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Cosmetic dental treatments

Published by Bupa's health information team, September 2009.

This factsheet is for people who are planning to have cosmetic dental treatments, or who would like information about them.

Cosmetic dental treatment includes any techniques used to straighten, lighten, reshape and restore teeth.

About cosmetic dental treatments
Cosmetic treatments to restore teeth
Tooth whitening
Veneers
Straightening teeth (orthodontic treatment)
Questions and answers
Related topics
Further information
Sources

About cosmetic dental treatments

Cosmetic treatments tend to look better and last longer in people who have healthy teeth and gums. So any tooth decay or gum disease should be treated before cosmetic dentistry begins.

Cosmetic treatments to restore teeth

Fillings, crowns, onlays, inlays, root fillings and veeners are used to restore decayed, worn or broken teeth or those affected by gum disease.

Tooth-coloured fillings

Fillings are used to fill holes (cavities) that have formed in your teeth, usually as a result of decay or tooth wear.

Tooth-coloured fillings can be used instead of amalgam (silver) fillings, making them a natural-looking alternative. They are often used in teeth that show when you smile or talk. They don't tend to last as long as amalgam, and so they aren't always recommended for the grinding and chewing surfaces of the back teeth.

Before you have your filling, your dentist will remove the decayed and weakened parts of your tooth using small drills, and clean the hole. With tooth-coloured fillings, your dentist may need to build the filling in layers, hardening each layer with a special blue light before placing the next. This technique takes a bit longer than having an amalgam filling done.

Tooth-coloured fillings must be kept completely dry while they set, so your dentist will take special precautions to keep saliva away from the area. This may include placing a sheet of rubber over your tooth (called a rubber dam).

Crowns, inlays and onlays

If a tooth has been broken or weakened by a large filling or a lot of decay, your dentist may recommend fitting a crown (or cap). A crown looks just like a healthy natural tooth. It is made in a laboratory and then glued over the top of the damaged tooth, to disguise it. For teeth near the front of the mouth, crowns are made of ceramic materials. Crowns on back teeth may be made of ceramic, gold or a gold/porcelain combination.

Inlays and onlays are similar to fillings (in that they fill a hole in your tooth). However, like crowns, they are made in a laboratory and then cemented to the tooth with special glue. Inlays and onlays are strong and can be an attractive alternative to amalgam fillings. They are suitable for the grinding surfaces of the back teeth and can be made out of gold, porcelain or tooth-coloured filling material.

The process of preparing and fitting crowns, inlays and onlays requires two visits to the dentist.

For more detailed information on cosmetic treatments to restore teeth, see Related topics.

Tooth whitening

There 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 toothpastes

This type of toothpaste is slightly abrasive, which may help to remove surface staining, but they don't alter the natural shade of your teeth. Experts are currently reviewing how effective whitening toothpastes are.

Over-the-counter (OTC) kits

OTC kits are sold in most major pharmacies 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.

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 bleaching

This 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 may be stronger and therefore more effective. Your dentist will give you tubes of bleaching gel and detailed instructions. It can take up to four weeks to achieve the colour you want.

There is some evidence that OTC home bleaching products work, but some products may be better than others. Possible side-effects of home bleaching include tooth sensitivity and gum irritation. Also, the long-term effects of using these techniques aren't known. Home bleaching is only recommended when done in consultation with your dentist.

'Power' or 'laser' bleaching

This is done in the dentist's surgery. Your dentist will 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 to try to enhance the whitening process. The bleach is much stronger than in a home kit, and so it is much quicker (it takes about an hour). Again, sensitivity is a common side-effect.

Internal bleaching

Internal bleaching involves placing a bleaching product inside a 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, your 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.

For more detailed information on all tooth whitening methods, see Related topics.

Veneers

If one of your front teeth is chipped, damaged or discoloured, a thin layer (veneer) of porcelain can be made to fit over it. In some cases, 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 need two visits to the dentist - on the first your dentist will take a mould of your tooth, which is then sent to a laboratory to make the veneer. 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 due to an accident, break or chip. The edge of a veneer may be fragile, so you should try not to bite your nails or other hard materials, such as ice, or tear sticky tape with your teeth.

Straightening teeth (orthodontic treatment)

Orthodontics is the branch of dentistry that specialises in straightening teeth. An orthodontist is a dentist who specialises in the prevention or correction of irregularities of the teeth. Orthodontic treatment usually involves wearing a brace (appliance). This puts gentle pressure on specific teeth to move them into the ideal place.

Orthodontic treatment is quite slow, and usually takes one to 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. Removable braces may also be made from a clear, see-through plastic, which is nearly invisible. They are mostly 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 meal times and at night.

Fixed braces (sometimes known as 'train tracks') can't be removed except by your orthodontist. They are made of small brackets that are stuck with filling material 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 filling material are cleaned off the teeth.

Orthodontic treatment is not suitable for everyone, so ask your dentist to explain the options available for you.

For more detailed information on straightening teeth, see Related topics.