GREAT WHITE HOPE
There are two types of people: those who smile broadly ear to ear, and those who, on even the most joyous of occasions, proffer only a closed-mouth Mona Lisa smile. The Victoria Beckhams and Nicole Kidmans of the world aside, it’s fair to assume that many of those in the latter category don’t particularly like their teeth.
Whether or not there’s actually anything unsightly about them, a perceived teeth issue can turn the most confident person into a mumbler in a bid to minimise people noticing. But the good news is, there are plenty of options for transformation. Cosmetic dentist and Invisalign expert Dr Steven Casci of Lumino The Dentists Ponsonby explains some of them.
What appearance-related complaints do you hear the most?
Tooth shade is always a big one, but predominantly my patients are concerned about the position of their front teeth. I’ve noticed people have become increasingly self-conscious about this since posting selfies online has become popular. Usually it’s a case of the teeth being too prominent or twisted. Sometimes if the front teeth are crooked, the teeth sitting further back are cast in shadow, which makes them look darker in photos. This is often key for people who spend a lot of time in front of the camera, like models, actors and journalists.
What’s the best way to achieve a Hollywoodworthy smile?
The three key things we’re looking at are the colour, shape and position of the teeth. Depending on the issues, the look a person is going for and their budget, we can select one or more of the following:
Whitening: The options here include in-surgery laser or dentist-recommended home whitening. The one that’s best for you will depend on your preference and the type of staining present. Whitening is probably the simplest, least invasive thing dentists do, and the formulations we use have been proven safe and non-damaging to enamel over a long period of time.
Cost: Whitening ranges from $150-$350. [All prices are a guide only.]
Bonding: This involves adding white filling to the edges of the teeth to disguise minor chips, wear, discolouration and blemishes. It’s amazing how [this approach] can drastically improve a person’s smile. Apart from being cost-effective, it’s noninvasive and can often be done within an hour with no need for anaesthetic. Cost: Around $250-$350 per tooth, but this can vary depending on the number of teeth and the amount of reshaping required.
Invisalign: Straightening teeth used to involve the old metal ‘train track’ braces, but now with discrete products like Invisalign [using removable clear plastic aligner trays], we can achieve great results with people barely noticing that they’re wearing anything. Minor corrections in tooth position can often be achieved with a few months of treatment. Cost: The fees associated with Invisalign depend on whether you see a specialist or general dentist, as well their experience. A full case will generally range from $7500-$12,000, so it pays to shop around. Straightforward ‘lite’ cases requiring minor movement of the front teeth range from $2000-$6000.
Veneers: Here, a porcelain sleeve is placed over the front of the tooth to help disguise poor colour, shape and sometimes position. Cost: From $1400-$1800 per tooth.
What’s exciting about the new options in cosmetic dentistry?
The biggest revolution at the moment is the growth of digital dentistry. It used to be that if someone was thinking about cosmetic work, they’d just have to trust that the final result would match what they imagined. Alternatively, the dentist would adjust stone models of the patient with white wax so the patient could try to visualise the final result. People would often have to make a significant investment just to get to the point where they could decide whether they wanted to proceed or not. The biggest challenge is that it’s incredibly hard for consumers to know what they’re buying and whether it’s fit for purpose. Although there are some reasonable products out there, there are many that are at best ineffective and at worst damaging to the enamel. I also recommend caution when using whitening toothpastes. Many don’t contain any active whitening component — they simply rely on using abrasive filler particles to scour stains off the teeth. This is probably fine in the short term, but I’m concerned about the consequences for the enamel over time.
What else can affect the appearance of teeth?
Gum health. It’s amazing how often patients focus on their teeth but aren't aware that when they smile their gums look puffy and inflamed. Regular appointments with a hygienist not only help keep your teeth free of decay but also help maintain your smile.
Electric toothbrush or manual?
Electric! There’s no contest here: studies prove that an electric toothbrush is more effective. If nothing else, many of the electric toothbrushes available have two-minute timers on them, which makes sure that the toothbrush is in your mouth long enough to make a difference.
What do you think of natural toothpaste and the trend towards using charcoal for whitening?
I‘m yet to be convinced of the products in this category and I think the claims around charcoal toothpastes for whitening are pretty dubious. Again, I think that, if anything, it’s probably the abrasiveness of the charcoal powder that’s having an effect.