The comprehensive guide to cosmetic dentistry

What's involved in tooth whitening?

A range of procedures known as 'power' or 'laser' whitening treatments are available in the dentist's chair. They can differ slightly but all involve a bleach gel being applied to the teeth then activated by laser beams. Some can transform the look of your teeth in just a few hours while others take two or three sessions. Tooth whitening is not available on the NHS. Expect to pay between £600 and £800. Alternatively, your dentist may give you the lightening product to apply yourself at night. It comes in a tray, which fits closely round your teeth and has to be worn over two to four weeks, for 30 minutes to one hour at a time.

There are new products coming on to the market, though, which can be applied for up to eight hours at a time which means a satisfactory result can be achieved in as little as one week.

In both cases the active ingredient is normally hydrogen peroxide or carbamide peroxide. Expect to pay at least £500 for home treatments.

Possible side effects

According to the British Dental Health Foundation, some people find their teeth become sensitive to cold during or after the treatment.

Others report discomfort in the gums, a sore throat or white patches on the gum line. These symptoms are usually temporary and disappear within a few days of the treatment finishing.

What about home kits? They are not recommended as they contain only a small concentration of hydrogen peroxide, which reduces their effectiveness.

"Whitening is also a complicated treatment procedure and should only be carried out by a dentist after a thorough examination and assessment of your teeth," says Dr Nigel Carter, chief executive of the British Dental Health Foundation.

"It is never too late and you are never too old," adds Harley Street cosmetic dentist Dr Anthony Newbury.

What can be done?

Orthodontic treatment, which involves wearing braces, will straighten teeth or move them into a better position.

A recent survey by the British Orthodontic Society revealed a three-fold increase in adult patients over the past 10 years.

The treatment may take between one and three years to be effective. Expect to pay at least £5,000. An alternative is to go for direct bonding or veneers, which can make teeth appear straighter.

"The teeth can be built up to make them look straight by adding material on to the surface of the tooth. This method effectively offers instant orthodontics," explains Dr Newbury.

Crowns and veneers

Crowns are small covers that fit over teeth and are made from metal or porcelain or from porcelain with metal.

They are used to restore teeth, which have been broken or weakened by decay or by a large filling beyond the point of repair.

They are also used to improve the appearance of teeth and to help hold a bridge or denture in place.

They are available on the NHS only if a tooth is badly chipped or broken. Veneers are thin 'fingernails' of porcelain that are glued to teeth. They can be used to improve the colour, shape, size and position of teeth and to close up gaps. Expect to pay around £60 per tooth on the NHS and anything up to £1,000 each if done privately.

White fillings

White fillings are useful when the edge of a tooth needs filling, to fill a chipped tooth or smaller gaps between teeth.

Made of a composite of resin and glass particles, they are cemented on to the existing tooth using a bonding agent.

White fillings are available on the NHS for the first five teeth at the front of the mouth at a cost of around £10 per tooth. Expect to pay from £95 per tooth privately

The smile lift

One of the latest techniques in the world of cosmetic dentistry is the smile lift brought to the UK from the US by the 'smile doctor' Mervyn Druian.

"By manipulating tooth width and size with porcelain veneers we can take years off someone's face," explains Dr Druian.

"A smile lift can change a person's whole lower face, making them look younger and happier."

Between eight and 10 porcelain veneers are placed over front and side teeth.

"This lightens up the side of the mouth, making the smile look broader and whiter," says Dr Druian.

"The veneers are cut slightly wider than natural teeth so they also have the effect of lifting the lips and widening the smile," he adds.

Finally, a special laser is used to trim the gumline, which makes teeth look more in proportion. Expect to pay between £3,000 and £4,000

The dental facelift

Another technique growing in popularity is the dental facelift, the brainchild of Dr Nick Mohindra of Added Dimension Dentistry.

"By changing the way the lower facial muscles work you can restore the face to ideal proportions," explains Dr Mohindra.

"The secret lies in increasing the height of teeth with crowns so that face and jaw muscles have to work harder. The effects can be seen all over the face - eyes become bigger, bags disappear and crow's feet improve." Expect to pay about £4,000 for a dental facelift if you have dentures. If you have your own teeth you will need a complete set of crowns, which can bring the price up to £20,000

Prices stated are only a guideline. Check with your dentist for prices.

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