Category: Cosmetic

Blog post and articles about cosmetic dentistry by Dr Nishan Dixit

Can you straighten teeth with veneers?

Dr Nishan Dixit

Dr Nishan Dixit

Dr Nishan Dixit is the founder and principal dentist of Blue Court Dental. Patients enjoy his relaxed, friendly and gentle approach while experiencing his meticulous attention to detail. He has a special interest in providing smile makeovers, natural-looking white fillings and cosmetic braces, but also provides a range of treatments from preventative and general dental care to complex dental rehabilitation.
Dr Nishan Dixit

Latest posts by Dr Nishan Dixit (see all)

If you are researching straightening crooked teeth then you will know that there are a wide variety of options available from Invisalign or lingual braces to straighten crooked teeth invisibly, through to the Inman aligner which has the ability to straighten crooked teeth very quickly, right the way up to conventional fixed orthodontics which can straighten the most severely crooked teeth.

But did you know there are also quicker and simpler ways to straighten a few crooked front teeth?

Dental bonding and dental veneers can also be used to give the illusion of straighter teeth, but who does this type of teeth straightening? A dentist or orthodontist?

Difference between cosmetic dentistry and orthodontics

Orthodontics is very often thought about into distinct ways:

  • Functional orthodontics – This type of orthodontic treatment is because the teeth don’t bite together properly or there is some dramatic malocclusion which means there are additional problems such as jaw joint pain, headaches or the inability to eat and chew. There may or may not be cosmetic elements to this treatment.
  • Cosmetic orthodontics – This type of orthodontic treatment is primarily driven by a desire for the teeth to be straighter and look better, there may or may not be functional elements to this treatment.

Turning our attention to cosmetic dentistry, this is generally considered a treatment modality whereby we look to improve the appearance of the patients’ teeth, always taking into account the function.

Cosmetic dentistry has a range of treatments which can be used to fulfil that requirement, typical treatments could include:

  • Straightening crooked teeth
  • Rebuilding worn down or damaged teeth
  • Whitening dark teeth

As you can see, straightening crooked teeth is one of the treatments used within cosmetic dentistry… And this could definitely include orthodontics.

In summary, orthodontics can be cosmetic in its nature and cosmetic dentistry can include orthodontics as part of the treatment to design a new smile.

How can veneers straighten crooked teeth?

Dental veneers can be made from a variety of materials including high-strength porcelain and composite resin. Most of the time veneers don’t actually straighten the tooth  moreover, they give the impression of straightness when viewed from the front.

Straightening your tooth with a veneer is usually done when there are only a couple of teeth that are crooked.

Looking at this photograph from the front, if you look at the 2nd tooth from the centre on the right-hand side (this will be the patient’s left) you can see that this lateral tooth is rotated in as well as being misshapen.

straightening crooked tooth with veneers

A simple way to correct this misshapen and crooked tooth was to create an immediate dental veneer using a composite resin. This creates an instant result. In this case even if the tooth was moved with orthodontics it would still have been misshapen and required some bonding to achieve the full cosmetic result.

It’s also possible to correct more crooked front teeth with dental veneers, there are however some advantages and disadvantages:

Advantages of straightening crooked teeth with veneers

  • Quick – Can also be instant if composite resin bonding is used.
  • Can change the tooth colour.
  • Can change the shape of teeth.

Disadvantages of straightening crooked teeth with veneers

  • May require removal of healthy tooth structure in order to accept the new veneer.
  • Can, in some circumstances mean the tooth is quite thick due to the fact there is a natural tooth with a veneer bonded on the surface.
  • May need replacement at a later date as gums naturally resorb.
  • Can be susceptible to fracture.

Who does veneers, a dentist or orthodontist?

Now that we know that dental veneers can be used to straighten crooked teeth, who does them, a dentist or orthodontist?

In almost all circumstances it will be a dentist that undertakes the treatment of veneers. Generally speaking an orthodontist will be a specialist and dedicated solely to orthodontic treatments.

 

What can a cosmetic dentist do?

A cosmetic dentist will primarily be looking at resolving dental problems, rather than trying to prescribe a specific treatment… Therefore  a cosmetic dentist can:

  • Straighten crooked teeth.
  • Whitening dark teeth.
  • Rebuilt broken down, damaged or misshapen teeth.
  • Replacing missing teeth.

To do this, they use a range of specific treatments such as:

  1. Dental veneers – These can either be a porcelain veneer or immediate/direct composite material veneer. These require a small reduction to the front surface of your tooth enamel.
  2. Teeth whitening – This is often either performed in surgery or at home.
  3. Orthodontics – Usually simpler orthodontics are performed by the dentist with more complex cases being referred to a specialist orthodontist.
  4. Dental Crowns – Crowns are often used to restore teeth damaged by decay, ageing or trauma.
  5. Dental bridges – Used to replace missing teeth.
  6. Dental implants – Used to replace missing teeth.

At the same time as this there will also be looking out for your oral health to ensure that either your current or desired situation doesn’t compromise it.

There is therefore a wide range of skills utilised by cosmetic dentist to help create a beautiful smile for you.

Many cosmetic dentists will also be a member of the British Academy of Cosmetic Dentistry (BACD), this is an organisation which seeks to help dentists achieve excellence in their cosmetic dental practice.

What is the process for a smile design?

The process with any dental treatment will always start with the patient. The concept of keeping the patient in complete control throughout is incredibly important for modern cosmetic dentists.

The smile design process will usually be something along the following lines:

  • Initial consultation to discuss your requirements.
  • Assessment of dental health, this is to ensure that your teeth and gums are in a good enough condition to begin cosmetic treatments that will then look good, function well and last.
  • Basic treatment planning, this will then give you a range of options for how you can achieve your desired result, this should also include a full treatment plan and pricing structure.
  • Diagnostic stages – This may include combinations of scans, x-rays and study models of your teeth.
  • Full treatment planning. From the diagnostic models your dentist and technician will be able to see where your teeth are now and work out the best way to get them looking the way you ideally want.
  • Trial smile – In some situations it is possible to provide a trial smile which can clip in over your existing teeth, this is not always possible and is usually only available if you have veneers crowns which require no reduction of your existing teeth, in reality this happens rarely.
  • Completed study models. You may not have a trial smile but you should be able to see your full completed smile on a model of your teeth, this will be constructive in advance by the technician. If you are having Invisalign then this is achieved with a digital trial smile known as a Clincheck.
  • Tooth preparation – Your teeth may then need to be prepared or trimmed down by the dentist, if they are trimmed then you will be provided with temporarily veneers or crowns.
  • Manufacture of your new veneers or crowns.
  • Fitting of the new veneers crowns.
  • Review of the process and treatment.

As ever, if you have any concerns or questions about straightening crooked teeth with either veneers or orthodontics your friendly dentist in Harrow is always here to help.

 

Charcoal teeth whitening – a review

Dr Nishan Dixit

Dr Nishan Dixit

Dr Nishan Dixit is the founder and principal dentist of Blue Court Dental. Patients enjoy his relaxed, friendly and gentle approach while experiencing his meticulous attention to detail. He has a special interest in providing smile makeovers, natural-looking white fillings and cosmetic braces, but also provides a range of treatments from preventative and general dental care to complex dental rehabilitation.
Dr Nishan Dixit

Latest posts by Dr Nishan Dixit (see all)

When it comes to having Beautifully white teeth, you have many options. You can either go for professional teeth whitening at the dentist’s office, or you can try whitening your teeth in the comfort of your home by using over the counter bleaching agents or trying various natural teeth whitening methods. Among them, charcoal teeth whitening is another natural method that has become one of the most popular methods, mainly because of celebrities talking about it. So, what has made charcoal teeth whitening so popular? Does it really work? Continue reading to find out.

What Is Charcoal Whitening?

Charcoal whitening does not mean you start rubbing your mouth with coals or using the artists’ charcoal as a brush for your teeth. The charcoal we are talking about here in the context of teeth whitening products is far superior in quality. Dentists call it the activated charcoal; a highly purified and finely ground form of charcoal which is added into teeth whitening pastes or powders, in addition to other minor ingredients like foaming agents, stabilizers and may be flavored. Of course, the formulation may be in the form of a paste or even a powder.

Activated Charcoal! What is it?

Activated charcoal is derived from the same sources as ordinary charcoal. Among the organic sources of charcoal, wood is the most common although waste organic material like coconut shells may be used. Charcoal may also be obtained from hydrocarbon minerals e.g. petroleum, peat, or coal, etc. The difference between ordinary charcoal and activated charcoal lies in the processing which modifies the enhances the absorption properties of the charcoal. Charcoal is exposed to a special gas so that the resulting charcoal is far more porous. That is activated charcoal with a highly enhanced ability to absorb. Such activated charcoal is also used in water filtration processes.

Ancient Tooth Powders Also Used Charcoal

The use of charcoal for teeth cleaning and brightening is not really new. It is a fact that ancient civilisations have also been using charcoal powder for preparing tooth powders and toothpaste for centuries.  They used (and use) the burnt coal which results from burning of fuel for cooking and baking. Burnt almond skin or peanut shells were also preferred, perhaps, because they were assumed to add medicinal properties. Charcoal powder has the additional advantages of acting a soft abrasive. It was also easily available at virtually no cost. To enhance utility, such formulations often added powdered alum {KAl(SO4)2. 12H2O}, because alum is considered an anti-bacterial agent in addition to being an abrasive when in the powdered form.

the substance is often used either in the toothpaste or in activated charcoal powder.

Does Charcoal Actually Whiten Teeth?

The popularity of practice since ancient times is not really proof of its efficacy. The argument in favor relies on the absorption properties of charcoal, and the activated charcoal. It is assumed that being highly absorbent it can absorb smelly gases from water. So, it should also be able to absorb and remove staining substances, such as red wine or tea stains from the surfaces of your teeth.  However, this is not necessarily a logical conclusion.

There is no denying the fact that powdered charcoal does act as a mild and cheap abrasive and thus be effective to remove plaque to some extent. Indeed, a recent study published in the reputed Journal of the American Dental Association in September 2017 concluded that further study on the subject of teeth whitening with charcoal needed.  The available scientific evidence was not sufficient to give a conclusive verdict.

But is it Safe!

Although there is currently insufficient information available to conclude with certainty whether charcoal or activated charcoal is effective in teeth-whitening, there is also no evidence of any harmful effects of charcoal or activated charcoal in teeth whitening. In addition, the cost-effectiveness and safety of this procedure have certainly made it an attractive option for getting those pearly whites.

Having said that, there are some reports which suggest that activated charcoal is a little too abrasive. Using a substance which is abrasive on your teeth can remove the outer layer (tooth enamel) over an extended time period, this could result in sensitivity at best or exposure of the softer dentine underneath which could lead to decay.

Another thing to consider is the use of fluoride in activated charcoal toothpastes. Fluoride acts to assist the tooth in the remineralisation process which is necessary after the acid attack that your tooth is subject to each time you eat. Fluoride has been shown to really help teeth remineralisation and therefore harden up again to prevent the onset of decay. Some charcoal toothpastes view themselves as being alternative ways to clean teeth and therefore don’t include fluoride. If you then add this effect to the abrasive nature of charcoal one needs to be very careful when using this type of toothpaste.

After that, all you have to worry about is about possibly blackening lips and parts of your face. Be sure to wash your lips thoroughly after use of such pastes or powders, and you won’t have to worry about their staining.

Other ways to whitening your teeth

Many people opt for natural teeth whitening such as using baking soda however, the same principles apply to this type of toothpaste as they do with charcoal whitening. Baking soda can be more abrasive and you need to ensure that any toothpaste contains fluoride.

Whitening toothpaste and whitening strips can also be purchased over the counter in many pharmacies, these don’t however contain very high contents of hydrogen peroxide which is required to whiten your teeth to any significant noticeable level.

In order to ensure a brighter smile that you were truly happy with it is recommended that you ask your dentist. Before carrying out any whitening treatment they will ensure your oral health is in the best condition and then offer you various options such as whitening teeth in the surgery or whitening teeth at home.

Top tips for whiter teeth without treatment

Most people want to have teeth that aren’t brown, yellow or badly stained. Teeth whitening is often the first port of call but there are also many things you can do at home, come to that, there are many things you can avoid at home to help you have whiter looking teeth.

We’ve broken the list down into:

  • Things you SHOULD do for whiter looking teeth
  • Things you should NOT do
  • Things you might want to consider
  • Things to avoid when looking for whiter teeth

We then finish off our list with one final secret for whiter looking teeth… Read on to find out more.

Things you SHOULD do

In order to have the whitest looking teeth without going for teeth whitening treatments we recommend:

 

  • Watching your oral health care routine. If you keep your teeth clean then plaque will not build up, stains adhere more to plaque then they do to tooth enamel so if your teeth are clean then they are more likely to look whiter.
  • Using an electric toothbrush. It has been shown that using an electric toothbrush means you are more likely to clean your teeth adequately. Many electric toothbrushes have a timer pressure sensor to ensure you don’t press too hard and clean for the right amount of time.
  • Cleaning in between your teeth. By using floss or an incidental brush you will keep your teeth cleaner and prevent the buildup of plaque which can look dark, yellow or discoloured.

Things you should NOT do

As well as taking positive action to do things to keep your teeth looking monitor, there are also things which we recommend you should not do:

  • Smoking. Smoking dries out your mouth, if the mouth is dry it has less saliva and it is saliva which neutralises the acid from the bacteria. This means that smokers are more likely to have tooth decay which can look dark, brown or black. If you have plaque buildup around your teeth then smoking will also discolour this plaque giving your teeth are very yellow look.
  • Avoid anything that can stain, think of your teeth like a white T-shirt, anything that can stain the T-shirt can stain your teeth! That doesn’t mean stopping eating food which is healthy for you, it just means think about how much you eat and cleaning your teeth afterwards.

Things you might want to consider

In addition to things you definitely should or should not do there are a few extra things which you may want to consider in your pursuit of whiter teeth.

  • Eating Strawberries. Now we don’t mean eating tons of strawberries every day, however strawberries contain malic acid, in small doses it has been shown that malic acid can whiten teeth… But don’t go overboard as it is also an acid and can actually damaged teeth if used too much.
  • Eating crispy or firm food can clean your teeth naturally as you go. Eat them towards the end of the meal as they will then help to naturally clean your teeth with their rough and crunchy edges, think about things like carrots or celery.
  • Chewing gum after eating stimulates production of saliva which neutralises and cleans your teeth by washing away debris. Always use a sugarfree gum.

Things to avoid when looking for whiter teeth

  • Coconut oil pulling. This seems to be a modern trend but there is no evidence to show that coconut oil whitens teeth in any way at all. In fact, some toothpastes are now including coconut oil but may not include enough fluoride. In this instance, this can lead to tooth decay due to a lack of fluoride. The same also applies to activated charcoal.
  • Beauty salon whitening. people often believe that you can go to a beauty salon for teeth whitening, however teeth whitening is not legal for anyone other than a dentist (or a dental hygienist or dental therapist working to prescription of the dentist) to carry out tooth whitening.
  • Using hydrogen peroxide/bleach. Whilst teeth whitening gel at a dental practice utilises hydrogen peroxide it does so in an extremely controlled and limited way. Using home bleach or any other form of non-dental hydrogen peroxide without the strict supervision or control of the dentist can be extremely dangerous as the soft tissue/gums can burn easily.

A final secret for whiter looking teeth

So here is our final secret for whiter looking teeth… Wear red lipstick! It’s a tip used by many celebrity and make up artist as the red lipstick forms a contrasting frame around your teeth making them look whiter.

red lipstick and white teeth

Image credit: Miki Hayes 2.19.15  https://www.bustle.com

Dr Nishan Dixit

Dr Nishan Dixit

Dr Nishan Dixit is the founder and principal dentist of Blue Court Dental. Patients enjoy his relaxed, friendly and gentle approach while experiencing his meticulous attention to detail. He has a special interest in providing smile makeovers, natural-looking white fillings and cosmetic braces, but also provides a range of treatments from preventative and general dental care to complex dental rehabilitation.
Dr Nishan Dixit

Latest posts by Dr Nishan Dixit (see all)

Crowns vs Veneers vs Bonding

It’s often a dilemma knowing which to choose, crowns, veneers or bonding so we thought we would explain the differences between each in order that you can make the best decision based upon your own requirements and clinical needs.

What are the main differences between crowns, veneers and bonding?

  • Cost
  • Strength
  • Removal of tooth structure
  • Ability to change appearance of the tooth
  • Frequency of replacement

Crowns vs Veneers vs Bonding Cost

The cost of crowns, veneers and bonding is determined by a couple of factors:

  1. The time it takes.
  2. The cost of materials.
  3. The cost of laboratory fees.

Bonding usually takes a little less time than veneers and particularly crowns, but the biggest difference is the cost of laboratory fees. Bonding is done directly onto your tooth and therefore there is no third-party laboratory required in order to manufacture the restoration, this keeps the cost down considerably.

Bonding typically starts from between £345-£445 depending upon the complexity.

Dental veneers and crowns Usually take longer than dental bonding as the dentist needs to prepare the underlying tooth structure in a very precise way in order to receive the new dental veneer and Crown. Once the dentist had prepared the underlying tooth an impression will be taken and sent to a dental laboratory, the dental laboratory then makes the veneer or crown. This extended procedure adds to the cost.

Veneers and crowns typically start from £650 depending upon the complexity.

Crowns vs Veneers vs Bonding Strength

These three restorations can be ranked in order of strength.

  1. Dental bonding-lowest
  2. Dental veneers
  3. Dental crowns-highest

With any type of restoration on a tooth one needs to be aware and be sensitive to the fact that what you have is not an entirely natural tooth. Dental bonding is most prone to fracture, however because the bonding is done directly onto the tooth it is the easiest to be repaired by the dentist. If veneers or crowns fracture they will need to be removed and sent back to the laboratory for repair, sometimes repairs are not possible and a full remake is required.

Crowns vs Veneers vs Bonding Removal of tooth structure

Most dentists will prefer to keep as much natural tooth structure as possible, this is generally the preferred option wherever clinically justified. Removal of tooth structure is needed in order to receive the new restoration, particularly with veneers and crowns although sometimes a small amount of tooth structure is removed for dental bonding.

The three restorations can be ranked in order of the amount of tooth structure generally required to be removed.

  1. Dental bonding-lowest amount of tooth structure removed
  2. Dental veneers
  3. Dental crowns-highest amount of tooth structure removed

Crowns vs Veneers vs Bonding Ability to change appearance of tooth

Depending on what change of appearance is required may define which type of restoration your dentist uses.

  1. Minor chips and shape defects can be corrected with dental bonding.
  2. More major chips and shape defects plus the colour of the tooth can be corrected with dental veneers.
  3. The most severe chips, shape defects, tooth rotations and tooth wear can be corrected with dental crowns.

Crowns vs Veneers vs Bonding Frequency of replacement

The frequency of replacement will usually be determined by the following:

  • How quickly the materials used becomes worn or discoloured.
  • How well you look after the restoration, teeth and gums.
  • How careful you are when eating.
  • How well do you protect your teeth during sport.
  • Not having any accidents!

As you can see you will play an active role in maintaining the restoration and ensuring it lasts as long as possible.

Typical problems and reasons for replacement are as follows:

  • Dental bonding
    • The composite bonding material can discolour due to strong coloured foods being consumed or smoking etc
    • The restoration can chip due to excessive biting forces.
  • Dental veneers & crowns
    • The restoration can chip due to excessive biting forces.
    • The surrounding teeth change colour (either darker through age or whiter through whitening) and the dental veneer no longer matches and needs to be replaced.
    • The gum margin on the tooth recedes due to age (a natural phenomenon), this can then expose the underlying tooth which often look starker. This necessitates remaking the veneer or crown in order to cover up his newly exposed underlying tooth.

Summary

As you can see, the decision about whether to have crowns, veneers or bonding is not a simple one. It involves taking into account many factors and balancing out the risk factors in order to ensure you have the very best restoration for your budget, requirements and clinical suitability. Cosmetic dentistry such as this is very often as much an art as it is a science.

Dr Nishan Dixit

Dr Nishan Dixit

Dr Nishan Dixit is the founder and principal dentist of Blue Court Dental. Patients enjoy his relaxed, friendly and gentle approach while experiencing his meticulous attention to detail. He has a special interest in providing smile makeovers, natural-looking white fillings and cosmetic braces, but also provides a range of treatments from preventative and general dental care to complex dental rehabilitation.
Dr Nishan Dixit

Latest posts by Dr Nishan Dixit (see all)

What alternatives are there to amalgam fillings?

One of the things most dental practices want to do is to offer you alternatives to treatments, having a dental filling is no exception. There are a wide range of options when it comes to treating tooth decay with a dental filling and in this blog post, our Harrow dentist, Dr Nishan Dixit discusses what alternatives there are to the classic silver amalgam filling.

Types of dental fillings in the UK

There are a variety of materials that can be used for a dental filling, each is selected depending upon the material properties, what the material needs to do and your clinical situation. Those materials include:

  • Amalgam (silver coloured fillings).
  • Composite (white fillings).
  • Porcelain ( white fillings).
  • Gold.

Amalgam Filling Alternatives

There are a few alternatives to amalgam fillings, these typically include restorative materials such as glass ionomer white fillings, composite white fillings, porcelain white fillings and even gold fillings although these are not used very often nowadays.

Amalgam fillings

Amalgam fillings are still commonly used in the UK, particularly in NHS dental practices. The material is relatively cheap, easy to work with and durable. Amalgam silver fillings contain a mixture of silver, tin and copper which is bound together with mercury.

Mercury poisoning is a concern of many people with amalgam fillings. The most risky time for release of free mercury is during placement and/or removal of an amalgam filling, this is due to release of mercury vapour. Having an amalgam filling removed can potentially release more mercury than leaving it in place.

Several studies have shown that the amount of mercury released from fillings is extremely low, especially when left in place. However, due to their typically unsightly nature and potential to release mercury many patients are preferring to opt for a more cosmetic option.

Another problem with amalgam fillings is that you can get what is known as an amalgam tattoo. This is where the dark silver colour from the amalgam shows through the front surface of the tooth creating a dark effect around the gum making it look like it has a tattoo.

Composite fillings

These are one of the most commonly used alternatives to mercury fillings. Composite fillings are mercury free and are often a blend of fine ceramic particles mixed with a composite material which sets when a special light is shone on it. The composite comes in a variety of tooth coloured shades so your dentist can select the right one for you. Composite fillings may wear faster than your natural teeth so you may need to have them replaced a little more often.

Amalgam fillings versus composite*

Property

Amalgam

Composite
Wear (1 highest 5 lowest) 3 4
Fracture resistance (1 worst 5 best) 3 4
Cost (1 expensive 5 cheaper) 4 2
Loss of tooth structure (1 least 5 most) 4 2
Health concerns (1 unhealthy 5 healthiest) 1 4

How long do white fillings last?

White fillings typically last up to 10 years. Data shows that after five years approximately 75% of fillings remain. This has reduced to 50% after nine years. This is based upon research undertaken in 2001.

Can you have White fillings on front teeth?

Yes, white fillings on front teeth are often called dental bonding. They can either simply replace a small decayed area or cover the whole of the front of the tooth. They can also be used to add to teeth to make the teeth longer, if worn down, or to change the shape of a tooth.

Are there any side effects from white fillings?

Unlike amalgam where people are concerned about the side-effects from mercury, white fillings have a few inherent side-effects related specifically to the material used. Any side effects from a white filling are common to all types of filling and include:

  • Numbing of the area due to the anaesthetic used.
  • Sensitivity of the tooth for a few days afterwards.

 

How long after a filling can I eat

This depends upon the type of filling you have had, amalgam takes approximately 24 hours to harden completely, during this time you should eat softer foods and avoid anything sticky. The white filling is set and made completely hard by curing the composite with a light in the dental surgery. This theoretically means that you can eat straightaway after a white filling.

We do however recommend caution as you probably will have had an anaesthetic to numb the area whilst the filling was placed. It is better to  wait until the anaesthetic subsides before eating as you should be careful of biting your cheek and tongue as these area are still numb.

*Subjective data based on experience. Individual properties may vary depending upon the size, position and age of the restorations including the skill of the dentist that placed the original restoration.

Dr Nishan Dixit

Dr Nishan Dixit

Dr Nishan Dixit is the founder and principal dentist of Blue Court Dental. Patients enjoy his relaxed, friendly and gentle approach while experiencing his meticulous attention to detail. He has a special interest in providing smile makeovers, natural-looking white fillings and cosmetic braces, but also provides a range of treatments from preventative and general dental care to complex dental rehabilitation.
Dr Nishan Dixit

Latest posts by Dr Nishan Dixit (see all)

Why do my teeth look yellow?

Dr Nishan Dixit

Dr Nishan Dixit

Dr Nishan Dixit is the founder and principal dentist of Blue Court Dental. Patients enjoy his relaxed, friendly and gentle approach while experiencing his meticulous attention to detail. He has a special interest in providing smile makeovers, natural-looking white fillings and cosmetic braces, but also provides a range of treatments from preventative and general dental care to complex dental rehabilitation.
Dr Nishan Dixit

Latest posts by Dr Nishan Dixit (see all)

 

This is a question we get asked lots at our dental practice here in Harrow, so we thought we would take some time to take a look at the common reasons why your teeth may not be quite as white as you’d like to be… Some of those reasons are obvious but others aren’t!

What are you eating?

red white
Image credit: Master-isolated-images FreeDigitalPhotos.net

It sounds quite obvious but there are many foods which have any impact on the colour of your teeth. Some foods stain your teeth directly whilst others contribute to dental decay by being rich in sugar.

Foods which contain high amounts of sugar feeds the acid excreting bacteria which live in your mouth, the more sugar there is in your food the more this bacteria is able to feed and excrete the bacteria which then attacks your teeth causing dental decay. Teeth can then become dark either through the dental decay or by the bacteria forming solid deposits, known as plaque, which then become stained by the strong colours in some foods.

Some food on the other hand is naturally dark staining such as dark berries, tea and red wine. These may stain your teeth on their own but the staining is compounded if you have plaque on your teeth caused by a combination of poor oral hygiene and sugar in your diet.

Of course, so many of us like to eat foods like this, so if we want our teeth to be bright and white then we just have to get on top of our dental healthcare!

Are you brushing as well as you could?

Even if your diet isn’t too rich in sugar and you avoid the food with strong colours then your teeth could still be yellow then it would likely that your oral health care routine isn’t as good as it should be.

Quantity of bacteria in your mouth
Image credit: wellordie.com/health

Your mouth contains so many bacteria, more than the population of the world in fact, so it’s really important that you keep on top of this and remove as much bacteria and food as you can after each meal.

When brushing your teeth we recommend using a pea sized amount of fluoride toothpaste twice per day for 2 min each time. We also recommend flossing daily to ensure your teeth clean in between and then using a fluoride mouthwash in between meals (never after brushing as the mouthwash has less fluoride in than toothpaste).

Are you scrubbing rather than brushing?

anatomy of a toothYes, it’s possible to clean your teeth too much! If you scrub your teeth too much then the gum can recede as it will often become irritated due to the excessive brushing. As the gum recedes it may expose the softer dentine part of your tooth which is lower down towards the root. This part of the tooth is softer than the enamel (a part which you usually see) and is therefore more susceptible to both dental decay and staining.

When you brush, go easy and don’t scrub, if you visit a dental hygienist regularly they will be able to tell you if it looks as though you may be pressing too hard when you clean your teeth. It may also be worth considering an electric toothbrush, many of these have pressure sensors and light up red if you are pressing too hard, a really useful aid if you find this is a problem for you.

Your teeth just are naturally yellower!

Some people’s teeth are just not naturally as white as other peoples. Over the years celebrities have had so much teeth whitening that the commonly accepted shade for teeth is now considerably whiter than it was a few years ago.

Dental manufacturers have had to create new whiter and brighter colours for their materials to match this new trend, what was considered an average tooth colour 10 years ago would now be considered yellow.

Shade guide
Whiter shades have been created by the dental manufacturers to cope with the cosmetic demand of white teeth

Perhaps you are taking medication which makes your teeth look yellow?

The first thing to say is that you should never stop taking any medication that has been prescribed to you without first consulting your doctor. It has however been reported that some medications may affect the colour of your teeth, most often this happens if the medication is taken during childhood whilst the teeth are still forming, rather than extrinsic staining of the teeth at a later date in adulthood.

Some medicated mouthwashes can also stain teeth, so please ensure that you read the label of any medicated mouthwash that you may have been prescribed.

Rest assured though, if your teeth have been stained through using a medicated mouthwash this can easily be removed by your dentist or hygienist.

Do you smoke?

Well, you knew this would probably come up at some point! Smoking darkens teeth because it changes the delicate PH balance in your mouth, it also dries your mouth out which leads to an excessive buildup of bacteria. This bacteria not only has a rather noticeable smell, but also can contribute to increased rates of dental decay.

Plaque on teeth

The smoke itself also has many of these colouring components which, particularly when coupled with poor oral hygiene, can stain the teeth quite noticeably.

As a sidenote, if you have any damage to the gum in your mouth then smoking also slows down the healing process, just another reason to begin the quitting process.

You are older than you were yesterday!

It’s just a fact that as we age various things happened to our body! Gravity takes over and alas, our teeth can appear yellower. The reason for this isn’t because your teeth are actually going yellow, it’s because that as we get older the outer surface of the tooth (enamel) wears away, as the enamel wears away with age the yellower underlying dentine becomes more exposed. As that dentine nears the surface it has the effect of making the teeth look yellower.

This is often more prominent on the lower teeth towards the biting incisal edge. It can be noticed that there is significant yellowing or staining right on that chip area, this is known as secondary dentine and is a common concern with people in, shall we say, more senior years!

And the good news is…

The good news is that most of these problems can be quickly and simply resolved. If you give up smoking, look at your diet and ensure your oral health care routine follows the suggested procedure then you can have a big impact on the colour of your teeth. Your dentist can also whiten your teeth in a couple of ways.

If your teeth just have surface staining perhaps from smoking or food stains then this can be removed with an air abrasion technique. This blasts very small particles at the end at your teeth which very gently remove the surface stain. If however the enamel of your tooth is intrinsically not as white as you would like them teeth whitening could also be the perfect option for you.

What ever you decide, your friendly dentist in Harrow is here to help, please contact us today to book your appointment and begin your journey to brighter, whiter teeth.

 

Time to make that change

Dr Nishan Dixit

Dr Nishan Dixit

Dr Nishan Dixit is the founder and principal dentist of Blue Court Dental. Patients enjoy his relaxed, friendly and gentle approach while experiencing his meticulous attention to detail. He has a special interest in providing smile makeovers, natural-looking white fillings and cosmetic braces, but also provides a range of treatments from preventative and general dental care to complex dental rehabilitation.
Dr Nishan Dixit

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Years of bad habits and irregular visits to the dentist caused this patient’s teeth to deteriorate very quickly.  Her top teeth were very uneven and heavily discoloured.  Close friends and family always commented on how her teeth looked, which over time, caused the patient’s confidence to drop.  She would never smile openly or laugh out loudly.  Meeting new people was impossible and having photographs taken was never an option.  This had a big impact on her life.  She wanted to become the person she was, someone who was full of life and confidence.

After careful thought and planning, the best course of treatment recommended by Dr Dixit was to replace the existing crown and provide new porcelain crowns for the heavily filled and discoloured teeth. The teeth were prepared to the ideal shape for the crowns using custom-made templates to minimise drilling. A soft-tissue laser was used to painlessly recontour the gums enabling the final crowns to be of the ideal length for her face. The new colour was matched to perfection using a special hand-held shade taking device.

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The patient was over whelmed  with the results.  Friends and family could not believe how confident it had made her. She was now able to hold her head up high and smile openly and laugh loudly.

 

 

 

Are British Teeth Finally Something to Smile about?

Dr Nishan Dixit

Dr Nishan Dixit

Dr Nishan Dixit is the founder and principal dentist of Blue Court Dental. Patients enjoy his relaxed, friendly and gentle approach while experiencing his meticulous attention to detail. He has a special interest in providing smile makeovers, natural-looking white fillings and cosmetic braces, but also provides a range of treatments from preventative and general dental care to complex dental rehabilitation.
Dr Nishan Dixit

Latest posts by Dr Nishan Dixit (see all)

There have often been jokes about the state of the teeth in the UK compared to those of citizens in the USA, but are things changing? Are British teeth finally something to smile about?

Ricky Gervais' teeth
“These are my real teeth. You think I’d wear them all the time if they weren’t real? ” Ricky Gervais’ reply to interviewer remarking on his ‘false teeth’. (Source news.bbc.co.uk/1/hi/7633254.stm)

Over the years more and more Americans have had cosmetic dentistry, teeth whitening and dental veneers have become commonplace, Linda Stradley (1) says:

A recent survey showed 80% of Americans aged 18 to 49 want whiter teeth, with women leading in this area at 85%. 6 out 10 believe a whiter, brighter smile would boost their self confidence especially in the 18 to 24 age range

It wasn’t that British teeth were particularly bad that put us as the butt of many a joke, It was simply that the idea of a perfect smile had become brighter and whiter thanks to the surge in Americans having cosmetic dentistry – British teeth were just more natural!

What we have noticed is that patients looking for cosmetic dentist‘s in the UK, particularly in our location of Harrow, Middlesex has also increased.

Natural smiles vs. Hollywood smiles

When dental companies first started to produce materials that enabled dentists to restore smiles with dentures, dental veneers and bonding the range of colours was very limited. Over the years this range of colours has grown and can be seen in the image below.

Shade guide

 

What is interesting to notice is that the three whiter Shade taps on the left of the image are additions. When Vita performed their original research to discover the different colours of teeth that existed throughout the populace they reproduced this in their a guide, from the lightest discovery through to the darkest discovery.

Since its original shade guide was introduced the American desire to have a whiter smile has forced the manufacturers to add on these three extra colours from mid-white through to the brightest dazzling white.

This session with having perfect teeth has been reflected in this Quora discussion.

Who is having cosmetic dentistry?

Source - American Academy of Cosmetic Dentistry Levin Group, Inc study 2013
Source – American Academy of Cosmetic Dentistry Levin Group, Inc study 2013

The distribution of people having cosmetic dentistry is fairly even across all age groups although more than half of the people having cosmetic dentistry are over the age of 40.

This is possibly contrary to what many people think in that cosmetic treatments are only for younger people.

 

 

Why do people consider cosmetic dentistry?

This is another extremely interesting aspect to look at, why do people want cosmetic dentistry in the first place?

One might initially think that it’s because people want to look younger however the results of the survey showed that 89% of people asked for cosmetic dentistry to improve their physical attractiveness and/or self-esteem

Reasons for having cosmetic dentistry
Source – American Academy of Cosmetic Dentistry Levin Group, Inc study 2013

 

What options are people going for to enhance their smiles?

Not surprisingly one of the most common treatments in cosmetic dentistry is bleaching or whitening at 93%, however crowns and bridges top the poll at 97%.

What treatments that people have with cosmetic dentistry
Source – American Academy of Cosmetic Dentistry Levin Group, Inc study 2013

 Why are British teeth now something to smile about?

The first reason is that more people are visiting the dentist. NHS statistics show that 52.3% of the adult population now visit the dentist and 69.2% of the child population visit the dentist. With more people visiting the dentist and having access to healthy teeth this will inevitably enhance the smiles of people in the UK.

One of the biggest problems however is that nearly 100,000 fewer children visited the dentist in the most recent research compared to previously produced statistics.If this trend isn’t reversed then the jokes about British teeth may become true again in years to come!

Campaigns such as this “Is your mouth making you sick?” infographic have also helped raise the awareness of going to the dentist, particularly with its links to heart disease, diabetes, Alzheimer’s and cancer

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Proof that the British teeth are something to smile about

 

Before
After cosmetic dentistry

This patient had cosmetic dentistry using dental veneers to restore her smile.

The advent of additional treatment styles has also enable more people to access treatments which make their smiles look better. In the past these treatments were not available in the UK but modern orthodontics which allow invisible, rapid and lifestyle treatments to straighten teeth have now become commonplace.

Six month smiles is a great example of this, this modern treatment has allowed more patients to access orthodontic braces than ever before. Orthodontics is generally the preferred way to straighten teeth, rather than have dental veneers. Orthodontics maintains your natural tooth structure which is an optimum treatment for most dentists.

If you live locally and would like to visit our dentist in Harrow please complete the form on this webpage to request a free cosmetic dentistry consultation. We are always happy to help you achieve your perfect smile.

References

(1) http://whatscookingamerica.net/HealthBeauty/TeethWhitening.htm

I’m not happy with my smile, what are my options for cosmetic dentistry?

Dr Nishan Dixit

Dr Nishan Dixit

Dr Nishan Dixit is the founder and principal dentist of Blue Court Dental. Patients enjoy his relaxed, friendly and gentle approach while experiencing his meticulous attention to detail. He has a special interest in providing smile makeovers, natural-looking white fillings and cosmetic braces, but also provides a range of treatments from preventative and general dental care to complex dental rehabilitation.
Dr Nishan Dixit

Latest posts by Dr Nishan Dixit (see all)

We find that many people are looking for options to restore their smile but simply don’t know what those options are. This blog post has been written to allow you to understand what the options are available, possible prices, the procedures and what to expect from cosmetic dentistry.

Cosmetic dentistry is broadly broken down into 4 main areas.

  1. Straightening crooked teeth.
  2. Whitening dark teeth.
  3. Restoring broken down teeth.
  4. Replacing missing teeth.

Let’s look at each of these areas in turn.

Options to straighten crooked teeth.

As with many areas of dentistry there is in one simple way of doing this, which actually works as an advantage as it means that you can choose the best approach for you. We thought one of the easiest ways to break these treatments down Is to look at treatment time is and how quick you could have straight teeth again.

Straight teeth in around 2 to 3 weeks

If you’re looking to have straight teeth in the quickest time possible them possibly dental veneers are the way forwards. Dental veneers are a precision made thin-layer which fit over the surface of your existing teeth. They made from a high-strength dental ceramic by a highly skilled dental technician and so often come with a higher pricetag than many other options.

Dental veneers can also be used to restore broken down teeth and whiten dark teeth, so at the same time straightening them you could end up with a perfect Hollywood smile at the same time!

teeth-veneers

One of the big disadvantages with dental veneers are that they often require some form of reduction of your natural teeth underneath. Many dentists prefer to work on a minimally invasive nature, whilst dental veneers are relatively minimally invasive they do still often require drilling of your natural tooth.

If your natural tooth is otherwise healthy then you need to know that some of this may be reduced in order to accept the new dental veneer.

Before cosmetic dentistry from our Harrow dentists
Before dental veneers
After cosmetic dentistry
After dental veneers

>> Read more blog posts about dental veneers

>> Information from the British Academy of Cosmetic Dentistry about dental veneers

Straighter teeth in around 12 to 16 weeks

One of the disadvantages of dental veneers is the fact that they often require a small amount of reduction of your natural tooth. Whenever possible we prefer to keep your natural teeth fully intact and so this is where the next treatment to straighten teeth comes in, it involves moving them with orthodontics and the technique which is fastest is known as the Inman Aligner.

The Inman aligner is a revolutionary new technique whereby a removable orthodontic appliance is used to push and pull your teeth in the correct direction. You need to be committed with your Inman aligner and wear it for at least 20 hours per day, removing it only for cleaning and eating.

Here’s a video of how the Inman aligner works by pushing and pulling at the same time.

>> more information on the Inman aligner

Straight teeth in around six months.

Many people dislike the fact that the Inman aligner, whilst being rapid, is a removable appliance. Some people prefer to have a fixed appliance. Fixed appliance orthodontics are generally able to move teeth slightly more than a removable appliance and the one that we prefer is Six Month Smiles.

This orthodontic system uses fixed, tooth coloured brackets to move your teeth around six months, this is much faster than conventional orthodontics which often takes between one and two years. The reason we can move the teeth quicker is down to a revolutionary type of bracket and the fact that we are often only moving the front teeth.

 

Before Six Month Smiles

 

After Six Month Smiles

>> more information on Six Month Smiles

 Cosmetic dentistry to whiten dark teeth

You have two options to whiten dark teeth:

  1. Teeth whitening.
  2. Dental veneers.

Teeth whitening and cosmetic dentistry

Teeth whitening is one of the most easily accessible treatments in dentistry as it can be offered to almost anyone. So long as you have natural teeth (dental veneers or crowns cannot be whitened) and you are in good dental health then you are more than likely candidate of teeth whitening.

As with any dental treatment it is absolutely vital that you are in good dental health before embarking on any programme of whitening. This is one of the reasons it is important to visit your dental practice to have your whitening treatment, if your gums are unhealthy or perhaps bleed on contact then this can affect the whitening process and inflame any gum disease you may already have.

The clear teeth whitening tray
The clear teeth whitening tray

Teeth whitening works by placing a small amount of peroxide gel in contact with your teeth. This peroxide whitening gel is held in place by close-fitting and precision made bleaching tray which is the spoke to you and cannot be used with anybody else. These trays need to be made with absolute precision.

They need to seal around the age of your tooth/gum margin to ensure that none of the peroxide gel touches your sensitive gums. This is another reason why we recommend going to see your dentist for whitening, they can accurately make sure that this tray fits precisely prior to beginning any treatment.

You will typically wear your teeth whitening bleaching trays overnight for approximately 2 weeks. The good thing with the treatment is that if you experience too much sensitivity or you reach your desired tooth colour then you can stop treatment immediately.

Dental veneers for whitening teeth

If your teeth are extremely dark, perhaps because they have died then we may find that whitening is not adequate to get them to the shade required. If this is the case then dental veneers can be used to cover up the dark teeth underneath.

Before restoration with veneers to whiten teeth

 

After restoration with dental veneers

Restoring broken down teeth in cosmetic dentistry

We’ve already discussed the ability for dental veneers to straighten crooked teeth and white and dark teeth, they can also be used to restore broken down teeth. Because we’ve already spoken about dental veneers we’re going to focus our attention now on dental crowns.

Dental crownsA dental crown is a precision made and highly aesthetic replacement for the natural crown of your tooth. The most aesthetic ones are made from pure high-strength dental great ceramic which is extremely long lasting and can withstand the force is exerted when you eat and chew.

Your dentist will remove any decayed area of tooth, prepare the remaining teeth and take an impression which will be sent off to the dental technician. The dental technician, who was a highly skilled member of the dental team will then make your new crown to fit exactly over the stump which the dentist has prepared.

This whole process takes approximately 2 weeks from start to finish, was the technician is making a new crown you will be supplied with a temporary crown.

Replacing missing teeth in cosmetic dentistry

We’ve written blog post in the past offering top tips for people wanting to replace missing teeth, so we’re not going to spend too much time here talking about this. What is important to know is that replacing missing teeth can also be done in conjunction with other forms of cosmetic dentistry.

If you have missing tooth it may be that in order to replace it we need to create more space, if this is true then we may use orthodontics to move the surrounding teeth around to create enough space. You may also want to restore broken down teeth and white and other teeth at the same time as replacing missing teeth. This then becomes a more complex form of cosmetic dentistry with complicated procedures.

If you’re going to have these more complex procedures we recommend you search for your cosmetic dentist on the British Academy of Cosmetic Dentistry website, in the search facility if you type in Nishan Dixit and enter the area as Harrow you will find that he is a full member of the Academy who has been qualified for more than three years, demonstrated a commitment cosmetic dentistry by fulfilling their strict requirements which include attendance at meetings and ongoing postgraduate education in subjects relevant to the practice of cosmetic dentistry.

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Dr Nishan Dixit runs a dental practice in the heart of Harrow offering cosmetic dentistry  to the local people. The practice offers a free cosmetic dentistry consultation with the treatment co-ordinator, please complete the relevant form here 

 

Who said I’m camera shy !

Dr Nishan Dixit

Dr Nishan Dixit

Dr Nishan Dixit is the founder and principal dentist of Blue Court Dental. Patients enjoy his relaxed, friendly and gentle approach while experiencing his meticulous attention to detail. He has a special interest in providing smile makeovers, natural-looking white fillings and cosmetic braces, but also provides a range of treatments from preventative and general dental care to complex dental rehabilitation.
Dr Nishan Dixit

Latest posts by Dr Nishan Dixit (see all)

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“Please make me look nice for my daughter’s big day!”  These were the words of a loving mother who desperately wanted nice teeth for what was going to be one of the most important days of her life, her daughter’s wedding.   For most of her life,  she had lived with a smile she was very unhappy with.  Her top teeth were very uneven and discoloured.  The  old existing crowns towards the back of the mouth  had began to deteriorate, as well as a tooth which had become very stained and unsightly.   The gap in between her front  two teeth always seemed to draw attention to her not so great smile.  This  made her feel very self conscious and even embarrassed.   She would never smile in front of the camera,  and even in general conversation,  she would raise her hand to cover her mouth.  Friends and family always thought she was very quiet, but in reality, she lacked so much confidence that smiling, laughing and even talking was something she found very difficult.    She wanted a smile that would make  her  look and feel great.

With careful thought and planning, Dr Dixit achieved this transformation by using a combination of all ceramic crowns and veneers.  To make the teeth brighter , the teeth were whitened using the home whitening system.  The heavily filled teeth were protected with new crowns and the new veneers helped to improve the shape and position of the teeth.  The colour was matched exactly to the patients new teeth colour.  The crowns and veneers were made to look as natural as possible.

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The patient was very pleased with the results.   It had given her so much  confidence that she felt like a new woman.  She looked and felt amazing.  The discoloured front tooth and filling had gone and the visible black lines were no longer there.  She finally had the smile she always wanted.