How to overcome dental anxiety and improve your smile

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Are you conscious of your crooked or ‘goofy’ upper front teeth or simply would like to have a brighter and whiter smile but feel anxious about dentistry and don’t know how to overcome dental anxiety? We have over 30 years of experience in helping nervous patients and we hope you will find our answers useful.

Does it hurt to do a smile makeover? I am really scared of dentistry.why do many people still fear the dentist

Answer:  No it does not hurt to have any form of dentistry today and generally, ‘cosmetic’ dentistry involves even less ‘sensation’ than other treatments…. as it tends to be less invasive. Even if some teeth need some ‘reshaping’ which involves a degree of enamel cutting, you should not feel that being done.

For particularly anxious patients, some practitioners (in addition, of course, to a calm, gentle, unhurried approach) do use additional techniques such as hypnosis, sedation and even acupuncture. One of the most successful and safest techniques is the use of ‘relaxing gas'(Nitrous Oxide with Oxygen); a technique very commonly used to relax women in labor. It is very safe.

I have crooked teeth. I hate them but I don’t want rail-track braces

Answer:  Generally, crooked teeth can be treated in one of two ways: Straightening them or ‘ making them look ‘ as if they have been straightened.

The former involves physical movement (and so actual change of position of the teeth) and is called orthodontics. The latter involves changing the appearances of the front surfaces of teeth and is called ‘veneering’.

It may also sometimes require some reshaping, which requires a little cutting of tooth enamel, to be done instead of or together with veneering of a tooth.  Today, orthodontics can involve ‘internal’ braces (the ‘rail tacks‘ are on the inside of the teeth) or clear removable plastic aligners (e.g. ‘Invisalign’),  both are not visible to others.

Obviously, orthodontics is much more time consuming than veneering. It is important to speak to an experienced dentist, who would explain the ‘pros and cons’ of each treatment approach for an individual patient.

I want whiter teeth. Does it hurt, how much will it cost and how long does it last?

your smile

Answer: Teeth can be whitened ( often called ‘ bleached’) in a variety of ways. Most commonly this is done by placing an oxidizing gel into small thin mouth guards that fit over the teeth and are left in place for an hour or more a day, or overnight for between a few days or weeks. Additionally a stronger form of the gel can be applied directly to the tooth surfaces by a dental professional in the surgery for a couple of hours, often under a ‘special’ light.

Another technique sometimes advocated are strips  or tapes of material, containing the oxidizing agent, placed over the teeth surfaces , each day for a while . The oxidizing gel is either hydrogen or carbamide peroxide. What has been shown not to work generally are tooth whitening pastes and solutions sold over the counter at chemists.
Many patients seek tooth whitening as a solution to their dental aesthetic problems, when in fact, other dental procedures are more appropriate for their individual situation and/or concerns. Synthetic materials such as composite or porcelain cannot be whitened. So often tooth whitening is done prior (and not after), say, veneering or crowning in the ‘aesthetic’ or smile zone.

I have a dark front tooth, what can I do about it?

Answer: Almost always a ‘dark’ tooth is one that at some stage ( sometimes, many years before’ ) has had the nerve removed and been root canal treated. If that had been done properly, these are ‘healthy’ teeth, although they are ‘dead’.

Occasionally a chronically infected tooth that has been untreated may show up as ‘dark’, even with little or no discomfort. Such a tooth may well need root canal treatment.  Also it is not uncommon for nature to do its own root canal treatment (the nerve canal ‘closes up’ over time, on its own) naturally resulting in a yellower tooth. It is painless and does not require root canal treatment.
It is imperative that any dark tooth is checked and x-rayed by a dentist to check its health status. For aesthetic, and sometimes ‘strengthening’ reasons, such teeth often need crowning or veneering. This is often required to be done in the ‘smile zone’ for aesthetic reasons to colour-match (lighten) such a tooth to its neighbors.

I am really conscious of my ‘goofy’ upper front two teeth, what can I do ?

Answer: ‘Goofy’  looking front teeth are usually the result of  central (1st) incisors that are either:

  • actually large compared to their neighbours (the 2nd incisors) and/or
  • are protruding somewhat ‘in front’ of the 2nd incisors and other teeth in the arch.

If the two front teeth are ‘in line’ or closely so with the other teeth in the upper arch then they can be slightly re-contoured to make them look smaller. This requires perhaps a little enamel taken off the edges to shorten them and the sides  ‘re-shaped’ a little to make these ‘look’ narrower.
Often, the adjacent 2nd incisors are rather relatively too small and these can easily be made larger; more ‘in harmony’ with the ‘bigger’ 1st incisors. Placing composite or porcelain veneers on these second incisors to increase their size will definitely make the central or 1st  incisors look relatively and proportionally smaller ….and more ‘ in harmony’ with the other teeth in the smile zone.

If the problem is very obviously that teeth are significantly physically protruding from the other upper teeth, then the obvious answer is orthodontics (physical tooth movements). This can be done with either internal (invisible) or external tooth wires and braces or with I aligners such as ‘Invisalign’).

It may or may not require removal if one upper premolar tooth on either side of the upper jaw ‘to make space’ to pull in the upper front teeth to be ‘in line’. Treatment is not that complex; but it each case needs proper evaluation and presentation of the ‘options available’.



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