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Information about teeth whitening, braces and veneers

Beautiful Teeth and How to Get Them (According to an Expert)

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Although the idea of a perfect smile is subjective- and I never notice anyone else’s teeth even 1 per cent as much as I notice the flaws in my own- having had braces when I was teenager I was pretty happy with them until I started to notice they’d started to move slightly out of alignment a couple of years ago.

And even though I’m not sure if I’m really up for having braces again (I think the flashbacks to my 13-year-old hair and wardrobe choices is enough to put me off), with a constant stream of social media images of perfect-looking teeth it seems I’m not alone in feeling a little self-conscious of my own pearly whites; with cosmetic dentistry predicted to grow by 5 per cent a year globally.

So I’m interested to know how to keep my teeth as healthy as I can at home, as well as my options for a slightly more ‘grammable smile if I did go down the route of whitening, veneers or braces.

A quick Google tells me I’m not alone in having a ton of questions about everything from how to best look after teeth at home to the safest forms of teeth whitening, the pros and cons of veneers, and even options for braces.

So I’ve enlisted the expert help of dentist Dr Stephanie Downes to give me answers to pretty much every question I’ve ever had about looking afer teeth.

Here’s what I learned…


Beautiful Teeth Are Healthy Teeth

While I was worried good teeth = expensive, happily it sounds like there’s quite a lot I can do myself to get teeth looking good and avoid yellowing or tooth movement without even visiting the dentist.

The First Step

According to Dr Downes, “tooth health drastically impacts good-looking teeth. Untreated tooth decay will cause discolouration, staining and thin teeth that can break causing uneven edges. Unhealthy gums will cause smelly breath, tooth movement and eventual tooth loss.”

Cleaning Tips

So what are her tips both for anyone lucky enough to already be happy with their smile and for those who want to enhance theirs? “An excellent oral hygiene routine twice daily using a combination of a toothbrush and something in between your teeth.”

And while I’ve been using an electric toothbrush for years now I was always unsure whether I should be buying a cheapie replaceable model or invest in one of the uber fancy ones that costs hundreds.

According to Stephanie the price isn’t the important thing though as long as I choose electric over manual. She tells me, “it doesn’t need to be expensive but there is firm evidence that shows electric toothbrushes remove more plaque than manual ones. I personally have also found they reduce stain build up too.

Bad Breath

Good news for keeping teeth looking healthy, but what about for those already worried about bad breath or unhealthy gums? According to Dr Stephanie this can be the result of, “poor oral hygiene causing gum disease, untreated tooth decay and smoking.”

Luckily enough though, “you can turn bleeding gums around yourself within days by getting into a good daily routine and habits. This can stop the plaque building up, stop the bleeding and make your mouth feel and smell healthier.”

Something like tooth decay does need to be treated in office though, and Dr Stephanie recommends good oral hygiene and regular visits to both the dentist and dental hygienist.

Go with Recommendations

When we do visit the dentist though, especially if it’s someone we haven’t used before, what should we be looking out for to make sure we’re going to get the best care?

According to Stephanie, “It’s always good to speak to family, friends or colleagues for recommendations, that’s how I get the majority of my work. Check qualifications, their websites and go for a consultation. I think face to face meetings with people are invaluable, you can get a feel for the practice, what it offers and the dentist. You can normally tell if something does not feel right, it’s a bit old school but trust your gut.”

The Extra (S)mile

And for anyone already undergoing orthodontist treatment like Invisalign, Dr Downes advises taking extra care from home and on the go, saying, “my patients undergoing Invisalign teeth straightening carry a toothbrush and small toothpaste with them. However the little interdental brushes are small and have a little plastic case on them; perfect for handbags.”

  • Brush twice a day and floss or use interdental brushes/ a water pick
  • Choose an electric over manual toothbrush
  • Smoking harms oral health and can cause gum disease
  • Visit your dentist and hygienist for regular check ups
  • When choosing a new dentist try to get some recommendations from friends and family, and ask for a face to face consultation before undergoing any work
  • Carry a toothbrush or interdental brushes for on the go cleaning


Teeth whitening

So now I know exactly how important taking good care of my teeth is, what can I do to get them looking, well, whiter?

Go Professional

While home products like whitening toothpastes aren’t harmful, according to Dr Stephanie the only true way to whiten teeth is with a professional whitening system.

She also advises against buying any whitening systems, “not bought from a registered dental professional. You do not know what’s in the products, the correct application or if your teeth are suitable. These products have been known to destroy teeth and burn gums.”

Ouch, that’s something to steer clear of then.

Instead she advises, “realistically, the best and only true way to white teeth is through a professional teeth whitening system bought at a dental practice.

In Office or Trays?

So if you do get professional whitening what’s best- an in office treatment or those trays your dentist can give you? According to the expert, “my colleagues and I have found the custom made trays and a professional at home system give better colour stability and longer results. There is generally less sensitivity, however it does take longer to achieve the desired shade.”

Who Can Benefit?

Before you think about going down that route though, Dr Stephanie advises, “you need to be 18 years of age or older to have teeth whitening and be considered dentally fit: this means a healthy mouth with no decay or gum disease.”

And what about anyone having other dental treatments as well or those with veneers? “If you are having cosmetic dental work it is best to have your teeth whitened first. This is to make sure any composite bonding or ceramic work you are having done will match your natural teeth once they are whitened. If you already have ceramic crowns or veneers on your front teeth you may need to have these changed after whitening as they will not change colour.”

And the Upkeep

Ok, so I’ve got white teeth. Now what? Is once enough or do I have to keep whitening them forever? “Some companies recommend ‘topping up’ once every 6 weeks in the first year, to ensure long lasting results. However I tend to just top up my whitening for one night before a special event or a holiday.”

According to Dr Stephanie there’s also quite a lot we can do at home to keep white teeth pearly including, “reducing your intake of strongly coloured foods and drink during the whitening process, and again, good oral hygiene.”

  • Supermarket or pharmacy whitening toothpastes can clean but won’t truly whiten teeth
  • Avoid any whitening systems not bought from a registered dental professional
  • Custom whitening trays made by your dentist may take slightly longer to get a result but the results are more colour stable and generally produce less tooth sensitivity
  • Wait until after treatments like veneers are complete before whitening so your dentist can colour match  properly
  • ‘Top up’ whitening with trays the night before a special event of holiday
  • Keep whitened teeth looking good by avoiding strongly coloured foods and drinks during the whitening process and by practising good oral hygiene


Straightening

A lot of people (me included) find their teeth move over time, but what are the options if you’ve had braces previously and teeth have since moved, or want results fast or without braces?

Fast Results

According to Stephanie, “it really depends on what your existing teeth look like but if they are only slightly out of place you could have composite bonding or veneers. Alternatively I do a lot of Invisalign lite cases that are 5 to 6 month courses which get excellent results.”

Other Options

For more severe cases though, or those who’ve never had braces before, she says, “there are lots of different brace options out there, there’s multiple ‘invisible’ aligner systems like the Invisalign system that I provide. Or there’s thin metal wires that are held in place with clear brackets. The treatment time depends on the starting point of your teeth and how far they need to move or rotate, it can take anywhere between 3 months to 2 years. Either way you need to be committed and the retention afterwards is a life-long commitment regardless.”

On a Budget

The pursuit of straight teeth can be an expensive one, and may mean a lot more money than most of us really have to spend. So I asked the expert what she recommends if you’re on a budget.

She explains “A lot of practices offer 0 per cent finance options to make treatment affordable, this means you can spread the cost at a level suitable for you. However, it can be cheaper if you just focus on either the top or bottom teeth, and if the treatment time is shorter by concentrating on just straightening the front teeth.”

The Maintenance

And to stop teeth moving again once the work is over she recommends, “retainers: either a fixed retainer that is stuck permanently on the backs of your front teeth or a removable one that you wear at night. Ideally a combination of both. It’s a lifelong commitment; I had my braces off 10 years ago and still wear mine every night.”

  • Composite bonding or veneers can offer fast results for misaligned teeth
  • For those who previously had braces or whose teeth are only slightly misaligned Invisalign Lite can give results in 5 to 6 months
  • Other straightening options include thin metal wires held in place by clear brackets
  • Save money on braces by focusing on just the top or bottom teeth, or even just front teeth
  • Keeping teeth straight is a lifelong commitment, combining a fixed or removable retainer or both


Veneers

Thanks to the speed and effectiveness of their results veneers have become big news over the past few years. So what are they and who are they for?

The Two Types

According to the Dr Stephanie there are two types of veneers, composite and porcelain ceramic. “Composite veneers are fast becoming the treatment of choice for smile makeovers and patients are requesting them more and more due to advertising on social media and people wanting to be ‘selfie’ ready. They are an excellent way to improve your smile in one visit, there is no tooth cutting and no need for injections. They last about 5 years.

“Porcelain veneers are still a beautiful treatment for teeth that are misshapen, discoloured or slightly out of place. These tend to last 10 years.”

The price difference is also significant since composite veneers tend to be half the price of porcelain ones.

And what about the upkeep on them? “Composite veneers last may require minor repairs such as polishing or chip repairs.”

The Drawbacks

According to Dr Downes, “Teeth are generally ‘prepared’ for a porcelain veneer which will involve some tooth cutting, although minimal. Composite veneers tend to be placed on top of your teeth with no cutting, however to remove them would inevitably remove some tooth structure. Neither option will last forever, and invariably they will need maintenance, and likely replacement in your life time.”

Choose Your Dentist Carefully

We’ve all seen the rare cases of veneers unfortunately going wrong and according to the expert, “unfortunately we see a lot of advertising now for cheap ‘dental holidays’ but a lot of these patients are not actually getting veneers. They are having their healthy teeth cut down to points and full wrap ceramic crowns placed.

“They tend to be poorly fitting, so thick they cause gum irritation and the cutting is so aggressive it can cause irreversible tooth damage leading to tooth death or possibly loss.”

The Alternatives

But for those who don’t want anything quite as permanent permanent as veneers, what are the other options? Dr Stephanie says, “the best option and my treatment of choice for smile makeovers is Invisalign teeth straightening, teeth whitening and composite edge bonding to tidy up uneven edges.

“This gives a real Hollywood straight bright white smile, as well as predictable long lasting results that looks natural.”

What Actually is Bonding?

So if bonding can tidy up around the edges of teeth, what exactly is it? According to Dr Stephanie, “When people refer to ‘bonding’ they are referring to composite bonding, this is ‘sticking’ a tooth coloured filling material- composite- to the surface or edges of your teeth. When composite is applied to cover the entire surface of the tooth it is classed as a veneer. Therefore a veneer is a thin covering placed onto the entire surface of a tooth, like a false nail would sit over your natural nail.”

  • There are two types- composite and porcelain
  • Composites require less tooth preparation and last for around 5 years but may need some minor repair work
  • Porcelain veneers last for around 10 years but are around twice as expensive
  • Either type of veneer will involve some tooth cutting and most likely will have to be replaced
  • Do research before choosing a professional to fit veneers and take extra care before exploring cheaper dental holiday-style deals, which could result in healthy teeth being damaged or even tooth loss
  • An alternative to veneers is teeth straightening, whitening and composite edge bonding to tidy up tooth edges
  • Bonding involves a tooth-coloured material called composite being applied to the edges of teeth. When it covers the whole tooth it technically becomes a veneer.


Special occasions

The Permanent Approach

While dental health is the result of years of brushing, flossing and all that good stuff, sometimes we want fast results before a special occasion, in which case Dr Stephanie recommends a course of teeth whitening and composite veneers.

Selfie Ready

And any tips before taking the perfect selfie? She says, “brush and avoid strong coloured foods and drink. A brightly coloured lipstick always make teeth look white in photographs.”


The Takeaway

Perfect teeth start with great oral health and I hadn’t appreciated how much tooth health had an impact of thinning, uneven ridges or even tooth movement, so I’ll be sticking to my electric toothbrush as well as stepping up my flossing efforts (both the dancing and the dental practice- who says a girl can’t have fun).

It’s nice to know that if I ever wanted fast results, though, there are a couple of safe quick fixes, like bonding, veneers and whitening, as well as budget-friendly options like concentrating on upper or lower teeth.

If I ever do go down the whitening/veneers/braces route though, I’ll definitely be making sure to stay with dentist-approved procedures and taking my time to find a professional I trust.

Dr Stephanie Downes is a member of the Royal College of Surgeons Edinburgh, as well as the Faculty of General Dental Practitioners. She is Director of Madoc Dental Care, providing general, cosmetic dentistry, Invisalign and facial aesthetics.

For more smile tips and inspiration follow her on Instagram @dr.stephanie.downes or visit www.madocdentalcare.co.uk

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