How much would you be willing to pay for a perfect movie star smile? For some, trying to achieve dazzlingly white, uniformly straight teeth without a Hollywood budget comes at a cost to their health as well as their wallet.
Author
Adam Taylor
Professor and Director of the Clinical Anatomy Learning Centre, Lancaster University
The UK social media trend for "Turkey teeth" - named after influencers' penchant for travelling abroad for budget veneers - may offer a cheaper alternative to more expensive cosmetic dentistry at reputable clinics - but it can come at the cost of oral health and may even prove life threatening.
But the health risks don't always outweigh the prospect of a gleaming grin. Naturally, teeth should be an off-white colour because yellow-coloured dentin (the middle layer of the tooth - between the enamel and the pulp - that makes up the majority of the tooth's structure) shows through the thin, tough, white enamel outer layer of the tooth. But the natural colour of healthy teeth is currently unfashionable and there's a heavy demand for sparkly white veneers.
While there are many people who're delighted with their new gnashers, there seem to be equally as many horror stories. From being left in "constant pain" to developing "rotting gums", fixing problems caused by cut price cosmetic dentistry can end up costing much more than it would have cost to get the procedures done properly in the first place.
This is something Ramazan Yilmaz discovered when his tooth implants at a private clinic in Bursa, Turkey, went disastrously wrong. During surgery, the dentist allegedly "forced" the implant through Ramazan's jawbone and into the area behind the eye where the brain and spinal fluid are located. According to reports, the dentist then took him to the emergency department of a local hospital and ran away.
But experiences don't have to be as extreme as Ramazan's to cause serious problems. Even the best cosmetic dentistry can lead to oral health problems if scrupulous oral hygiene isn't maintained. Poorly fitted veneers, for example, can allow plaque, food and drinks into the space between the veneer and the tooth, causing bad breath, staining, tooth decay and gum disease.
Gum disease is also linked to liver disease, chronic kidney disease, oral cancers and cardiovascular diseases.
Risky business
There are a number of options to achieve the Turkey teeth look popularised in the UK by reality shows such as Towie and Love Island, from veneers to more invasive procedures such as crowns or implants that are screwed into your jawbone.
Veneers are thin shells applied to the surface of existing teeth to hide imperfections. They are the least invasive of cosmetic dental procedures but usually require the removal of enamel. Improper preparation of the tooth for this process leaves the tooth susceptible to decay.
There are different types of veneer, including porcelain, composite and no prep. No prep veneers preserve tooth structure with minimal, if any, removal of enamel but they tend to last only between five to seven years. With proper care, well fitted porcelain and composite veneers can last up to 20 years.
Dental crowns are permanent tooth-shaped caps that cover broken, worn down or damaged teeth. Crowns are fitted over existing teeth, which are filed down to fang-like pegs. Filing away the teeth removes protective material that cushions the soft living tissues and can open up these areas to pathogens causing local or systemic infection, potentially resulting in death.
Similar risks exist for dental implants; however these can take much longer to bond into your existing bone and therefore it may be months before any potential issues arise.
Dental implants are a permanent replacement for missing teeth or to support dentures. The implants are screw-like metal fixtures that are fastened surgically to the jaw bone, beneath the gums. Implants are expensive and it's a challenging procedure - they are prone to damage and fracture if fitted without proper attention to bite force and the way the mouth works when eating.
Replacing teeth can cause significant changes in how bite forces are transmitted through the jaw bones and the rest of the face.
Bones take time to remodel and, because many people have all their teeth done at once, implants can cause large scale alteration of the mouth's bony micro-structure, resulting in pain and discomfort in the gums, jaw joints and muscles of the face that can last for months. Dental implants can reduce bone in the mouth by up to 22% three years after insertion.
Home free… or not
Cosmetic dental procedures can be risky - but so can the journey home. Patients who've undergone restorative treatments like veneers should avoid flying for at least 24 hours post-procedure. Those who've had implants and extractions - with no complications - should wait at least 72 hours before hopping on the plane home to limit the risk of swelling during the flight.
There's a serious complicating factor for anyone suffering with problem dental work on their return to the UK: who will fix any issues and to what extent? The shortage of NHS dental provision in the UK means that dentists are unable to help patients who've had faulty work done abroad.
The UK regulator for dental professionals, the General Dental Council, have put together a useful "need to know guide" for anyone considering overseas dental work.
Don't forget that while overseas cosmetic dentistry might seem like a bargain it could turn out to be a very expensive - and painful - mistake.
Adam Taylor does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.
