It’s the whitewash that prevents a cover-up. Anne Johnstone reports on how cosmetic dentistry is changing the look of a nation.
Question: What do Martine McCutcheon, Catherine Zeta- Jones and Jamie Oliver have in common?
Answer: - All of them have turned to their dentists to reverse the ravages of time. Yet, while cosmetic dentistry used to be the province of the rich and famous (and the Americans), now it seems more and more of us are putting our money where our mouths are.
A few years ago we’d have said: “The queen mother still has all her own teeth. Isn’t that fantastic?,”, even though they look terrible. Today we’re more likely to admire ageing author Fay Weldon’s dazzling white smile, even though she appears to have porcelain in her mouth than the average en suite.
Next month hundreds will desert the couchside for the World Dental Aesthetic Congress in London. Maybe some will pop in to Selfridges to check out the store’s new cosmetic dental department, offering tooth whitening and veneers amid all the glittering paraphernalia of modern consumerism.
Or they could drop into Boots to have a look at its new cosmetic dentistry service, already available at 54 branches including the Bon Accord Centre, Aberdeen, the Thistle Centre, Stirling, Sauchiehall Street, Glasgow and Princes Street, Edinburgh.
Hayley Rothwell, 24, picked up a brochure in the Glasgow Store and was attracted by a £200 special offer on tooth whitening.
“There’s nothing wrong with my teeth but I’d always liked the idea of a pearly white smile. It was a real impulse buy. My student loan had just come through and I thought I’d treat myself. It’s not much more than you’d pay for a decent outfit”
The dentist took an impression of her mouth, then supplied a tray shaped to her palate that she filled each night for two weeks with a peroxide- free gel. She soon learned to sleep with it in her mouth and after around a week noticed her teeth were visibly whiter.
‘People used to talk about the ‘Hollywood smile’. Now it’s nothing special. Lots of people I know are getting it done. It’s just like a nice treat.”
Glasgow dentist, Lloyd Jerome, says its all part of the new British obsession with appearance: no different to nail extensions, facelifts, and fancy hair treatments.
It’s odd because we Brits used to a byword for stained, crooked teeth. Look at how we are caricatured in the Austin Powers films. “I’ve even heard Americans describe someone as ‘Looking great but with very British teeth’,” says Mr Jerome.
In the US, where dental treatment is expensive, white even teeth hand the wearing of braces has always carried a social cache.
Alastair MacLean, Scottish secretary of the British Dental Association, says that in recent years there’s been a realisation in this country that a person’s smile plays a major part in creating a first impression that can be vital in securing a job or social partner.
“When you meet someone, you take in their whole face. Then they speak and you automatically focus on the mouth.” In a recent NOP poll 84% of those questioned said bad teeth detracted from the rest of a person’s appearance and 11% admitted to trying to cover their mouths while talking.
According to the British Orthodontic Society, corrective dentistry has risen by two- thirds in 10 years. The number of practitioners offering aesthetic treatments is rising by a quarter each year.
Though Jerome still carries out some conventional treatment, last year he extracted only five teeth. In a typical day this week, his appointments included dressing a damaged tooth, a tooth whitening session, some fissure sealants, repairs to a bridge and a tooth, replacing five metal fillings with tooth- coloured ones, and a couple of check- ups.
“The big growth areas are tooth whitening, replacing metal fillings and replacing crowns and bridges that people think could look better. Digital photography has made a huge difference because you can show people what their mouth will look like after treatment,” he says, as we study some dramatic “before and after” shots from his collection.
Bleaching teeth isn’t new. It was all the rage in the 1920s. A step beyond whitening is “power bleaching” a light activated bleaching treatment, delivered in one almighty zap. Customers at the London Teeth for Life Clinic include Sadie Frost, Jude Law and Liam Gallagher.
Lloyd Jerome says: “Power bleaching is a bit of a gimmick. It makes people think something’s happening. It’s been known for years that if you heat peroxide, it will work more quickly, but the quicker you bleach, the quicker your teeth return to their natural colour afterwards.”
Part of the reason for the high demand for tooth- coloured fillings is that the NHS still insists on metal fillings for back teeth.
More invasive than whitening, but suitable for those who cherish perfect white teeth, are porcelain veneers. The modern versions look considerably less like bathroomware than their shiny predecessors.
“The materials are now available to make people’s teeth much better at much less cost, using less invasive techniques,” says Lloyd Jerome. For those with money in the bank, cosmetic dentistry is likely to become as common as having one’s hair tinted.
Many patients in their forties and fifties are now looking for resin contouring, which can reshape and widen teeth that are starting to work loose with age, as bone support deteriorates.
For the dental equivalent of the facelift, some practitioners are now offering the “Smile Lift”. This involves using veneers to bulk out the front teeth, giving the lips a fuller look and scratching out the lines that tend to form around the mouth with age. At £10,000 or more it may hurt your debit card more than your gnashers.
Our now-found oral vanity means fewer patients are prepared to wear dentures. Dental implants date back to Ancient Egypt, but were a crude, painful and unsatisfactory treatment until the Danish dental pioneer Branemark came up with titanium implants.
Arshad Ali of the Niddrie Square Clinic in Glasgow specialises in this work. Many of his patients are cancer patients who have undergone radical surgery. His aim is to produce not only teeth that work but an overall appearance that will give the patient back their sense of well- being and enable them to go out and live a normal life.
“People feel they are judged by their teeth,” he says. His work exposes the fine dividing line between functional and cosmetic treatment. As Lloyd Jerome argues, if someone is so embarrassed by their teeth that they won’t go out socially, they become increasingly withdrawn. Transforming their smile can transform their life.
Is our new obsession with the quality of our smiles good or bad? Both perhaps. An attractive smile increases self-esteem and a general sense of well- being which can feed through into a healthier lifestyle. But, given that most tooth decay is concentrated in the poorest members of society and most cosmetic isn’t available on the NHS, we can expect smile quality to reflect increasingly the gap between the haves and the have-nots in 21st century Britain.
Also, says Lloyd Jerome: ”If you have your teeth whitened because magazines have convinced you that it will make you look like Britney Spears, that’s terrible. There’s a worrying trend towards regarding the dysfunctional as normal. Sometimes we need to separate someone’s expectations of dentistry from their expectations of life.”