by Dr. Nizar Kharma
Do we all need a dazzling white smile? What used to be an exclusive celebrity obsession seems to have become a universal dream.
What is a Hollywood Smile?
It is certainly not a dental term and no one can confirm who invented it for sure. Historically, the term has almost always been associated with veneers — layers of thin material covering the outer surface of teeth to improve their appearance. The very first mention of veneers was in 1928 by the Hollywood-based dentist, Charles Pincus. The veneers were mainly aimed at temporarily improving movie stars’ smiles for the roles they played. Since then, their appearance, strength and bonding have considerably improved. By the early 1980s, veneers had become a key player in cosmetic dentistry.
Types of Veneers
Veneers these days come in different shapes and shades, as do the cements used to bond them to teeth. They are very versatile and can be made to look as natural or eccentric as needed. There are several materials used to make veneers, and some elements require multiple dental visits to fabricate and fit.
No Pain No Gain? Advantages of Veneers
- Minimal removal and less pain: We have historically associated any improvement of our smile with pain, suffering and the dreaded NEEDLE! This is extremely unlikely with veneers, as minimal or sometimes no tooth removal is involved. Therefore, little or no anaesthesia is needed!
- Strength and protection: Research shows that veneers strengthen teeth by protecting them from destructive factors such as acidity and abrasive foods.
Getting carried away? Indications for Veneers:
Veneers are not for everyone and are only an option if your teeth are:
- Mildly chipped
- Superficially decayed
- Slightly displaced, crowded or spaced
You cannot get veneers if you have:
- Straight and undamaged teeth
- Large areas of tooth loss/decay
- Poorly aligned teeth
- Grinders or heavy-biters
- Untreated gum disease
Too Good to Be True! Risks and Disadvantages of Veneers:
While veneers can provide you with bright white teeth, there are significant drawbacks, which must be considered before embarking on treatment. These include:
- De-bonding: Little or no tooth-tissue removal will sometimes result in less than satisfactory retention. This can lead to veneers falling off.
- Fracturing: Minimal or no tissue removal means that veneers can sometimes be extremely thin, leading to high incidents of fracture.
- Irreversibility: Veneers are a permanent option; they are strongly bonded to teeth. As a result, some tooth loss will occur if patients request the veneers to be removed.
- Aesthetic and practical issues: Some patients struggle to cope with the new appearance of the veneers or how they feel in the mouth. In addition, patients may initially or for a long time encounter difficulties with speech and eating. Furthermore, patients may not be happy with the appearance and request replacement, leading to further long appointments.
- Long-term maintenance is needed:
- Regular dental visits: Six-monthly check-ups are crucial for examining the veneers for any issues.
- Healthy dental lifestyle: excellent oral hygiene habits and minimal sugar consumption are pivotal for long-term success.
- Avoiding extremely hard and/or sticky foods such as caramels and toffees.
Other Hollywood Smile Options
Although veneers are closely related to the Hollywood Smile, other treatment options can also give you the same result, if veneers are not a suitable choice. These include: crowns, bridges, orthodontics, simple composite bonded fillings or whitening.
These are indicated in cases of excessive tooth wear/decay, tooth loss, severe discoloration, heavy biters/grinders or following root-canal treatment. They have the advantage of better retention, stability and strength then veneers. However, they involve the use of anaesthesia, considerable tooth-tissue removal and a resulting higher chance of loss of tooth vitality. This can lead to pain or infection and the need for further root canal treatment in the future.
When teeth are displaced, but have a good shape and colour, braces are highly recommended. Once teeth are straightened, there will be a dramatic improvement without the need for veneers. The main down side of orthodontic treatment is possible relapse and the continuous need for retention, as teeth will always try to move back to their original alignment.
Bleaching has the main advantage of being the most conservative treatment in dentistry, as it only involves applying whitening gel on the teeth, with no tooth-tissue removal. Issues around this type of treatment revolve mainly around the safety of whitening gel’s main ingredient, hydrogen peroxide. Though safe and effective at low doses, tooth sensitivity and gingival irritation can occur. For this reason it is best to have the treatment administered by a dentist rather than using whitening products at home. Studies have shown hydrogen peroxide is toxic at high doses and although these thresholds are not achieved during treatment, repeated treatments can cause adverse effects.
Direct Bonded Composite Veneers or Fillings:
These have the main advantage of needing only one visit, and are therefore a simple, quick and cheap option. However, they will easily wear and discolour as they are relatively weak and easily pick up stains from coffee, tea, dark foods and smoking. Therefore, this option will only suit a limited number of patients.
If embarking on the Hollywood Smile journey is on your future to-do list, the following tips will help you take the first steps:
- Find your dentist: This is the most essential part of your journey. Cosmetic enhancement of your smile is a continuous dialogue and a multidisciplinary approach involving your dental, medical, social and psychological well-being.
- Do your own research: Despite the bias of some sources, the more research you carry out, the larger the amount of information you accumulate.
- Resist social pressure: Your unique, distinctive, healthy smile is a part of who YOU If, despite that, you still want to explore the Hollywood smile option, chose the most natural look that suits your own personality and character.
- And remember: Veneers and cosmetic dental treatments are more WANTED for appearance enhancement than NEEDED for health reasons. Looking after your teeth and improving your oral health should be your main priority.