Cosmetic dental treatments Q&As
Published by Bupa's health information team, September 2009.
Answers to questions about cosmetic dental treatments.
This section contains answers to common questions about this topic. Questions have been suggested by health professionals, website feedback and requests via email.
- Can I have all my grey fillings replaced with white ones?
- Can anything be done about the gap between my front teeth?
- I'm getting a veneer fitted. Will my tooth look odd between appointments?
Can I have all my grey fillings replaced with white ones?
It's usually possible to replace grey (amalgam) fillings with a tooth-coloured alternative. However, it may not be necessary to do so all at once or at all, particularly if you have good-quality amalgam fillings in teeth that don't show when you smile.
Explanation
Tooth-coloured fillings used to be considered too fragile for the chewing and grinding surfaces of back teeth (molars). Therefore, if you have fillings in your molars they are likely to be made of hard-wearing amalgam, which can appear grey or even black. However, advances in technology mean that tooth-coloured fillings are now much stronger than they used to be, although they may not be as durable as amalgam.
If you have an amalgam filling that is very noticeable when you talk, laugh or smile, you may wish to ask your dentist about the more attractive options available. He or she may suggest replacing the grey filling with a tooth-coloured one, or disguising the filled tooth with a crown.
If you have good-quality amalgam fillings that aren't usually visible, your dentist may encourage you to wait until they need replacing anyway. It may then be possible to use a tooth-coloured material to fill it instead.
If you're concerned about the mercury in amalgam rather than the appearance, you may actually prefer to keep your grey fillings. This is because drilling into amalgam causes mercury to be released. Dentists use suction and plenty of water spray when removing a filling to minimise the amount of mercury that is produced.
Further information
- British Dental Association - Smile
www.bdasmile.org - British Dental Health Foundation
0845 063 1188
www.dentalhealth.org.uk
Sources
- Mitchell DA, Mitchell L. Oxford handbook of clinical dentistry. 2nd ed. Oxford: Oxford University Press, 1995
- Chestnutt IG, Gibson J. Churchill's pocketbook of clinical dentistry. 3rd ed. Elsevier, 2007
Can anything be done about the gap between my front teeth?
Yes - there are a number of options available to disguise or reduce the gap between your front teeth. However, it's important to talk this through with your dentist because everyone is different. Your dentist will be able to recommend the most appropriate treatment for you.
Explanation
The technical names for a gap between your front teeth are a midline diastema, median diastema or incisal diastema. A diastema can be disguised by reshaping your front teeth with fillings or veneers, or closed using orthodontic braces.
Your dentist probably won't need to do any drilling of your teeth if you decide to have tooth-coloured fillings. The fillings are glued onto the sides of your teeth to build out the shape and close the gap. Closing up a gap can make a big difference to your overall appearance, so this could be a good option if you just want to see how it would look. If you decide that it doesn't suit you, tooth-coloured fillings can be removed.
Veneers are coverings made of porcelain. They can be made slightly wider than your natural teeth. The ceramic fills the gap when the veneers are cemented onto your teeth. Your teeth may need to be trimmed for the veneers to fit properly. This option involves more dental work and isn't as easy to reverse.
Sometimes it's possible to use orthodontic braces to push the front teeth together. However, it may be that the gap is caused by an unusually thick piece of gum tissue (fraenum) between your front teeth. If this is the case, your teeth are more likely to return to their original position after the braces have been taken off. To prevent this from happening, your orthodontist (a dentist who specialises in aligning teeth) may recommend removing the fraenum in a small operation (fraenectomy) just before fitting the braces. Once you have had the braces taken off, a wire will usually be cemented along the back of your front teeth, where it can't be seen, to stop the gap opening up again.
It may take months or even years to orthodontically correct the gap between your teeth. For some people it may not be possible. Ask your dentist or orthodontist for more advice.
Sources
- Mitchell DA, Mitchell L. Oxford handbook of clinical dentistry. 2nd ed. Oxford: Oxford University Press, 1995
- Chestnutt IG, Gibson J. Churchill's pocketbook of clinical dentistry. 3rd ed. Elsevier, 2007
I'm getting a veneer fitted. Will my tooth look odd between appointments?
Your dentist will try to make sure that your tooth looks as acceptable as possible during the time between your appointments. You can get a temporary veneer stuck on, but often this isn't necessary because only a very small amount of enamel (the white surface of your teeth) is shaved off to prepare your tooth for a veneer.
Explanation
Your dentist will shave off a thin layer of enamel from the surface of your tooth when preparing it for a veneer. The appearance won't be perfect while you wait for the veneer to be made but it shouldn't be too obvious. Try to plan with your dentist when you will have the veneer fitted so that you aren't waiting for it at the time of an important event or special occasion. Your tooth will be more sensitive to hot and cold because the outer layer of protection has been removed. It will also feel a bit rough against your tongue.
If your treatment means you need to have a greater thickness of tooth removed at the first appointment, the change in appearance may be more noticeable. It may be possible for your dentist to make a temporary veneer for you to wear until the second appointment.
Your dentist will try to make the veneer as lifelike as possible, but a temporary is usually made of acrylic and can be more likely to stain. Also, it will only be stuck on with weak cement because your dentist needs to take it off easily at the second appointment. This means it could come off unexpectedly, for example if you bite something too hard.
Talk to your dentist before starting the treatment about any concerns and any important events you have planned.
Further information
- British Dental Association - Smile
www.bdasmile.org - British Dental Health Foundation
0845 063 1188
www.dentalhealth.org.uk
Sources
- Chestnutt IG, Gibson J. Churchill's pocketbook of clinical dentistry. 3rd ed. Elsevier, 2007
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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 peer reviewed by 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: September 2009
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