Sunny Smiles

Posted: Wednesday 19 January 2011 03:35pm

Want a dazzling Hollywood smile to complement your summer glow? The good news is, celebrity smiles are not always those they were born with. With help from advances in corrective and cosmetic dentistry, you too can flash a photogenic grin worthy of the red carpet.

“Improvement in dental materials, technology and our understanding of soft and hard tissues, mean that dentists are able to perform cosmetic procedures with greater predictability,” says Dr  Sarkis Nalbandian from Designer Smiles in Cremorne, Sydney.  “We are able to move the teeth faster, create a beautiful smile faster using dental implants and deliver immediate results conserving the tooth structure, at a lesser cost.”

WHITER, BRIGHTER TEETH … IN 2 MINUTES

Prevention is the best cure, so minimise the risk of your teeth becoming discoloured. Reduce (or even better, cut out) consumption of staining agents such as tea, coffee, red wine and cola drinks.

Clean your teeth for 2-3 minutes twice a day using a brush with a small head and soft bristles or, better still, an electric toothbrush. The Australian Dental Association recommends placing your toothbrush at a 45-degree angle to your teeth, aiming the bristles toward the gum line. Jiggle the brush gently back and forward, only brushing one or two teeth at a time.

Use an advanced formula whitening toothpaste – brands like Colgate and Macleans come highly recommended by the ADA. They help remove/bleach external stains and reduce internal ones. Rinse with a whitening mouthwash, such as Listerine, and you’re good to go.

WHITER, BRIGHTER TEETH … IN 30 MINUTES

Over the counter home whitening kits, paint-on whitening solutions and adhesive whitening strips will give subtle results, which are more effective on younger than older people. Visit the ADA website for recommended products.

Don’t underestimate the whitening effect of professional teeth cleaning at your dentist at least every six months. The procedure usually involves a “scale and clean” to remove tartar (calculus) from the tooth surfaces, tooth polishing and if too much tartar is present, debridement. Plaque (bacteria) builds up on teeth and cannot be removed by brushing. If the plaque is not removed it forms tartar which can cause tooth decay, gum disease and tooth loss.

Dr Sandra Short, of DentArtistry in Double Bay, Sydney, says: “A professional clean is essential. Home cleaning doesn’t do the job alone. Even with our instruments and mirrors, research has shown we cannot do a 100 per cent job but it is far, far better than what you could ever achieve at home. The basis of any whitening treatment will not be as effective if teeth are not clean. You will get a much better result.” Teeth cleaning, as part of 60-minute dental check-up, costs around $200.

Using a file to slightly reshape the edges and angles of your teeth, can make them appear more aligned. Shaving off just one-tenth of a millimetre can make all the difference.  “Teeth reshaping is becoming more common and it’s a very conservative, great thing you can do for patients, says Dr Short. “Often it’s just a tiny bit of tweaking needed. It’s simple and really makes a difference. It’s like having manicured fingernails – a manicured hand looks more refined than someone who chews their nails. It’s not painful because you’re not taking off much tooth. It can be achieved within a one hour consultation. The patients are always happy with the result.”

WHITER, BRIGHTER TEETH … IN 60 MINUTES …

A professional whitening treatment at your dentist – either in the chair or a take-home system – will give the most effective whitening results. Dr Cary Fraser of Bay Dental & Orthodontics in Double Bay, Sydney, uses Sapphire Whitening System. “We have a take-home system ($250) and an `in the chair’ system ($850). The take-home requires custom made trays. For the best result, we recommend the ‘in the chair’ system backed up with some ‘at home’ treatment. The ‘in the chair’ treatment is a one-off, whereas the ‘take home’ system you use for 3 minutes per day for 1-2 weeks, depending how white you want your teeth.”

Sydney ’s Dr Michael Finkelstein also offers two whitening systems. “We have the ‘take home’ treatment where we make moulds of the mouth to make trays for the teeth. We give the patient 2-3 tubes of bleaching gel and we teach them how to use it. We instruct the patient to use it for about 35 minutes during the day. Anywhere between 30-45 minutes a day. There are lots of different brands and they’re pretty much the same but we use Discus Dental and Opalessence. The ballpark cost for us is around the $450 mark. We also sell the whitening gels over the counter – once the trays are made – you can buy the gels for around $25 a tube. The ‘in the chair’ system Dr Finkelstein uses is Zoom. “Bright Smile is owned by the same company – they’re virtually the same product. It’s a one hour treatment in the chair and we’ve had fabulous results over the years. For around $1000 we do the treatment in the chair and offer take-home kits (trays and gel) for maintenance.”

Whitening treatments offered at stands in shopping centres or at beauty salons without the supervision of dentists might be a cheaper option but you are risking expertise and assurance.  Melbourne’s Dr Yvonne King warns that “the Australian Dental Association is not happy about these kiosks. You do not know how well trained these people are. If there is a complication, we don’t know how these people are equipped to handle it. There is a chance the procedure is not as safe or as controlled or efficient as it would be in a dental surgery.” Prices start at around $170 for one treatment.

Bonding, in which your dentist sculpts  resin over the tooth, can conceal imperfections like spacing, chips and stains. The appearance of a straighter, more balanced smile can be achieved and you can build out back teeth to hold out the cheekbones for the appearance of a more chiselled bone structure. Bonded resins are simple to re-polish and replace if they eventually discolour. “You can change the colour of the tooth with bonding,” says Dr Sandra Short. “I will use it for financial reasons but I regard it as temporary and so don’t particularly like it as a procedure. After two years, you start to see stains develop in resin, chips and they do wear down readily. For me, it’s a false economy.” For resin bonding, you’re looking at anything between $500-$900 per tooth.

WHITER, BRIGHTER TEETH … IN 2 HOURS

Dental implants are titanium rods threaded into the jaw to replace missing teeth, which crowns are then cemented over them months later. Technology now allows for implants to be inserted as soon as the tooth is extracted. “It depends on the amount of bone at the extraction and also if there is any infection and where it is in the mouth,” says Dr Michael Finklestein. “The products and knowledge have improved which is why, in some cases, implants can be inserted as soon as a tooth is extracted. Implants can range anywhere between $5-8000 per tooth. If you’re placing the implant in immediately, it’s a lot easier. You remove the tooth and if the amount of bone is right and there is no infection, you take a titanium screw and you screw it into where the existing tooth was. If it is a front tooth, we may not be inclined to go in straight away, but if it’s a back tooth we will. You’ve got aesthetics to consider with the front teeth.”

GlamSmile porcelain veneers, which are thinner than traditional veneers, can be placed after two one-hour dental visits. The first visit is for a consultation, “before” photos and an impression of your teeth. At your second visit, which is usually three weeks after your first visit, the veneers are placed. In most cases, patients don’t require painful and unnecessary removal of healthy tooth structure which means no needles, no anaesthesia and no drills. Not only will veneers whiten severely stained and discoloured teeth, they can change the shape, size and alignment of your teeth.

Obviously, every veneer case is different. Your dentist will evaluate your teeth and decide whether orthodontics is necessary before placing veneers. According to the GlamSmile website, where the misalignment is moderate, GlamSmile veneers will change the alignment and the shape of the teeth making them straighter and more symmetrical. GlamSmile’s Dr Yvonne King says there are three systems – GlamSmile, GlamSmile Plus and GlamSmile Platinum.

Like anything, veneers are operator-dependent. If your dentist has a good aesthetic eye, the results you get with even the basic system, the results are very good.  Dr King advises patients to ask their dentist for before and after shots of their work – and to be sure it really is that dentist’s work. “A dentist really needs to find out what result the patient is after. It is important to sit down with the patient to find out what really bothers them about their smile, what they’d like to change and the end result they want. It is the patient’s choice, but we must inform the patient of all their options, the advantages and disadvantages and possible consequences of their decision. Once the patient is fully informed, they can make an informed decision.”

The basic GlamSmile range will cost you from $5000 onwards for the upper set, GlamSmile Plus will cost you from $6500-$7000 and the GlamSmile Platinum will cost you from between $8000 and $10,000. “The cost is very patient-dependent,” says Dr King. “It depends how much work is required beforehand.”

WHITER BRIGHTER TEETH … THE LONG HAUL

In many cases, a significantly improved smile can only be achieved by orthodontics or even surgery, requiring treatment over weeks, months and possibly more than a year.

Jaw expansion can be used to not onlycorrect facial contours and bite and create a broader, “Julia Roberts”-type smile, but can also beneficial for patients with sleep disorders such as sleep apnea, or who suffer badly from sinus complaints and chronic headaches and migraines due to the position of the jaw.

“Some people do it purely for cosmetic reasons – for a broader, more ‘toothy’ Julia Roberts type smile,” says Dr Cary Fraser, “but I’m looking at function as well”. Dr Fraser points out, however, that the procedure is case sensitive and also invasive, “so not every adult is going to opt for it. For an adult who has stopped growing, jaw expansion is very different for what you do for a child”.

A Corticotomy – a slit in the bone – is performed to allow the jaws to spread apart. An expander – which can be a removable or fixed– is then used, and is “wound”, depending on the situation, possibly once a day to gradually expand the jaw.

The patient then needs braces afterwards to align the teeth.The whole procedure can be “uncomfortable”, says Dr Fraser, “and possibly take between one and a half to three years. There are surgical costs involved so you’re looking at a cost of anywhere between $5-20,000.”

A broader smile can also be achieved with braces.  Many adults opt for more aesthetically pleasing invisible braces, or those placed on the inside of the teeth.

“Braces on the inside braces are just as effective as outside braces but they take a little bit longer to work and they may affect speech for a little while,” says dr Fraser. “There is a technique I use where braces are applied only to the six front teeth – the “social six” – that can take three months and cost around $3000. Full inside braces, because they’re cat gold and made individually for each tooth, it can be expensive, around $12,000 and you’ll be wearing them for around two years. Normal braces cost anywhere between $5-15,000 and a patient can wear them for up to one and a half years.”

Dr Michael Finkelstein recommends Invisalign “invisible” braces as a more subtle way to sort your smile. “We change the plates every two weeks – based on the original model, computer imaging determines where we want the patient’s teeth to be,” he says. “Results all depend on patient compliance. If your patient wears their plates all the time you get a great result. Invisalign takes anywhere between 9-18 months and costs range from $6-11,000.” The manufacturers stress that not all people are suitable candidates.

by Jenni Gilbert

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