‘People have made the connection between teeth and general health’

The early days of the pandemic caused fear and consternation for both dentists and patients alike. Few lines of work were less conducive to social distancing or more susceptible to an airborne virus.

Innovation in Dentistry looks at the latest innovations in orthodontics and cosmetic dentistry and how advances in technology mean that dentistry has changed irrevocably.

[ The Irish Times ePaper ]

The vaccine changed all that. “Initially with Covid we all worried it might be the end of dentistry, but it’s gone the other way,” says Dr Morgan O’Gara of Blackrock Dental in Dublin.

“Now everyone [in the field] is out the door busy and not just because of a backlog, but because people have become more health conscious generally, as a result of Covid, and have made the connection between teeth and general health. The mouth, after all, the pathway to the inner body.”

There is one other big factor driving demand: Zoom.

Almost 18 months of working from home has given us all a new perspective on our gnashers. “All those Zoom calls left people looking at themselves in a little box up on screen for up to seven hours a day,” says O’Gara. He only came across the video service because so many of his patients told him it was what prompted them to come in.

Unlike a mirror, for which people usually adopt their best pose, talking on video camera gave them a whole new perspective on their teeth.

On top of that – literally – came masks. For some of his patients, the wearing of masks while out and about provided them with good cover for work on their teeth, in particular braces.

The stigma of adult braces is more than gone. If anything, he suggests, they are almost a status symbol. “However, working from home and wearing masks going out encouraged some people to think now is the time to do something they’d been planning for ages,” he says.

The most common cosmetic treatment currently sought out is teeth whitening. Teeth have a naturally yellow tint which gets more pronounced as we age. Too white is not a good look, and a good practitioner will steer you away a shade liable to blind motorists.

“Teeth whitening today is about bringing them up just a couple of shades. You get gumshields made for you, apply the whitening gel at night over two weeks. It’s simple and easy, and you look healthier and younger,” he says.

Straighten up

Next comes demand for straighter teeth. Today much of this demand comes from adults who wore traditional “train track” braces as a teenager and, as is the teenager’s wont, stopped wearing their retainers as soon as their parents stopped banging on about the thousands of euro forked out for their teeth.

This particular cohort is disinclined to go back to wearing train tracks. However, the advent of clear aligner alternatives has prompted many to remedy the situation. These kind of aligners – though much the same in terms of cost – sit on top of your teeth, aren’t immediately obvious to observers, and can be removed while you eat. Crucially, they can get the job done in six to eight months.

Innovations in this area also include at-home aligner treatments. Thérapie Smile, which has a number of clinics around the country, provides at-home treatment times of just 20 weeks, for suitable candidates.

Innovations such as these are in part why aligners are now so prevalent. “We’re providing them to everyone from teens to people in their 70s,” says O’Gara.

However, he prefers to opt for traditional fixed braces for teenagers, simply because that age group is more likely to succumb to the temptation to take them off. Also, you can’t leave your train tracks on the train.

If your teeth are where they should be, but gaps exist, there are a variety of options, starting with composite resins that a dentist can mould and shape to fill a chip here, or an unevenness there.

The next step up is a veneer, a thin, tooth-coloured shell that sits over the front of the tooth to improve its appearance. These can be made from resin composite materials or from porcelain, which looks more natural and can resist stains better than resin veneers.

“Porcelain gives us the best aesthetic results. It’s a beautiful material and works very well for old, discoloured teeth, or teeth with fillings or which have an old veneer here and there. It can give you brilliant results,” he says.

Again, not too brilliant. “What gives porcelain a bad name is what I call Turkey Teeth, where people go abroad to get a job done and come back with ultra-white teeth that are often too long,” he says. Just as you don’t want people complimenting your make-up, but rather how good you look, “Good veneers are the ones you don’t know about”.

Dental implant

For teeth that simply have to go, or are lost in an accident, the dental implant is the gold standard, and the closest thing you’ll get to a natural tooth.

Perhaps the biggest innovation in dentistry in recent years is that so much of the preparatory work now is done digitally. “The digital side of things has changed things dramatically. All the making of moulds and feeling like you’d gag, that’s all gone,” he says.

New software is even being developed which can scan teeth and use predictive technology to indicate the likely progress and impact of wear and tear, to prevent issues down the line.

Digitisation has helped with implants too, enabling the dentist to know much more precisely where to position the implant to avoid nerves. “It makes it safer and more predictable,” he says.

The use of photos and digital scans means dentists can work with a lab to achieve a ‘trial smile’ virtually before embarking on the work. “It takes the unknown out of it for the patient,” says O’Gara, “so you can go on that journey together.”