The changing face of cosmetic dentistry

Bedazzled by the avalanche of cosmetic solutions now available to improve your teeth? You are not alone! The face of cosmetic dentistry has changed rapidly. While it would seem that most people would jump at the thought of improving their smile, the strong emotions of fear, embarrassment and anxiety stops many of us from even getting close to a dentist, as discussed in a previous blog.

Notwithstanding people’s affinity to seeking their own dental solutions, it is important to acknowledge the rapid evolution in the field of cosmetic dentistry in the past 50 years. History does not attribute a single person as being responsible for heralding the arrival of “cosmetic dentistry”. Instead, advances in dental material science have been the driving force behind many breakthroughs. Porcelain veneers, invisible “tooth-coloured” fillings and the ability to restore a severely worn-down mouth are just some of the solutions made possible because of these advances.

The past decade has seen a major shift away from “drill-happy” dentistry towards a more conservative “minimally invasive” approach. Why? As a profession we recognise that no dental work, no matter how perfect, has a finite lifespan and will need replacement perhaps several times throughout a patient’s lifetime. Dentists now need to consider the sacrifice that your teeth and mouth will need to make in offering you various dental solutions. This sacrifice has been termed the “biological cost” of treatment.

Man with crooked teeth

Meet Jake

Let’s take the example of the young man shown in the picture to the left, who we shall call “Jake”. If you had Jake’s teeth what option would you choose? Complete dental crowns (caps), direct resin bonding or orthodontics are just some solutions that come to mind. If you’d like to, or need to, have work done, there are some questions to consider. How long will it take to treat your teeth? What is the expected lifespan of the proposed dental work? What is the true biological cost to your teeth? There is so much more to consider than the most obvious “How much is it going to cost?” question. Be wary of accepting a solution because it is cheaper or more expedient!

To help guide you through the maze of considerations that you should “chew over”, I have provided a table of the various issues raised and discussed the benefits and drawbacks of each of these factors.

Solutions to improve Jake’s smile


Cosmetic solution

Treatment time

Expected lifespan*

Biological cost

Comparative cost**


Direct resin veneers

Single visit

7 – 10 years

Minor biological cost – however, requires the most maintenance

The least costly option (no
lab fees)


Dental crowns

Two visits

7 – 12 years

Highest biological cost – extensive
drilling often required

Traditionally the most



1 – 2 years

Lifetime (if teeth are
retained in position)

Minimal biological cost – very minor or no modification are required to the patient’s own teeth

Usually mid-way between
extensive crown work and direct resin veneers

* Expected lifespan will vary depending upon many factors including whether the patient is a “tooth grinder”, the appropriate material chosen and the quality of work performed.

** The comparative cost will vary depending upon the complexity of the work to be performed, laboratory fees and extensiveness of what is actually proposed.

In a utopian world, every person would fit neatly into one of the three categories in the table shown above. Unfortunately, it is easy to forget we are dealing with human beings who come with a plethora of emotions, expectations and concerns. Spend enough time with your dentist, and you will ultimately be better informed to make the appropriate choices for your teeth! As the human development guru, Deepak Chopra, mentions in one of his blogs on staying happy and healthy:

“You can’t make positive choices for the rest of your life without an environment that makes those choices easy, natural, and enjoyable.”

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