Q. Dear Dr Solanki, I have a few problems with my teeth that have bothered me for years, I am so embarrassed to smile as my teeth look so awful, I think about my teeth all the time there is not a minute that goes by in the day that I don’t think about them. My teeth are very brown and stained (I think because of excessive smoking and my love for Indian food! Have at least 3 curries a week) even though I brush them twice a day, I have tried whitening toothpastes but they don’t make any difference. My teeth are also crooked and my front teeth stick out a bit. I haven’t seen a dentist in the last 5 years (I know its bad!) and I have some savings to pay for my treatment, do you offer payment plans where I can spread the payments out, as I do not think I could afford paying for it in one lump sum, do you have any idea how much this treatment will cost.

Many thanks for taking the time to read this in advance,
A.C.

A. Dear A.C,

First of all I can empathise with you when you say that you are embarrassed to smile, I see patients in the same situation everyday. The effect that your smile can have on your self esteem and confidence is huge and one of the most rewarding aspects of my job is after transforming a patients smile, is the positive change in their personality and confidence, to be able to change someone’s life like that is priceless. You have quite a few questions so let me dissect them for you:

You say you haven’t been to the dentist in over 5 years, my main concern before considering any cosmetic dentistry would be to assess the health of your mouth and teeth, to make sure that you don’t have any gum disease and get your mouth back to full health. This may involve several visits to the hygienist, on the other hand if your mouth is healthy then you could consider the following:

For your Stained teeth the two main options are tooth whitening or veneers. Tooth whitening will maintain the structure of your teeth whilst improving their shade, you mention that you have used whitening tooth pastes without success, however these only remove surface stains and teeth whitening actually bleaches your teeth achieving results that cannot be obtained with brushing alone. Eating Indian food and smoking will however stain your teeth again once you have had them whitenined and you may need top up home whitening treatments to keep them white. Smoking can also have a negative impact on your oral health and gums and can delay healing after having dental surgery. Dental veneers are often used to improve the shade of people’s teeth however this is a more drastic option and requires some tooth reduction.

For your crooked teeth that stick out orthodontics using either fixed braces or clear aligners such as invisalign may be the answer. However, without actually seeing you it is difficult to know what is the best option. Orthodontic treatment does take some time and you could be wearing aligners or braces for over 12 months. If your teeth are only slightly crooked veneers may be an option, referred to by some as “instant orthodontics”. The veneers would then solve your problem of both discoloured and crooked teeth and the treatment could be completed in as little as a day with CEREC veneers or over a period of about two weeks using conventional laboratory made veneers.

It is vritually impossible for me to tell you how much your treatment will cost without a plan of action for your treatment. But to give you a ball park estimate teeth whitening costs from £450 to £750 depending on the whitening system used, dental veneers cost around £500 to £700 per unit and orthodontics can cost any where from £4000.00 upwards depending on the level of treatment required. Once you have seen a dentist and had a full consultation they should be able to give you a more accurate idea of costs. Payment plans – high quality cosmetic dentistry can be expensive and not everyone can afford to pay for this in one upfront payment. Most of the treatment sold in my practice is usually on an interest free payment plan, this makes cosmetic dentistry more affordable for everyone. You will find that most dental practices offer some type of payment plans.

Dr Kailesh Solanki

Q. Dear Dr Solanki, Hello I am interested in having my smile ‘madeover’ I currently have quite large, protuding front teeth. I visited an Orthodontist regularly as a child but was told my lower jaw was too small and it would grow. It has but, at 20, I am still not happy with the appearance of my smile. Is there anything you would be able to do to help? Thank you, L

A. Hi L,
this is a common problem we as dentist face day to day. The good news is that yes some thing can be done and in a relatively short time frame. Due to your large protruding front teeth, the ideal situation would be to spread the large sized teeth across your smile making the smaller teeth slightly larger to allow for the larger teeth to be made slightly smaller, giving you a more pleasing aesthetic smile. We would first take photos analyse your smile, wax your teeth up on a stone model and show you what your final result would look like. If you were happy with this then we would then carry out the work. The treatment of choice being eight to ten porcelain veneers. A veneer is a great way of treating this type of mouth as the preparation of the tooth is minimal and the results are generally awesome. You could also have tooth whitening in the lower jaw to then allow us to improve the overall colour of your smile. Hope all this is helpful.

Dr Kailesh Solanki

Q. Hello dr kaliesh, In March of this year I had extensive cosmetic work to my teeth (17 teeth in all) including veneers. crowns and 1 bridge. I asked my dentist for a white Hollywood smile. Already the veneers are discolouring (particularly the lower ones) and there is becoming a difference in colour between the veneers and crowns. They were all the same colour when fitted. My dentist said this is due to the different materials used in the crowns and veneers. This was not explained to me at the time. My dentist says that people don”t look that closley anyway but surely that is not the point. This work cost me a substantial amount of money – what can I do. My Dentist is a great dentist but I am worried that maybe he was out of his depth with my substantial dental cosmetic makeover. S.

A. Hi S,
I can tell from your email that you’re concerned about what has gone on regarding your smile makeover. The first thing to say is that as cement under an all porcelain restorations mature there can be a colour shift. Secondly the core colour of the teeth under the crowns and veneers and bridge work can influence the final colour of the work. Thirdly, the thickness of the porcelain can also affect the final colour of the work produced. In fairness to your dentist I feel it would be impossible to guarantee that the colour would remain exactly the same as the day they were done. However if you feel that you are unhappy with the result I would advise you to see your dentist and voice your concerns to him. I am sure he will be more than happy to sort out any problems you present with.

Dr Kailesh Solanki

Q. Dr Solanki, I have gum disease due to illness as a child and prolonged use of penicillin, I have treatment for this but it doesn’t seem to work that well and I now have a pronounced gap between my front two teeth. Please can you tell me what procedure is best to close or fill the gap and give me back my confidence and smile.
F.

A. Hi F,
The first thing we would need to look at is that your gum condition is now stable and your mouth is healthy. If the answer to this question is yes the modes of treatment to close the gap would be:

1: Non-invasive – orthodontics (braces), this could be done using the new invisible braces but the main disadvantage would be that this is a lengthy process, but it maintains the integrity of your natural teeth.

2: Invasive – veneers, this would mean preparation of the teeth and removal of some of your tooth structure to then place porcelain veneers over them to close the gaps. The advantage of this treatment is the time frame would be reduced.

Hope this is helpful.

Dr Kailesh Solanki