Teeth: Give your mouth a makeover

Suffering from 'British teeth'? More of us are opting for expensive treatments to fix a wonky or off-colour smile – but which are worth the money?

Teeth whitening

Up to 100,000 people undergo some form of teeth-whitening treatment each year, 10 times more than five years ago. It's hardly surprising as whitening can make a dramatic difference. But how do you choose between low-cost toothpaste and other over-the-counter products at one end, and high-cost dental procedures?


Use whitening toothpaste to get rid of everyday stains. Ask your dentist about home bleaching kits such as Optident (around £700). He or she will prepare a rubber mouth tray you fill with bleaching gel and wear for several hours each day over several weeks. "It's the best-researched method," says Professor Andrew Eder, consultant in restorative dentistry at the Eastman Dental Hospital and director of the London Tooth Wear Centre.


Try DIY bleaching using baking soda or hydrogen peroxide, or by rubbing salt in your teeth, as recommended by users of several websites popular with teenagers. "These are abrasives that with repeated use will wear away the white enamel and eventually leave the tooth browner and with increased sensitivity," Professor Eder says. And don't be talked into expensive laser treatment – "there's little evidence to support its use," he says.


Absolutely everyone going on a cosmetic-style reality television show gets veneers, the wafer-thin laminates made from po rcelain, ceramic or composite bonding material that are cemented to the front of a tooth like a false fingernail on a nail.

Veneers can spectacularly improve discoloured, chipped or broken teeth. Yet they are dangerous in unskilled hands, particularly when dentists offer to provide a whole mouthful of veneers at a suspiciously low price.

Many widely promoted procedures require dentists to destroy "vast amounts of sound, hard tooth tissue", even sometimes "drilling a sound tooth down to a stump", according to Dr Martin Kelleher, a consultant in restorative dentistry at Guy's, King's & St Thomas' Dental Institute. Nearly one in five teeth becomes "dead" within five years of being prepared for a veneer, according to recent studies – making them far more likely to become infected and cause permanent problems.

"Many dentists offer veneers after a one-day hotel course, which I believe is wrong," says Shaun Smith, senior partner at The Dental Surgery in the City of London.

It's little comfort for patients with continuing dental problems that, according to Dr Kelleher, there's been a "huge increase in settlements in cases involving aesthetic treatment when this has not led to patient satisfaction".


Ask your dentist if he or she would recommend the veneer project for his or her own daughter. This "daughter test" should be an essential element of "clinical decision-making in this difficult and complex area", says Dr Kelleher, writing in the journal Dental Update. "At its simplest, it asks the question: 'Knowing what I know about what this procedure would involve to the teeth in the long term, would I carry out the procedure on my own daughter?'" It is curious, he says, how often the answer is no.

Be prepared to pay for the best

Take your time to have a veneer or crown. Find a dentist who is not going to rush you and who is ready to try non-invasive methods such as white fillings, tooth whitening or braces.


Choose a veneer that is whiter than the whites of your eyes. "We've got used to whiter teeth over the last 10 years and our smiles have got wider," Shaun Smith says. "But you still don't want to be too white."


The heavy metal brace that once characterised the early teenage look is now increasingly rare. But braces are used far more widely today than ever before: they are simply invisible. They are also far safer than invasive procedures. The downside is that the best braces have been patented by US companies which remain the sole manufacturers. As a result, the cost of modern braces tends to be high – around £3,000 on average, though costs vary between practices.

* The Inman Aligner uses nickel titanium springs to provide a constant gentle pressure that squeezes teeth together by pushing and pulling them into alignment. Dentists recommend it for frontal overcrowding or for teeth that protrude or need rotating.

* Invisalign is a series of removable, clear aligners that straighten teeth. Patients graduate to a new set of aligners every two or three weeks.

* Six Month Smiles straightens the most prominent teeth and so can't be used on back teeth or to change the bite. Tooth-coloured brackets and invisible wires cause tooth movement to occur two to three times faster than standard methods, it is claimed.

Cracked teeth

This occurs as a result of severe grinding or clenching of the jaw, largely caused by stress – though ecstasy use is a also a risk factor. "Working in the City makes this a common problem in my practice," Shaun Smith says. "People clench their teeth so hard they crack healthy teeth right down to the root. It can be a huge problem, causing facial pain and headaches as well as dental damage."

Treatment options

Discuss the need for stress management with your dentist or GP. Try a nightguard to prevent grinding, and consider dental treatment, such as a veneer, crown, or cap, to eliminate the crack. A root filling may be needed in extreme cases.

Tooth erosion

Another modern problem caused mainly by acid in fizzy drinks or from acid reflux (a frequent effect of hiatus hernias), or in alcohol, fruit and salad vegetables. Mild cases cause blotches and discoloration. More severe erosion slowly dissolves teeth, making them shorter or misshapen. One in two children has tooth erosion, according to the most recent Child Dental Survey. In adults, it can cause the lips almost to disappear. Treatment can be "like having a face lift or lip fillers", Professor Eder says.

Treatment options

Lifestyle changes are essential. Tooth-coloured fillings may help. Veneers, or in extreme cases crowns, may be required.

Top tips to stop tooth erosion

* Don't swish fizzy drinks around your mouth – use a wide straw whenever possible.

* Don't sip acidic drinks over a long period. The acid stays in your mouth for an average of 45 minutes and sipping on a can of cola over several hours keeps your teeth in an acidic bath.

* Don't clean your teeth within 45 minutes of consuming anything acidic or you'll push the acid into the enamel.

tooth crowding

Your lips, cheeks and lower jaw change as you grow older, causing your teeth to become more crowded or to move forward, especially in the lower jaw. "These soft tissue changes can occur because of normal ageing or teeth that have been straightened in early life can relapse at a later stage," says Dr Neera Maini of the Aqua Dental Spa in west London.

Treatment options

A brace often works best. Dr Maini advises following it with a "retainer", an invisible wire device fixed to the back of the teeth to keep the changes in place. Treatment may involve extracting a tooth. Don't be rushed into this – if it is necessary, it requires careful planning.

Suggested Topics
Professor David Nutt wants to change the way gravely ill patients are treated in Britain
people Why does a former Government tsar believe that mind-altering drugs have a place on prescription?
Norway’s ‘The Nordland Line – Minute by Minute, Season by Season’ continues the trend of slow TV
television The BBC have commissioned a series of programmes doing away with high-production values, commentary, script or drama
Arts and Entertainment
Jonny Evans has pleaded not guilty to an FA charge for spitting at Papiss Cisse
Life and Style
ebookNow available in paperback
ebookPart of The Independent’s new eBook series The Great Composers
Latest stories from i100
Have you tried new the Independent Digital Edition apps?

ES Rentals

    Independent Dating

    By clicking 'Search' you
    are agreeing to our
    Terms of Use.

    iJobs Job Widget
    iJobs General

    Ashdown Group: Technical Presales Consultant - London - £65,000 OTE.

    £65000 per annum: Ashdown Group: Technical Presales Engineer - central London ...

    Recruitment Genius: Physiotherapist / Sports Therapist

    £20000 - £50000 per annum: Recruitment Genius: A Physiotherapist / Sports Ther...

    Recruitment Genius: Sales Executive / Advisor

    £8 - £9 per hour: Recruitment Genius: Sales Executives / Advisors are required...

    Recruitment Genius: Warehouse Operative

    £14000 - £15000 per annum: Recruitment Genius: An opportunity has arisen for a...

    Day In a Page

    Homeless Veterans campaign: Donations hit record-breaking £1m target after £300,000 gift from Lloyds Bank

    Homeless Veterans campaign

    Donations hit record-breaking £1m target after huge gift from Lloyds Bank
    Flight MH370 a year on: Lost without a trace – but the search goes on

    Lost without a trace

    But, a year on, the search continues for Flight MH370
    Germany's spymasters left red-faced after thieves break into brand new secret service HQ and steal taps

    Germany's spy HQ springs a leak

    Thieves break into new €1.5bn complex... to steal taps
    International Women's Day 2015: Celebrating the whirlwind wit of Simone de Beauvoir

    Whirlwind wit of Simone de Beauvoir

    Simone de Beauvoir's seminal feminist polemic, 'The Second Sex', has been published in short-form for International Women's Day
    Mark Zuckerberg’s hiring policy might suit him – but it wouldn’t work for me

    Mark Zuckerberg’s hiring policy might suit him – but it wouldn’t work for me

    Why would I want to employ someone I’d be happy to have as my boss, asks Simon Kelner
    Confessions of a planespotter: With three Britons under arrest in the UAE, the perils have never been more apparent

    Confessions of a planespotter

    With three Britons under arrest in the UAE, the perils have never been more apparent. Sam Masters explains the appeal
    Russia's gulag museum 'makes no mention' of Stalin's atrocities

    Russia's gulag museum

    Ministry of Culture-run site 'makes no mention' of Stalin's atrocities
    The big fresh food con: Alarming truth behind the chocolate muffin that won't decay

    The big fresh food con

    Joanna Blythman reveals the alarming truth behind the chocolate muffin that won't decay
    Virginia Ironside was my landlady: What is it like to live with an agony aunt on call 24/7?

    Virginia Ironside was my landlady

    Tim Willis reveals what it's like to live with an agony aunt on call 24/7
    Paris Fashion Week 2015: The wit and wisdom of Manish Arora's exercise in high camp

    Paris Fashion Week 2015

    The wit and wisdom of Manish Arora's exercise in high camp
    8 best workout DVDs

    8 best workout DVDs

    If your 'New Year new you' regime hasn’t lasted beyond February, why not try working out from home?
    Paul Scholes column: I don't believe Jonny Evans was spitting at Papiss Cissé. It was a reflex. But what the Newcastle striker did next was horrible

    Paul Scholes column

    I don't believe Evans was spitting at Cissé. It was a reflex. But what the Newcastle striker did next was horrible
    Miguel Layun interview: From the Azteca to Vicarage Road with a million followers

    From the Azteca to Vicarage Road with a million followers

    Miguel Layun is a star in Mexico where he was criticised for leaving to join Watford. But he says he sees the bigger picture
    Frank Warren column: Amir Khan ready to meet winner of Floyd Mayweather v Manny Pacquiao

    Khan ready to meet winner of Mayweather v Pacquiao

    The Bolton fighter is unlikely to take on Kell Brook with two superstar opponents on the horizon, says Frank Warren
    War with Isis: Iraq's government fights to win back Tikrit from militants - but then what?

    Baghdad fights to win back Tikrit from Isis – but then what?

    Patrick Cockburn reports from Kirkuk on a conflict which sectarianism has made intractable