When you’re smiling - the whole world smiles with you

The song was written by Larry Shay, Mark Fisher and Joe Goodwin in 1928 and the sentiment is just as much true today as it was when the song was written. Today, in many cultures across the world people have become obsessed with achieving the perfect smile. The combination of celebrity influence and social media has helped drive the desire for that perfect smile. Celebrities such as Kim Kardashian and Kylie Jenner and many other celebrities, trend setters and beauty bloggers have had a much greater influence over patients’ dental aspirations and have used their online influence to promote cosmetic dental products and treatments they value. Today’s selfie culture coupled with the fact that more interactions now take place via social media and other forms of digital communication, has led to greater emphasis being placed on an individual’s online image and persona. This has driven the desire for good looking teeth, particularly as a straight, white smile can influence perceptions of success, popularity, intelligence, attractiveness, and general health.

So, it should not surprise anyone that the global market for cosmetic dentistry is predicted to grow at an annual rate of 5%, increasing its value to an estimated £21 billion by 2026. The American Academy of Cosmetic Dentistry conducts regular surveys amongst its members. The 2015 survey showed that 52% of respondents reported earning between $100,000 and $500,000 from cosmetic dentistry and 10% earning more than $1m. The same survey reported that around 50% of patients spent between $500 and $2500 on their teeth.⁽¹⁾ Cosmetic dentistry is expensive across the world. There has been a rise in dental tourism as some countries in Eastern Europe and South East Asia try to attract patients by offering cheaper procedures than the patients’ home country. The table below illustrate typical cosmetic dentistry costs in the UK.

Procedure	Cost (£)
Teeth Whitening- needs repeating every 6 months	£500 per session
Veneers	£350-£450 per tooth
Cosmetic teeth straightening	£600
Orthodontic teeth straightening	£5000
Crowns	£400 per tooth
Bridge	£250-£3000
White Fillings	£95 per tooth

So, you have spent a great deal of money on the perfect smile and now you need to protect that investment. You need to be careful what you eat and drink. Dried fruits are highly acidic and will damage teeth. So is wine and even hot water with lemon. Tea, and coffee can also cause staining. Binge eating sweets can cause decay. Chewing ice and hard nuts can chip or crack a tooth. Using your teeth for odd jobs such as opening a packet or tearing a label off an item can cause chips or fractures. Playing most sports will require a mouth guard.

You even need to protect your teeth if you need an operation that requires you to be anaesthetised. This is because insertion, manipulation, or removal of almost any airway or suction device in the mouth can result in damage. Biting and grinding of teeth during recovery may also cause dental and oral injuries. Damage to teeth is more likely if they have been subjected to the cosmetic procedures described above. Also, age and poor dentition can increase the risk of damage. Clearly there are procedures in place to reduce damage to teeth and anaesthetists take great care, so they do not damage a patient’s teeth. However, in several series of closed claims data from multiple countries, dental damage is the most common claim made against anaesthetists and makes up 20 -30% of claims^(2),(3). Should dental damage occur you would be referred to the hospital dental department if they have one. However, it is more common for you to be told to go back to your dentist, meaning you will have to pay for any treatment and sue the hospital to get your money back. We all know that can mean a lot of form filling, jumping through a lot of hoops and a long wait for your money!!

One way to prevent damage to your teeth from you unconsciously biting down on your airway is to make sure your anaesthetist uses a bite block. Many practitioners use rolled pieces of gauze as bite blocks, but these must be “constructed”, may be difficult to insert, and often are ineffective. Some use a guedel airway which, as its name suggests is designed to maintain an airway not act as a bite block. So, make sure they use a specifically designed bite block such as BiteMe™. BiteMe™ is made of a very strong, but soft, plastic that resists the shear forces of a human bite very well. The combination of the soft plastic surrounding a closed air-filled space means that when a patient bites down, there are two forces opposing the bite. This means BiteMe™ has a spongy recoil and is therefore less likely to damage the teeth compared to a guedel airway, which has been shown to increase the risk of dental trauma.

After all they are your teeth and you have paid a lot of money for them.

References:

1. American Association of Cosmetic Dentistry. State of the cosmetic dentistry industry survey 2015

2. Ranum D, Ma H. Analysis of patient injury based on anesthesiology closed claims data from a major malpractice insurer. J Health Risk Manag 2014;34(2):31-42

3. Chadwick RG, Lindsay SM. Dental injuries during general anaesthesia: can the dentist help the anaesthetist? Dent Update 1998;25(2):76-78 5.

Author: Niall Shannon, European Business Manager, Innovgas

This article is based on research and opinion available in the public domain.