Sydney cosmetic dentist Dr David Dunn explains how a beautiful smile can be achieved.

In today's ever-competitive society, a beautiful smile is an asset - it denotes attractiveness, youthfulness and success.

Most people desire a beautiful and attractive smile, whether to be more attractive and youthful or to look successful and improve their employment or business prospects.

However, for many people time is a limiting factor and often patients find it difficult to have extended time available to undertake cosmetic procedures. They may also be concerned as to how they will look during the treatment process.

There are many factors that can contribute to an unattractive smile. Often with increasing age we see aggressive wear of the teeth with worn, chipped and serrated biting edges as against the more rounded and even appearance of an attractive, youthful smile.

Colour is also an important aesthetic factor and with increasing age we see darkening of the tooth shade to a yellow or yellow-brown colour. Often some childhood diseases or certain medications can also cause tooth discolouration. Again, attractiveness and youthfulness is associated with a lighter, whiter appearance of the teeth.

Often many patients are understandably concerned especially with the arrangement of their front teeth. Often they comment that they used to be straighter, but with increasing age they have become crowded or out of alignment. Alternatively, they had not had orthodontic treatment when they were younger, and as time went on their teeth became more crowded and unattractive. For many of these people, whilst orthodontic treatment would be the ideal approach, often due to time constraints or the reluctance to wear braces and have orthodontic correction, they have had to accept this appearance.

The other extreme is where spaces exist between the front teeth due to small front teeth or a jaw size to tooth size discrepancy where the teeth are of normal size but they do not coincide with the size of the jaw and hence the spaces.

Finally, one of the most common aesthetic problems is where the teeth have been filled or restored repeatedly with tooth coloured materials that are stained and give a mottled, aged and worn appearance to the front teeth. This is often associated with several other factors such as wear or discolouration of the teeth.

Today with modern technologies and techniques, that beautiful and attractive smile may only be 10 days and generally only 2 appointments away!

BEFORE This 50 year old woman's primary concern was her prematurely aging smile. Note: visibly anaesthetic fillings and wear to biting surfaces of teeth.	AFTER The 1st phase of this client's overall treatment plan. Her smile is rejuvenated with porcelain veneers creating a much younger youthful appearance. By Dr Dunn.	AFTER Close-up of porcelain veneers. Note the rounded, softer, whiter natural looking teeth characteristics and healthy gum tissue. By Dr Dunn.

With a combination of treatments including tooth bleaching, soft tissue (gum) re-shaping and porcelain veneers, worn, misshapen, crowded (or spaced) and discoloured teeth can be rejuvenated to create a younger and more attractive smile with an excellent life span and minimal maintenance needs.

Remember, however, that porcelain veneers are but one component of a treatment solution. They should be not viewed as a product but as part of a treatment option involving many skills to achieve excellence. The art and science of achieving excellent results is the understanding of dental and facial aesthetics, colour, form and proportion, and knowing and being able to perform what other treatments may or may not be required to achieve the ultimate desired results. An equally important part of this treatment is the close interrelationship and support of specialised ceramic technical services. It is the totality of these skills that makes the difference between achieving beautiful and natural looking teeth as against those quick fixes that look like pieces of white plastic or porcelain stuck on the front of the teeth!

Unfortunately many people know of someone who has had this done to their teeth! It is the high quality results that you look at and admire as a beautiful smile and how lucky that person is to have such a smile without realising they have had high quality cosmetic dental treatment utilising porcelain veneers!

By far the best facelift is a new smile!

BEFORE This client's concerns include the discoloured-dull unnatural appearance of teeth, food trapping around bulky restorations and "gaps" as well as crowding of teeth.	Custom made Porcelain Veneers ready for placement.	AFTER A comprehensive treatment plan including orthodontic alignment for the optimal cosmetic restorative solution of a natural highly functional and gorgeous smile with the use of porcelain veneers. By Dr Dunn.

Teeth chatter

Q: I am getting married in 3 weeks time.

I had my upper front teeth bonded a few years ago but now they are wearing and looking stained and not as good as they started. My lower teeth that weren’t bonded are also looking quite yellow. Is there anything that can be done to improve my appearance that will last a lot longer and make me look great on my wedding day?

A: “Bonding” entails attaching or adding a tooth coloured composite resin material to the front and biting surfaces of your existing teeth. Unfortunately, this composite resin material tends to wear, take up moisture, stain and is not colour stable over time.  Most importantly it is limited in the artistic changes one can make to the appearance of your teeth. They can be considered a temporary solution at best with the limitations as previously described.

Porcelain veneers on the other hand, are a procedure whereby following a diagnostic work-up to define the ideal shape, length and new tooth arrangement, the teeth are prepared. Thin shells of ceramic material specifically designed and artistically constructed in the laboratory in accordance with the diagnostic work-up are then bonded at a separate visit to the prepared tooth surfaces to achieve a natural and brighter appearance.

Thus, porcelain veneers for your upper front teeth in combination with some tooth bleaching for your lower front teeth would be your best option to achieve a lasting, lighter, brighter and more natural looking appearance and importantly, is readily achievable by your wedding day!