What is an ethical dentist?

glam2World renowned dentist to the stars, Miguel Stanley, discusses the importance of remaining ethical when helping patients achieve their perfect smile

He says, ‘2016 has been declared the year of the teeth – pricey toothpastes and tooth brushes are on the rise and statistics show that more and more people in the UK are investing in upgrading their smiles. Indeed, at the moment, a Google search reveals hundreds of clinics offering “one-day smile makeover” veneer treatments and endorsements from celebrities showing off their perfect mouth makeovers.

‘Private cosmetic dentistry has never been hotter – and this year will top £2 billion. A quarter of Britons have had some form of cosmetic dentist, a survey by the British Academy of Cosmetic Dentistry found; people who regularly use Botox and fillers to create a better looking face are moving onto their smiles.’

But not all is well in the world of great looking teeth.

TV influence

‘In cosmetic dentistry, there is a real problem with ethics at the moment. This began through make-over TV shows and, of course, led to the exponential growth of dental practices and dental marketing pretty much all over the world and particularly in the UK. And when you have exponential growth of any industry, you will find that there’s a huge portion that is not up to par with the leaders. This happens in every field but when it happens in health it can be particularly demoralising.

‘Veneers can be a life changing and wonderful thing but the use of veneers, especially in younger patients, where not directly indicated could leave patients thousands of pounds worse off and needing dentures by their 50s. A 2012 report cited in the Daily Mail found that claims against dentists involving porcelain veneers doubled between 2005 and 2010.

smile2‘And earlier this year the UK’s six leading specialist dental societies published a dramatic joint statement in the British Dental Journal expressing concern at the risks of “increasingly popular” cosmetic dentistry, describing cases of permanent damage to teeth caused by veneers as a “worrying and growing problem”.

‘It is important for people to understand that making over a smile using veneers is a very high-end cosmetic procedure, in terms of costs, much more than breast augmentation, than a nose job or a hair transplant. And there are a lot of other options out there. A full smile makeover can run up into tens, and sometimes even hundreds of thousands of pounds.

‘It is imperative for the general public to understand what they are buying and what exactly they are going to put in their mouths. No longer is it acceptable to just go in blindly and just perform veneers because the patients wish to do this. I believe that “no” is the strongest word that a cosmetic dentist has in his arsenal.’

Creating the perfect smile

So what about creating the perfect smile? ‘It’s always case specific and in many cases dental implants have to be put in place first. Of course, the higher the quality of the ceramics, quality of the materials, technique and experience of the dentist, the better the overall outcome, and these things come at a hefty price. I always tell my patients: If you can’t afford it, don’t do it.

‘Sadly, some people are pressed by society and the desire to have a more beautiful smile, which associated with a less scrupulous dentist, who is more focused on his business than on his craft, then you have a dangerous combination. Dentists should be cautious when promoting a treatment with veneers – once you touch a tooth it’s irreversible.

‘It’s a huge responsibility to get it right the first time. I would strongly urge patients to focus more on using invisible orthodontics to straighten their teeth and doing less invasive procedures. Of course, in some cases, I would say in fewer than 20%, it is the right thing to do – and in that case, in the right hands it is a life changing procedure.’

And there is a way to minimise risk that all patients should be demanding. ‘It is possible nowadays for the patient to envision exactly how much of the tooth structure will be removed and exactly what will they look like, using an intraoral mock-up, meaning that the lab and the dentist design the smile, that then goes into the patient’s mouth temporarily, so that they can take photographs and see themselves in the mirror before advancing into the unknown.

‘This allows patients to take control of their treatment. That way the power is in their hands, where it belongs.’

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