Health: Grin and bare it

Published on Friday 5 June 2009 13:22

IT MAY be National Smile Month but we've not had many reasons to smile lately. Even if we were to grin and bear it, our pearly whites probably wouldn't come close to the gleaming gnashers belonging to, say, Cheryl Cole or Tom Cruise.

Both the Girls Aloud star and the Mission: Impossible actor, along with everyone from David Beckham to Kirsten Dunst, began their careers with distinctly uneven ivories. But once the dental surgeons got their hands on them they were almost unrecognisable. Even former Pogues frontman Shane MacGowan has had his trademark toppling tombstones transformed into a dazzling row of marvellous molars.

If the first step for anyone in the public eye is a trip down to the dentist, in our attempts to keep up with the Catherine Zeta-Joneses we, inevitably, follow them. In the last five years the popularity of cosmetic dental work has soared. In fact, so keen are we to emulate our favourite stars that some pioneering dentists are even issuing patients with 'snap-on smiles' – moulded dentures that are carbon copies of famous people's teeth that can be popped on and off at will.

But are we putting too much emphasis on expensive, interventionist treatment and not nearly enough on basic dental health? Has the brush-twice-a-day-and-don't-forget-to-floss message got lost amid the bridge-work, veneers and tooth whitening kits?

"If somebody came into the surgery with slight overcrowding and wanted their teeth crowned, which would involve cutting the teeth down into pointed shapes to fit crowns over, I would – and I have in the past – said, 'No, I'm not prepared to do that'," says Kieran Fallon, a dentist working in central Glasgow. "There are times when that just isn't responsible."

In fact, before you can even begin to choose your new chompers, you'll need to convince the dentist of your commitment to keep them clean. "Any patient who wants a Hollywood smile will be told that to get that they must first have good oral health and hygiene," says Fallon, "and the first stage of that would be to make sure they are able to brush and keep their new teeth clean."

That's because, once you have your shiny new Cameron Diaz dentures, you're not off the hook when it comes to good, old-fashioned brushing. "People can have veneers done – which are like facings on false nails," says Fallon. "But if they don't keep them clean, the very least that can happen is that the veneers themselves can develop staining, but you can also get decay because the tooth substance is still there behind the veneer."

If we have unrealistic expectations, however, he lays the blame firmly at the door of television makeover shows. "Patients see programmes like Ten Years Younger and they see the potential for change," he says. "Of course, these programmes show Harley Street stuff that is very advanced dentistry and some of it is very high-maintenance, not only financially but it will need constant repair. They think the dentist does the treatment and that's them set up for life and that's not the case. You have to rein people in a bit and help them be realistic about their expectations."

He says these shows can be a mixed blessing for dentists. "It's good that it makes people more aware of their oral health; but it also sometimes causes them to have an incredible expectation of what can be achieved. These people have thousands of pounds' worth of treatment but then the show finishes, the TV companies go away and they're left with very advanced work. They walk into an ordinary dentist who says, 'Woah! I'm not touching that, you'll need to go back to the dentist who did that.'

"I just fear sometimes that people are left with very advanced work without the means to maintain and look after it."

In his own surgery he has seen a dramatic rise in demand for cosmetic treatment. "People are a lot more interested in their teeth these days," he says. "It used to be that people didn't bother at all, all their teeth would go bad, they'd need to be taken out then they'd just get a set of dentures. That's clearly not the case now.

"There's a big increase in things like teeth whitening and straightening teeth either by orthodontics, veneers or crowns; and the other big increase area is replacing the old silver amalgam fillings with white ones."

However, whitening is still not a fully regulated practice, which means people other than qualified dentists can carry out the work. "It's a major concern," says Fallon, "because places like hairdressing salons and beauty salons are offering teeth whitening, and although it's a very safe and non-interventionist procedure, there is potential with some strengths of gels used to cause extreme sensitivity in teeth and irritation to gums.

"At first our regulatory body was taking the attitude that it wasn't the practice of dentistry so they didn't want to get involved, but now they are getting involved."

In the meantime, he advises anyone interested in whitening to approach only a qualified dentist. And to resist the temptation to go over the top. "All the stars have these almost uniform white smiles," says Fallon. "The teeth look very square and straight and probably a bit soulless, so there is a tendency for people to want to get their teeth whitened way beyond the natural colour.

But most dentists would caution people to go for a much more natural and healthy colour, not a bright, super-white."

More important, however, than straight super-white teeth, he says, is having a good diet and oral hygiene.

"The first thing is regular brushing – not just giving them a good scrub before you go to the dentist – at least twice a day, but particularly last thing at night; that's the most important time because your saliva is your natural defence against tooth decay. As you sleep your saliva flow dries up and any bacteria and sugar on the teeth would have more opportunity to cause decay.

"Diet is also very important," he adds, "avoiding as far as possible foods that contain sugar. And that's not always the obvious things like sweets, biscuits and fizzy drinks. A lot of things you don't normally think of as sweet also contain hidden sugar, such as tomato soup, baked beans and ketchup. What we advise people is, if you're having something sweet as a treat, have it at a mealtime." Then, ideally, brush your teeth a bit later on.

And whatever you do, stop snacking between meals. "The worst offender is the sort of person who sits at their desk sipping from a can of Coke all day, or sucking mints – they're going to have serious problems."

And if you still need encouragement to floss, consider the recent research that has linked poor oral health to heart disease. "Researchers have found a lot of people with heart problems also bad gum conditions," says Fallon, "and they are investigating that."

So it seems that looking after your teeth could also help you live longer. Which has got to be a reason to smile.

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Mouth to mouth

FORTUNATELY not all stars have felt the need to tamper with what nature chose to give them. Shawshank Redemption actor Morgan Freeman's teeth are distinctly stained and misaligned, but it doesn't seem to affect his performance in any way – and possibly brings even more character to the roles he plays.

Comedian Alan Carr's gappy smile and overbite are part of what gives him his charm – he has even made a virtue of it, releasing a tongue-in-cheek DVD entitled Tooth Fairy.

Perhaps unsurprisingly, Pete Doherty's well-documented excesses have resulted in badly stained chompers. Ditto Amy Winehouse, who also has several missing teeth.

In fact, rock music is harbouring all manner of quirky molars. Razorlight's Johnny Borrell seems to have no trouble pulling the ladies, despite his prominent incisors. And then there is Goldie, whose metallic mouth is a trademark. Would any of us recognise him without it?

Madonna, meanwhile, has always resolutely refused to have the gap between her two front teeth fixed. When, in 1990, Glamour magazine photoshopped a cover to close the gap, the singer was allegedly so furious she refused to accept the magazine's Woman of the Year award.

Jamie Oliver has been quoted as saying he doesn't need a perfect smile – and his gappy, overlapping teeth are testament to that.

And Helena Bonham Carter's oft-criticised scruffiness extends to her mouth – she appeared at the Sweeney Todd premiere last year not just with unruly facial hair but also with a badly-stained set of teeth.

Fashion designer Zandra Rhodes is known and loved for her refusal to conform, so her teeth are reassuringly uneven.

Emmy-award winning actress Patricia Arquette loves her overlapping teeth. "I remember being 12 years old at a new school and some kid saying, 'You're so pretty you should just straighten your teeth.' I said, 'Why would I do that? I'll never straighten my teeth.' Why should I straighten my teeth and look like everybody else?"

And comedian-turned-actor Paul Kaye, probably most famous for his spoof interviewer character Dennis Pennis, was once described as "looking like Ralph Fiennes with a mouth full of Shane MacGowan's teeth". Not any more, he doesn't.

Brush up on oral hygiene

STEP away from your toothbrushes and read carefully, because some of the things you think might be good for your teeth could actually be harming them instead.

In January this year, a study claimed a link between some mouthwashes and oral cancer. In fact, researchers said mouthwashes containing alcohol should be taken off the shelves and only be available on prescription.

Even brushing your teeth, if done incorrectly, can do more harm than good. Using a hard brush could be cutting through the enamel and over-zealous brushing can damage it. Back and forward strokes – like a saw – can end up wearing a groove at the base of the teeth, and though brushing after meals was always the old-school mantra, dentists are now recommending waiting at least an hour. This is because eating and drinking weakens the enamel and immediate brushing could result in tiny particles of the tooth surface being rubbed away.

As for diet, even though fruit juices contain vitamins, they also contain large amounts of natural sugar so can contribute towards tooth decay and should only be drunk with a meal.

Finally, crunching on mints might feel like they are freshening your breath, but many contain high sugar levels so feed oral bacteria – bad for your teeth as well as your breath.