Why are so many people spending money on cosmetic dentistry?

Having forked out for their children’s dental work, parents now want to invest in their own teeth. Helen O’Callaghan looks at the growing celeb-driven market for cosmetic dentistry.

IT’S my turn now! Words rarely heard by orthodontists 10 years ago. But now, mid-lifers — ultra-conscious their smiles need a tune-up — are saying just this: It’s my turn.

“Parents whose children are coming in for treatment will send the kids out and come back to you and say ‘we need to do something about my teeth’,” says Dr Robin Foyle, president-elect of the Irish Dental Association (IDA) and a practising dentist in Wexford.

It’s the same at Crotty Orthodontics in Cork where Dr Owen Crotty practises: “Parents will have seen the benefits of orthodontic treatment for their children. They’ll say ‘now it’s time to treat me’.”

But midlife mums and dads aren’t the only demographic seeking the perfect smile and contributing to the burgeoning client lists of orthodontists and cosmetic dentists. 

“If you were to ask 100 women aged 18-35 if they’d like their teeth a little whiter, 90% would say yes,” says Dr Barry Buckley of Dental Options in Clane.

This chimes with results of a 2015 survey of 159 people by Dublin’s Seapoint Clinic: it found nine out of 10 Irish women envy other people’s smiles and long for whiter teeth. 

So do men: 52% of them admitted to smile envy and 48% wished their teeth were straighter.

At Seapoint Clinic, where clients are as young as 18, Dr Sarah Flannery says they saw their biggest jump in demand for tooth-whitening — 25% — in 2015-16. 

In the previous few years, the year-on-year increase was 15%. She recalls one dad coming for teeth whitening because his 15-year-old son told him his teeth were “so dark and embarrassing”.

In our social media-driven lives, we’re looking at each other and ourselves — and critically examining ourselves — an awful lot more. We’re FaceTiming, Snapchatting, and constantly taking photos. Small wonder that our smile comes in for scrutiny.

The “huge upward curve” Dr Buckley sees in demand for cosmetic dentistry is “an awful lot to do with social media, with the advent of the Kardashians, Instagram, and the emergence of the blogging fraternity, where celebs and non-celebs document all parts of their life”.

The 2015 survey found one in five people cite a good smile as the first thing they notice on an online dating profile and 91% say they wouldn’t consider dating someone with bad teeth. More than half said Cheryl Cole has the best smile (with Amy Huberman second at 36%).

This doesn’t surprise Dr Buckley. 

“If you were to create a postcard of what most young girls want their smile to look like, you’d look at Cheryl Cole. She represents the ideal smile guideline, even for cosmetic dentists.”

He gives a rundown of what makes Cole’s smile so compelling: “She has central dominance — her front two teeth dominate her smile, not in a goofy way but in a sexy, attractive way. Another indication of that sexy smile is when the upper teeth rest on the border of the upper lip.”

Aesthetic dentists look towards proportionality and symmetry in the teeth, attributes Dr Buckley says are programmed into our DNA to find attractive. 

“It’s very rare in nature. When we see these beautiful smiles on celebrities, they’ve been artificially created. Cole has had her teeth straightened with Invisalign, she’s had them veneered with porcelain veneers.”

Meanwhile, out in the real world, if your set of gnashers is a long way from straight and pearly white, there’s plenty more than Cole to remind you of that. 

Google ‘teeth before and after’ and you’ll find a whole host of celebrities flashing the perfect Hollywood smile — among them Molly Cyrus, Demi Moore, and Katie Price. 

And even if your teeth were pretty good to begin with, age delivers the sucker punch. As we get older, teeth naturally darken, explains Dr Flannery. 

“The dentine on the inside becomes thicker and stronger. It builds up on the inside of teeth. It’s yellowish and shines through the enamel. As well as that, we pick up stains along the way.”

Cosmetic dentists are well used to initial consultations with clients who don’t smile or who have learned to only half-smile or smile with closed lips — anything to divert attention from what they see as imperfections. 

“They’ll say they’ve never been comfortable smiling. They hide their teeth a lot. They put their hand over their mouth or turn sideways when they smile,” says Dr Crotty, who cites a 2016 British Orthodontic survey that found 90% of adults — post orthodontic treatment — reporting dramatically improved health and feelings of wellbeing.

“In orthodontics, we take a lot of before and after photos. After, you see the difference in their facial appearance, in the clothes they wear — they’re much more confident in how they appear.”

It has a huge impact, agrees Dr Flannery, who sees it in clients’ Facebook profile pictures. 

“Before treatment, they wouldn’t be smiling or they’d have their lips closed. After, they have these big beaming smiles.”

Deirdre Denman, in her late 40s and mum to two university-going children, attended Crotty Orthodontics and had a big job done two years ago. 

“I had them straightened, the gaps closed up, and two teeth rotated around that hadn’t been facing forward properly.”

The Killarney-based woman says she’s much more confident about smiling. 

“It does affect you emotionally. I see them in the mirror now and think ‘oh yeah’. People say ‘Wow! Your teeth are lovely’ and when I ask if they remember them before and show them the pictures, they say ‘oh my God!’”

Denman chose not to get her teeth whitened (“I didn’t feel they were discoloured”) but many see it as an easy way to get a smile upgrade. “It’s non-invasive and removes nothing from the teeth,” says Dr Foyle.

A 2012 EU Directive set the maximum legal concentration of tooth-whitening product — hydrogen peroxide — at 6% but this can only be prescribed by dentists. 

Over-the-counter whitening products are limited to 0.1%. 

“Between 0.1% and 6% has to be administered by a dentist,” says Dr Foyle, an IDA representative on the Council of European Dentists and on the Tooth-Whitening Working Group. 

He points to three Council of European Dentist surveys (of 350,000 dentists in the EU), which found no damage from tooth-whitening using legal concentrations of hydrogen peroxide.

Tooth whitening involves putting hydrogen peroxide bleach on the teeth and light-activating it. The patient continues the process using trays at home. Fitted over the teeth, trays are thin, clear, and flexible. 

After about two weeks, you get a nice white shade. Of course, nobody wants a high-wattage, full beam, Day-Glo smile and, says Dr Flannery, people worry they’ll glow in the dark. 

“A good guide is not to go whiter than the white of your eyes.”

On average, the effect lasts two years. 

“You can maintain it by regular cleaning, good oral hygiene, using whitening toothpaste and touch-up treatments once or twice a year,” says Dr Flannery.

Whitening is ideal if teeth are nicely aligned, there are no oral health issues, and the client doesn’t have lots of work already done on front teeth (you can’t bleach crowns or veneers and it doesn’t work well on fillings). 

“When you look into someone’s mouth, there can be lots of reasons why bleaching wouldn’t be suitable,” says Dr Flannery.

Sensitivity is one. 

“It’s a side-effect and resolves once treatment finishes. But if there’s pre-existing sensitivity, teeth can become very sensitive — you need to stop and find out why there’s sensitivity in the first place.”

Another no-no is receding gums — the exposed root area won’t whiten. 

Heavy drinkers and smokers aren’t good candidates either, unless they’re seriously prepared to cut down on the alcohol and cigs. 

“The stains will pick up again,” warns Dr Flannery, who cites tooth-whitening benefits: Youthful smile, improved self-esteem, improved oral hygiene (hydrogen peroxide has a low Ph level that neutralises bacteria), while some studies say it reduces root decay.

In-house tooth-whitening can cost anything from €150 to €350. Much cheaper, of course, are over-the-counter products like herbal remedies and whitening toothpaste. But, says Dr Buckley, the only ingredient clinically proven to whiten teeth is hydrogen peroxide. 

He points out that Spotlight teeth-whitening strips — created by Galway dentist sisters Drs Lisa and Vanessa Creaven — are the only European whitening strips that contain the ingredient.

The British dental-care market was estimated to be worth £9.6bn (€11.35bn) at the end of 2016, according to market research firm Mintel. There are no figures for the Irish industry. 

“Total value of Irish cosmetic dentistry must be in excess of €40m-€50m a year,” says Dr Buckley.

Extensive orthodontic work can cost anything between €1,800 and €6,000. Veneers — essentially a fingernail of porcelain laminated to front of teeth — and crowns (like a thimble of porcelain that goes all the way round the tooth) can cost anything from €500 upwards per tooth. 

Composite veneers (bonding), using white filling material that’s placed on the tooth to mask irregularities can cost between €150-€250 per tooth.

A big number of Seapoint Clinic patients come for implants — a titanium screw placed into the bone replaces a missing tooth. General price for an implant and crown is €1,995, says Dr Flannery.

Explaining how price impacts on client profile, Dr Buckley puts it in context: “A porcelain smile makeover is going to cost over €10,000. Rarely can a 30-something afford that — the vast majority of clients are women approaching 50 and over.”

At Crotty Orthodontics, about one third of patients are aged 25-40 with another fifth in the 40-50 category. Certainly, says Dr Crotty, there are brides getting pre-wedding work done but mums of the bride are also represented. 

“They’re at a point later in life where teeth have begun to drift.” 

Dr Crotty cautions against getting work done on just the front visible teeth. 

“If you focus in on just improving the appearance of those, you can miss out on other problems. Patients may have gum disease, decayed teeth, or poor bite — if you don’t tackle underlying problems, cracks will re-appear,” he says.

A 2015 report from the Royal College of Surgeons of Edinburgh stated that the number of complaints involving short-term braces alone has risen by 20% since 2010, with 80%-90% of those claims directed at general dental practitioners rather than specialist orthodontists.

Dr Buckley says a smile makeover has to be designed for the particular client. “It’s not like we have a box of smiles that we roll out for everybody.”

Like any beauty makeover, it’s not about getting a bling, bling smile — more about getting one that looks a lot like yours, just somewhat enhanced.

Specialist dental treatments are also provided by Kinsale Dental and Smiles Dental.

Linda gets her smile back

When she hit her mid-40s, Carrigaline-based Linda Murphy, now 50 and a mum of three children aged 11 to 17, decided it was time for her to fix her teeth.

“They were crooked, off line, over-crowded and I was missing a tooth. They’d been like that from a young age. Finishing the mortgage and after raising the children, I felt it was time. Having a nice smile is important to me. My natural instinct is to smile. When I was younger, I was known as the smiler.”

Linda attended Cork Orthodontics, where she had Invisalign on the inside of her front teeth. “That orthodontic work got me to a place where I was able to go for cosmetic work, to go that extra mile and have the smile I wanted.”

The extra work included two porcelain veneers (her two front teeth were pitted and cracked) smile balancing and whitening.

“I didn’t want a straightened Hollywood smile. I wanted a natural smile but with everything in place and in balance. With the whitening, I didn’t want sparkling white. I got them to a shade I was happy with.”

In total, the treatment cost her just over €10,000.

“It was a present to myself. I feel great. A lot of people comment on my teeth. When I have my make-up and lipstick on, I think ‘Wow!’.”

‘My voice now is a voice’

Chris Eubank had two implants, a six-unit bridge, two crowns and 18 veneers done by Barry Buckley at Dental Options in Clane.

The 50-year-old former professional boxer recalls celebrity Simon Cowell once saying ‘if you’re going to be on TV, you’ve got to have your teeth whitened’. But, for Eubank, getting his teeth fixed was as much about finding his voice as finding his smile. 

“During my career, I always had a mind that spoke of humility, consideration, decency, and integrity, yet my voice could never be heard because there was air going through my two middle teeth and that caused a lisp. When your teeth are unattractive, it’s difficult for people to digest what you’re saying. 

“It’s so important to have decent teeth. I thought making world champion would give me the respect I’d always yearned for. But, while I was respected as a fighter, no matter what I had to say, however community-focused and decent it was, it wasn’t accepted because of my lisp. 

“My voice now is a voice. It’s one that resonates. My words are now digestible. People can’t hear the lisp anymore. After getting my teeth done, it was another level of confidence, not arrogant, a quiet confidence.

“Women ask ‘are your teeth yours?’ I say to them: ‘Are your shoes yours, is your handbag yours? Well, these teeth are mine’.”

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