In general, there are two diseases that many of us as adults will suffer from. The first
is gum disease, which is entirely preventable. It's important to thoroughly clean your teeth,
but not just with a toothbrush, but also to clean between the teeth. Classically, that's
floss. But wiping a tooth with a piece of string isn't always that effective, so we'd
recommend little brushes between your back teeth. The other disease is dental decay,
and again, largely preventable. I think we all know it's caused by sugar, but what we
don't maybe appreciate is that it's really the frequency of the sugar intake that can
be an issue. Other diseases that we check for are tooth erosion and general tooth surface
loss from tooth to tooth contact, which we call attrition; and as long as we have all
of those stable, we can ensure we have a nice healthy mouth to make the long-lasting restorations
that we're considering.
I'm a general dentist and I will refer to
specialist orthodontists for what we'd call comprehensive orthodontics. But that's generally
going to take 18 months to two years. What we now have are some options that mainly straighten
the front teeth and that can happen as little as five or six months. The first option are
aligners. Clear removable trays that each one moves your tooth a little bit. The positive
is that they are removable, but the downside is they're removable. Because you need to
wear them 22 hours a day and therefore be quite disciplined. The alternative is, we
can fix braces to your teeth and those can be tooth coloured on the outside or even on
the inside of your teeth and we can straighten most adults’ teeth in as little as five
to six months. Once they're straightened, we can look at correcting anywhere and correcting
the colour with many different treatment options.
Tooth whitening as long as it's carried out
by dental care professional is completely safe. We would recommend home whitening where
moulds are taken off your teeth and a very close-fitting tray is made in which you put
hydrogen peroxide gel. The trays are worn either overnight or for two to three hours
in the evening, whilst you're whitening, you may expect your teeth to be a little bit more
sensitive, but at the end of the whitening process, they'll be no more sensitive than
they were before. Whitening as long as it's maintained with a day of whitening every other
month will maintain the colour of your teeth so much so that we're happy to match porcelain
or plastic filling restorations to the whitened shade. Power whitening is available but you
would still need to wear trays for about the same amount of time as if you weren't power
whitening, and so with the concentrations that we're allowed to use, we would generally
recommend home whitening as being a best option.
A porcelain veneer is a facing of porcelain
that's bonded onto the front of your teeth. We can sometimes correct worn teeth with just
edge bonding; and we can do composite veneers. But porcelain is probably going to last longer
than any of those. A porcelain veneer is added onto the front of the tooth, and if we're
doing a single tooth, we'd have to make space for that veneer generally about half a millimetre.
However, the more we can add to the front of the tooth, the less we have to drill. So,
if we can add point two or point three, we only have to remove 0.2 0.3 of a millimetre.
If we can add the whole half a millimetre without making the teeth too wonky, then we're
in the realms of a prepless veneer. A veneer works best when it's bonded
to enamel and so it's very important that we think additively and don't just drill teeth
away. Done correctly, porcelain veneers should have a life expectancy of 10 to 15 years or
possibly more. I think it's important to realise, however well we do anything, it will have
a lifespan and so being conservative is the most important.
We have a few options to show you what veneers can look like and the first option is, we
take photos and we can do a digital imaging of that photo to give a simulation. The problem
is, that's not showing you in your mouth; and so, the best way is if we can put plastic
material onto your teeth. So, I would take moulds of your teeth and ask the lab to wax
up the teeth onto that model, a 3d preview of the shape of the veneers. If I have a mould
of that and I fill that with plastic material, I can put that on your teeth without touching
your teeth. We call it a visual trial and that's a real simulation in your mouth of
what the teeth could look like. We can then shape that until we have the final result
that you like. We can also now mill 3d veneers, plastic temporary veneers that we can also
put on your teeth. So, it's entirely possible before touching your teeth to show you exactly
what your new smile can look like.