How much would you pay for the perfect smile? One writer tells her very expensive story

Lip repositioning Not all cases require surgery. In some patients, Dr Shah performs minimal gum

Lip repositioning

Not all cases require surgery. In some patients, Dr Shah performs minimal gum contouring with a laser to create subtle symmetry or to even out an over-long tooth. In some specific cases Dr. Shah points out that lip repositioning will adjust where the lip lies at rest, resulting in less exposed gum. 

Depending on the individual case, the dentist can do this with Botox in the nasal labial folds (nose to mouth lines), or in some cases, Dr. Shah will correct a high lip line surgically by removing a small band of tissue inside the top of the lip. He points out, “when patients show more gum than is proportionate, some dentists would create more length at the bottom of the teeth with bonding or veneers. All that does is accentuate a gummy smile so it’s important to do treat each case individually and do what’s appropriate for each person in order to achieve the most aesthetically pleasing result.”

Reversing gum recession

Conversely, Dr. Shah can reverse receding gums that are caused by gum disease or age with a gum graft. “In the case of gum recession, the easy option is to cover the recess with a longer veneer which can look disastrous – there is this sweet spot of gum-to-tooth proportion,” he says.  

Bespoke veneers – the new frontier 

Thanks to the crown lengthening surgery my teeth were now in correct proportion, but they still had cracks, ridges and yellowing; all part of the natural ageing process, but confidence-draining nonetheless. I had tried whitening to little effect as my teeth were too porous for peroxide, which I later discovered was due to wearing down the enamel with abrasive brushing and whitening toothpastes. I had also previously tried bonding: a whiter, Shellac-thin composite material that’s applied over the tooth, which ultimately chipped and stained. This left one option: veneers. 

Veneers (porcelain shells that are bonded on top of your natural teeth) can conjure up horrifying images of blocky false-looking teeth attached to shaved-down stumps, but skilled ceramists can make contact lens-thin veneers that require far less filing down of the natural tooth – and sometimes, none at all.

Dr. Eskander uses one of the few master ceramists in the UK, Simon Caxton from Simplee Dental, who has won awards for his lifelike veneers. 

Good veneers should mimic the nuances and imperfections of real teeth, a process that takes skill and time to get right. Claxton explains, “It’s the deviations in shade and contours that create vitality; When you craft a porcelain veneer, you start with a base layer of whiteness and then build thin layers of colour over the top. Blindingly bright, flat veneers are made of one or two layers and lack the aliveness of real teeth.”

He can work subtle individual details into the design process, such as a thin gap between the front two teeth or added translucency. “Teeth have convexities and concavities that bounce the light to create shine and texture, a bit like the facets of a diamond. A good technician understands the morphology of a natural tooth, otherwise veneers can end up looking like false nails.”

Claxton explains that teeth are ever so slightly darker at the neck, brighter in the middle and have some translucency at the edges, details he builds into the veneers for a natural effect. He adds, “It’s not a one-shape-fits-all process, it takes artistic flair and an understanding of the client’s expectations, which is why I prefer to collaborate with the dentist and the client directly.”

Veneers last around 15 to 20 years, and so you must be prepared for future maintenance, but if you have tried whitening, braces, and bonding like I have and still hanker for a glossier, whiter, younger-looking smile, then bespoke veneers at a specialist cosmetic dentist such as The Chelsea Dental Clinic will elevate your whole face.  

How many teeth should you do? In my case, I opted for twelve on the top row in a shade that matches the whites of my eyes (an insider tip for getting it just right). Eskander says that in some cases, four veneers at the top is all that’s required.

“In the States dentists typically do 20 teeth, 10 top and 10 bottom, but we take a softer approach. I tend not to recommend veneers on the bottom teeth because they are smaller and weaker than the top, especially in older patients. Instead, I prefer to whiten the bottom to match or do a little edge bonding to brighten and smooth any worn edges.”

The test drive

After taking multiple photographs, videos and X-rays, I joined a Zoom consultation with Dr. Eskander and the ceramic technician, Simon Claxton, to discuss my preference for the brightness, shape and character of my veneers. A wax up (3D model of my future teeth) is then made up, which allowed me to view the design and try it out. 

Happy with the basic design of the wax up, ‘temporaries’ of the veneers are then made, which are fitted at a separate appointment giving me a chance to test drive my new teeth in case any tweaks are required, before the final veneers are fitted. On the penultimate appointment, Dr. Eskander filed my natural teeth before fitting the temporary veneers, following a precise technique that minimises over-filing, allowing her to take as little from my natural teeth as possible. 

“The goal is always to retain as much of the natural tooth as we can for health reasons. It’s quicker and easier to shave a lot of tooth away but it’s not in the patient’s best interest,” stresses Dr. Eskander. Next, the temporary teeth are bonded in place, and, while they look similar in shape to what will be the final veneers, they are made from an acrylic material that lacks the glossy finish of porcelain. 

Now Claxton, Eskander and I discuss the final details. We opt for a natural looking white shade with ridges to reflect the light and boost shine with a little translucency on the bottom edges.  

The final result

Having lived with my temporaries for three weeks, my veneers are made and ready to be fitted. The final appointment is the most joyous one of all, not dissimilar, I’m guessing, to trying on a couture gown following months of adjustments.

After numerous discussions had, mood boards shared, pictures taken and questions answered, I was ready for my new smile. When Dr. Eskander removed my temporary teeth, I felt a sigh of relief and a wave of worry all in the same breath. What if I don’t like what I see?

The feeling was short lived. When I finally sat up and looked at my new smile in the mirror, it was both breathtaking and familiar, which is the beauty of going through this journey patiently, over many months, and not in one full swoop.

Dr. Eskander and her team did a beautiful job at listening to my needs and delivering the attention to detail that makes all the difference between a cookie cutter smile and one that is unique to me. 

In the end, my smile rejuvenation journey was not about sticking to the golden ratio; after all, Kate Moss fared pretty well with a charmingly crooked smile. It was about a few can’t-quite-tell enhancements that respected the character of my face, done in the most minimally invasive ways. And you need a few pairs of super skilled hands to that pull off.

Invisalign with Dr Laing costs from £5,500. Crown lengthening with Dr Shah starts at £2,500; lip repositioning surgery costs from £1,500, and gum recession surgery from £1,300. Veneers with Dr Eskander and Simon Caxton at Chelsea Dental Clinic cost from £1,025 per tooth, and Botox with Dr Eskander costs from £450. 

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