Q. This may be a long winded note but I’m hoping you may be able to advise me. I am 43 and my teeth are not great and need work. The work I have done to date is-

1. Removal of incisor not front tooth but next, prep for implant (specialist was not happy to progress as bone did not grow back well enough). I trust this decision and have opted for a bridge – cantilever.

2. 2 x re-root canal – 1 lower molar (first one) fine 2 top 2nd molar – can flare up occasionally. (may need an apisectomy).

3. Prep of 2 upper premolar for crowns.

I think my dentist is OK (part of a dental chain) and was recommended; not cheap but not Harley Street prices – about £1000+ a crown. Root canals were £1400 done by the specialist in restorative work. But practically every time I leave the surgery I seem to have to go back due to pain. The most recent being after a temporary crown was fitted, the whole of side of face hurt. Went back he could not see a problem drilled a bit and sent me on my way with another load of antibiotics. (Is it usual for a dentist to be looking at the internet whilst waiting for X-ray to be developed). Also, he seems to not remember my case notes (or does not look at them before I arrive). I suppose I just don’t feel comfortable with him but now feel I would have to find another and have no idea how to. Nobody I know can recommend one – my husband sees a NHS practice but I have decided to go the private route as want cosmetic work on front. I will be having 3 crowns, 3 crowns or veneers and 1 bridge on the upper and 2 crowns, couple of fillings to replace leaking on lower as well as bleaching the bottom row – the odd thing is I have been told that you should bleach first and then try and match up the natural teeth to this. He did not seem to think this was necessary. Also, on the top I have one perfectly good tooth – I think it a good shape (canine) and would ideally like to just bleach and match to this. It is the front four that are in the worst shape. But he says why am I basing my whole smile around one tooth which I can understand but I have so few ‘virgin’ teeth. I would like to keep the ones I do have. Is this not a challenge for a Cosmetic dentist working with the good teeth? May have to have another top molar removed as endodontist said it was not good enough to re-root canal (it was filled with silver points) and could be destroying the bone around other teeth. My main priority is to have a good bite as I suffer from tmj and facial pain, and clench my teeth. Sort out the foundation I want a very natural smile – not too white and Hollywood a la Jodie Marsh just an ordinary ‘you have nice teeth’ look. Definitely do not want bulbous teeth (chicklets).