WHAT IS YOUR SMILE WORTH?

post-doorIt has always amazed me how much money we are prepared to spend on a handbag, shoes, our hair or other such indulgences to make ourselves look or feel better but in comparison how stingy we can be when it comes to our teeth.

I broke a top, front tooth when I was 8 or 9 (falling off my……skateboard! It was the 80s) and the years that followed were full of dental appointments, name calling, self-consciousness, lack of smiling and pain. Poor me! After I’d finished with all the orthodontic work needed- including the wear of a head brace, which a friend likened to Hannibal Lecter, I became obsessive about my teeth. First, I had to teach myself how to smile properly again- I’d mastered the art of smiling with my eyes and not showing my teeth- it took a long time to relax into a natural, teethy smile without feeling like my face was going to crack! I then had to take on quite a stringent dental-hygiene routine, as people who have had braces are more prone to gum disease due to the teeth not being in their natural position and have therefore left little, plaque-loving pockets in the gums where they used to sit.

I also became very aware of the foods I ate and how I ate them- for example; I haven’t bitten into an apple since having my first veneer fitted in 1995 after the dentist said “you’ll probably bite into an apple one day and your tooth will pop off!”. Great.

*In case you’re not sure! Veneers are thin porcelain ‘covers’ that fit over your natural teeth. Usually a small amount of enamel needs to be removed from the front of your teeth before the veneers are fitted but not in all cases*

So, when I hear people talk about veneers like some glamorous passage to a perfect smile, it baffles me. Why on earth would you file down healthy teeth to fit veneers as a ‘quick-fix’? Don’t get me wrong, I think veneers are amazing and an absolute Godsend for those of us that have few other options, I just don’t get it when they are used as a short cut to a great smile.

Type into any search engine ‘dental veneers’ and you will find lots of ‘deals’ popping up- this terrifies me! Partly because, had my dental problems occurred in my early 20s, I fear I would have fallen prey to the appeal of these ‘deals’ too. I say deals in inverted commas because, to me, they are not deals at all. Primarily, veneers are a long-term expense, they must be changed every 10-15 years of your life! You have no choice in this! If the veneers are not done well you will probably have to change them sooner. This is a huge expense over a lifetime, incomparable to the cost of less invasive (but possibly more time-consuming) dental work that could give you the same results.

I’m 36 and have already had to change my veneer twice since it was first fitted; once just before I got married and the second time was just recently- I was dreading it! In fact, I had been putting it off for a whole year. The problem I have is that mine is a single, front veneer which needs to be matched exactly to my natural teeth to look realistic. Matching isn’t just about shape and colour, it’s also the texture, the thickness, the variations in colour and the position- in short, it is a very difficult process, needing the skill of a highly adept technician.

post-invisalignI finally mustered up the courage to change my veneer when I decided to report on the pit-falls of ‘dental deals’, so for fairness and transparency, I went along to 3 different types of dentist; one whom was offering a cheap deal on veneers, one mid-priced dentist and one high-end dentist. The treatment plans given were totally different from one another.

I stated the same intention to all 3 dentists; I wanted to change my veneer and was disappointed with the alignment of my teeth (after I’d changed my veneer previously, despite continuing to wear my brace retainer at night, my teeth had moved and were beginning to look pronounced. This wasn’t hugely noticeable to others but after all the years in braces, I wanted my teeth to be perfect!)

‘Deal dentist’ offered me a new veneer for £229, he could book me in that week and have my new tooth ready within 2 weeks, which would “match my teeth nicely”. ‘Mid-Price dentist’ recommended that I have both my front teeth veneered so that “they match perfectly” he also said that he would make the new teeth slightly smaller to slot into the space better which would make them look straighter. This was going to cost me £695 for the single veneer or £1250 for 2 front veneers including preparatory work (i.e. filing down the healthy tooth)

Last, I went to the ‘high end dentist’ Harley Street Dental Studio where Dr Manrina Rhode recommended I should first wear Clear Aligners (clear braces- from £1500) to straighten my teeth as the veneered tooth was not sitting in line with the rest of my teeth which was making it look false and unnatural, before having my single veneer replaced (£1400). Along with the cost of the examination (£95), this was going to cost considerably more than the previous 2 dentists but I knew instantly it was the right treatment plan for me and the only way to achieve the smile I wanted.

If I had gone with ‘deal dentist’, maybe I would have been one of the lucky ones, maybe the lab making the veneer could have matched it perfectly to my natural teeth via a photograph, but even so it still would have been protruding slightly, which over time would have put it under more stress- potentially damaging it and therefore needing it to be replaced. My gut instinct was one of distrust- it was all too rushed and not thought through at all.

The ‘mid-price dentist’ was the worst in my opinion. I could not believe they advised filing down the healthy tooth too so that both veneers ‘were straight and matched’ I was horrified! The new veneers would be smaller than the original teeth so that they could slot in between my 2nd incisors. The cost would be less than half of the ‘high end dentist’, but the look achieved was not what I wanted and once the healthy tooth is filed down, there is no going back! I would also need to replace the 2 veneers every 10 years, which over my lifetime would cost as much as the ‘high-end dentist’ anyway, for a look I wasn’t happy with! I wasn’t convinced by the notion that the smaller teeth would necessarily enable a better position in the mouth either.

The main points to consider when making a choice like this are; what is the long-term cost and is the treatment going to give me the desired result? Dr Manrina has a ‘conservative’ approach to dental work, she is not a quick-fix-kinda-gal and she is most certainly a perfectionist- qualities you want in a dentist! Add to that the way she makes you feel totally calm and at ease, and I would say she is pretty much the perfect dentist!

So, we got started with the Clear Smile aligners; 6 aligners over 6 weeks. I had to wear the aligners continuously (except when eating or drinking) and I won’t lie- the first few days hurt a lot!! It’s a great diet though- the aligner was so painful to take out at first that snacking just wasn’t worth the pain! After that, it became much easier and every week I would put a new aligner in- slowly edging my teeth into a straighter position, it is SO clever and really exciting to look at the last retainer to see how your teeth are going to look at the end! After the 6th aligner, Dr Manrina wasn’t quite satisfied with the alignment- even though the teeth were lovely and straight she thought they would benefit from being pushed back slightly more to protect the future veneer, so another 6 aligners were ordered (at no extra cost- the price you are quoted at the start is the price you pay regardless of any additional aligners needed).

The 12 weeks of aligners flew by; you get used to them very quickly and they honestly don’t notice when you are wearing them. When I did point out to people I was wearing them, so often the response was “I want those!” If that’s you, I would say 100% do it! I am so happy that I did!

The bit I was dreading throughout this process was having my old veneer removed. When my last veneer was fitted (at a mid-price dentist) they over-prepped my broken tooth- this means they filed much more of my real/broken tooth than was necessary, and the thought of it makes me feel quite sick. Dr Manrina was so understanding, she made sure there were no mirrors over me so I wouldn’t see the exposed tooth and she was considerate of my feelings throughout. She is also the master of injections! (I had to have a big injection in the front of my gum, which I wasn’t looking forward to!) I can’t work out how she managed to do it so painlessly!

Now for the part where you really see where your money is going; the making of the veneer. One of the hardest things in dentistry is matching a single veneer to its neighbouring teeth, especially when like me, you have a transparency to your teeth. Detail is key, so at The Harley Street Dental Studio, photographs alone just won’t do! Of course, they take photographs and moulds of my mouth like other dentists, but unlike most other dentists they also do a ‘stick bite’ technique whereby a measuring stick is placed parallel to your eyes to make sure the teeth are set at the right inclination and the middle of the of the face is marked to show where the centre line of your teeth should ideally be. They also consider the position of your eyes and nose etc, in short, it is very precise- the veneer needs to match your face as well as your other teeth.

Next, I was off to Dr Manrina’s lab of choice, Uniqa- where the veneer is made- to meet master ceramist, Khristo, whom Dr Manrina assured me is “a genius!” It was absolutely fascinating to see them all at work in the lab. Khristo took more pictures of my teeth, this time with lots of different light settings to pick up the variation of colour, and then he drew a diagram of my tooth, noting all the transparent areas and colour differences- he really is a genius and the finished veneer is incredible!

However, I (stupidly) whitened my teeth the night before I met with Khristo which made it incredibly difficult for him to colour match, as freshly whitened teeth have a ‘blue luminosity’ to them so the finished veneer was slightly too white. Personally, I thought it was fine but Dr Manrina and Khristo, perfectionists that they are, wanted the colour adjusted before the final fitting. This absolute care and attention to detail is priceless in my opinion.

So, I had to wait one more week for my new tooth but my goodness it was worth it! For the first time since I broke my tooth, I felt like I had ‘normal’ teeth again! It was such an overwhelming thing to see when I looked in the mirror, I could barely take it in. That’s the thing with teeth, there is a huge emotional connect there, which takes me back to ‘why are we so reluctant to spend on them?’.

I started this article to research the different options available for someone like me who needed cosmetic dentistry or indeed anyone who isn’t happy with their smile and wanted some guidance, to give open advice on where to start; well, I would advise you to start at The Harley Street Dental Studio. My open opinion became very biased, very quickly! I totally get that it’s an expense none of us want but the long-term cost will end up the same as a mid-priced dentist anyway yet with (I believe) much better results. There are payment options available to spread the cost of the treatment too which helps and, importantly, there are no hidden costs.

I will continue to use ‘deal websites’ for hygienist appointments and I will still use my ‘mid-price’ dentist for check-ups and fillings etc but for anything cosmetic, there is just no comparison for me. As my dear old nan always says “buy cheap, buy twice!”

Dr Manrina Rhode @ The Harley Street Dental Studio 020 7636 5981 www.harleystreetdentalstudio.com

www.clearaligner.co.uk

Khisto, Master Ceramist @ Uniqa lab

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