Minmally Invasive, Oral Health conscious, High Tech Cosmetic Dentistry

As seen in ‘The Times Raconteur Supplement‘ Monday 20th Feb

I’m excited.

For years I’ve been banging on, extolling the virtues of a philosophical approach that puts Cosmetic Dentistry and Healthy Dentistry in bed together – often in the face of a seemingly increasingly agressive approach being driven by our Atlantic cousins.

I’ll explain.

If you were to have followed my musings over the years you will know that I am inclined to be kind to both patients and their teeth. Our emphasis at Winning Smiles is pain free dentistry (eg use of the wand) and tending to try and enhance the natural tooth (eg Alignment, Bleaching and Bonding or ‘ABB’ rather than wall to wall enamel destruction and shed-loads of porcelain veneers).

These treatments are not only better for the teeth, they are better for the patient experience, better for their pocket! More ‘Gentle’ in every way!

So for me to read in the National Press that they have dedicated a whole supplement to Gentle, Healthy Cosmetic dentistry, well it’s music to my ears [grist to your mill? - ed].

As the title page of ‘Raconteur’ (linked above) says: previously ‘Cosmetic Dentistry’ was all about grinding miles of enamel off teeth to make room for great big ultra-white porcelain veneers – and this aggressive approach continues today. But clearly the New Wave is on the ascendent and the old way of doing things is being replaced by a more health conscious, gentle approach.

Sadly there are still well known clinics in well known parts of London encouraging patients to spend ‘A grand a tooth’ on that ‘Perfect Smile’:

A 2nd Opinion

Only last week a young lady of 20 came to me for a 2nd opinion. She smiled broadly at me to reveal a perfect set of straight teeth albeit for one upper central incisor which was grey…’I've been told I need 10 veneers’ she confided. On further investigation it was revealed that she had had an ‘E-consult’with a West London Clinic who had advised her that to get a perfect smile she needed 10 veneers at a grand each.

Needless to say, she is coming to us to have a single EMAX crown fitted to the grey front tooth after we have internally bleached it. The colour matching will take a while and will probably involve re-shading that crown a couple of times to get it to blend seamlessly with the natural teeth.

Matching a single front tooth to its natural neighbours is one of the hardest things to do.

I wonder how many times people have been recommended to fit 6, 8 or 10 veneers because the dentist finds it easier than the alternative. At best, a lazy approach, and it does all make you wonder sometimes.

But veeners will always match each other, won’t they?! (it’s hard to do sarcasm written down)

Shaping and restoring teeth to their former glory:

• Better for teeth – tick
• Better for patient – tick
• Less expensive – tick
• More challenging (and therefore more rewarding) for the dentist – tick

That’s our kind of dentistry!

Or the story of how three techniques (alignment, bleaching and bonding), when skilfully combined, can save you money and give you better results than just one (wall to wall teeth veneers)…

Before alignment, bleaching and bonding

After alignment, bleaching and bonding

Alignment Bleaching and Bonding vs Wall to wall teeth veneers

Here in Essex, Cosmetic dentistry is evolving. A decade ago when decent porcelain veneers came along cosmetic dentists were very keen on placing lots of veneers – in 2010 there are still a lot of veneers being placed by cosmetic dentists, but here at Winning Smile we believe that the Age of the Veneer is on the wane.

A colleague of mine Dr Tif Qureshi (www.dentalelegance.co.uk) recently addressed the profession with his ‘evolved’ concept of Cosmetic Dentistry – updated to reflect the progress in dental knowledge and treatments within the profession and changing attitudes among our patients. Tif brought the Inman Aligner to the UK from the States and combines this brilliant little brace with 2 other treatments to produce significant dental transformation without the need to grind away good teeth as is the case with veneers.

Tif’s concept is called ABB: ‘Alignment, Bleaching and Bonding’

Alignment

Using the inman aligner the front teeth can be lined up orthodontically in as little as 10 weeks

Bleaching

The cosmetic dentist’s best friend – professional teeth whitening to noticeably ‘lift’ the colour of all the teeth

Bonding

The addition of cosmetic filling material (like our Italian HFO system) where necessary to add the finishing touches.

Here at Winning Smiles we have been using the bleaching and bonding techniques for years and Michael Fennell one of our orthodontists has been doing the straightening. We are no strangers to these ideas. But Tif has put a label on it for us, and we think people will be hearing of this costmetic dental technique a lot more.

As always my regular readers will notice that I like to bullet point the pros and cons

ABB Advantages over Teeth Veneers

• No grinding off of the front surfaces of the teeth
• No porcelain veneers that can fracture easily and begin to lose their looks after a few years – ABB simply enhances your own teeth
• Cost – ABB costs around £2000 at Winning Smiles, 6-8 veneers cost £3600-£4800!
• ABB is one hit: veneers usually need to be replaced every 10 years or so (think of the cost implication of that)
• ABB is kind to the teeth – occasionally a veneered tooth will need a root filling because the nerve reacts badly to the grinding process

Disadvantages of ABB vs Veneers

• Very badly discoloured teeth or teeth with lots of visible fillings may be better treated with crowns or veneers
• Teeth that have always been the wrong shape (eg too small, or misshaped) usually benefit from veneers/crowns despite the drawback
• ABB will take on average 12 weeks – veneers can be done in 2-4 weeks
  Jodie Marsh lookalikes need porcelain veneers for that level of whiteness