It's now widely agreed that your smile makes the first impression and increasingly we are wanting to improve our smile in just the same way as our hair and other aspects of our appearance. Cosmetic dentistry is the business of altering teeth, gums, and even the jaw to improve appearance.

Common cosmetic procedures

• Bleaching: lightening and brightening the teeth
• Orthodontics: use of wires and brackets to move teeth into more ideal positions
• White Fillings: use of plastic, resin or ceramic materials rather than metals to fill cavities
• Veneers: very thin facings of ceramic, rather like a false fingernail, bonded onto the minimally prepared front surface of the tooth to change its colour, shape or position
• Crowns: use of full coverage crowns (caps), involving substantial preparation of the tooth, to improve the appearance of unsightly, highly restored and/or broken teeth
• Bridges: use of crowns on either side of a missing tooth/teeth to support a fixed artificial replacement tooth/teeth. These are usually cemented in place and are not removable.
• Dentures: removable artificial teeth supported on plastic or metal frameworks
• Implants: titanium artificial roots surgically placed in the jawbone at the site of missing teeth, and used to support crowns and bridges to replace them
• Gum surgery: unsightly or missing gum may be surgically enhanced/replaced

Where can I have it done?

Depending on the complexity of the case and his/her own training in this area, your own dentist may be able to carry out the work or may refer you to a dentist more experienced in the kind of treatment you wish.

Recommendation by a dentist or someone who has had cosmetic dental procedures is the best way to choose a practitioner. Ask to see examples of their work, whether they have had specific and advanced training in this area of dentistry, or are on a specialist list.

How do I find out what's involved?

Most cosmetic dentists will have a portfolio of cases they have performed and should be able to explain to you exactly what they are planning to do. Ask to see examples, models, diagrams, etc, if you are unclear. You should be given a treatment plan before the work starts, outlining not only the procedure but any potential problems, and the price. Make sure you fully understand what is involved before you start the treatment, don't be afraid to ask questions and seek a second opinion if in doubt.

What will it cost?

Cosmetic dentistry is almost always carried out privately, and will vary with the complexity of the case and dentist's own price structure. The dentist should be able to give you a reasonably clear estimate of cost to avoid nasty surprises. However, dentistry is not an exact science; sometimes unexpected issues arise so you should be prepared for possible additional fees.

Will it hurt?

Dentistry today should rarely hurt, though some patients are more sensitive than others. Modern local anaesthesia is extremely effective and is universally used. For patients with significant issues regarding dentistry, sedation techniques are available to help reduce the stresses involved.

How long will it last?

Your practitioner should be able to give you an idea of how long the results should last, but there are no certainties in this, and young people who have irreversible procedures carried out, e.g. veneers or crowns, should be aware that they will need to be replaced a number of times in their lifetime however well the work has been done.

What if I'm not happy with the result?

Try as far as possible to settle the problem directly with the practitioner who undertook the procedure. If you are unable to resolve it this way, then most practices have a complaints procedure. If this fails, you should seek the help of the General Dental Council's Complaints Service.