentistry) BUPA Wellness and other BUPA doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional. Publication date: August 2007. Expected review date August 2009.
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