Cosmetic Dentistry

My teeth are yellow or stained

The cause of the discolouration is assessed first. Surface stains can often be removed with a professional clean; darkening of a single tooth may be linked to decay or to the tooth's nerve. In suitable cases, whitening is considered. How well it works depends on the cause. Yellowish teeth usually respond well, brownish teeth may respond less, and greyish teeth may not lighten at all¹. A 2024 umbrella review brought together systematic reviews of clinical trials. It found that whitening at home with a low-concentration gel over a longer period gives a colour change similar to whitening in the clinic². For home whitening, your dentist decides the product and how long to use it. Whitening lightens the colour of natural tooth tissue. Existing fillings, crowns and veneers do not whiten; if a colour difference remains, they may need replacing. The effect is not permanent and needs topping up. A single root-filled tooth can be considered for whitening from the inside. Rarely, this method has been linked to external cervical resorption, a gradual loss of hard tissue from the root surface near the gum line. For discolouration that does not respond to whitening: bonding or porcelain veneers.

One of my teeth is chipped, worn or small

For worn teeth, the cause is assessed first, such as clenching or grinding, or acidic food and drink. Bonding can often be done in a single appointment, usually without drilling tooth tissue away. The surface is treated so that the material bonds to it. A large fracture, one that extends towards the root or the nerve, or a large filling may call for more. A crown or a partial-coverage restoration may then be considered. If the nerve is affected, it may need treatment first. The choice depends on how much sound tooth remains. Crowns are named after their material: lithium disilicate (often called e.max), zirconia or metal-ceramic (porcelain fused to metal).

My teeth are crowded, rotated or stick out

Orthodontic treatment: braces or clear aligners move the teeth instead of cutting them for crowns or veneers. Some plans remove a thin layer of enamel between the teeth, or need extractions. Treatment takes months, and keeping the result needs retention. Hiding crowding with crowns or veneers means removing a great deal of tissue from the teeth, so orthodontic treatment is assessed first.

There is a gap between my teeth

Depending on the cause and width of the gap: bonding, porcelain veneers or orthodontic treatment; sometimes leaving it alone is the right choice.

Colour and shape together on several front teeth

Whitening for the colour and bonding for the shape may be enough. If they are not, porcelain veneers may be considered, if there is enough enamel and the teeth are healthy. They cannot be undone. How veneers differ from crowns, and what to ask before any tooth is prepared, is covered on the dental veneers page.

My gums show a lot when smiling, or the gum levels are uneven

Treatment depends on the cause. Too much visible gum can come from the gum level or the position of the supporting bone. It can also come from the position of the teeth, the structure of the jaw or the movement of the lip. In suitable cases the gum, and where needed the supporting bone, is reshaped; this is covered on our cosmetic gum contouring page. In others, orthodontic treatment or other treatments are considered. Unevenness caused by gum recession may need tissue to be added. The decision is made after an examination and any imaging needed.

My old fillings or crowns do not match

Depending on the cause of the mismatch, polishing, reshaping, repair or replacement is considered; where possible, the existing restoration is kept. If replacement is needed, whether more tissue will be removed from the tooth is discussed beforehand.

Changing the whole smile

This is a matter of planning, not a single procedure: a smile makeover. A trial stage gives an idea of the planned look before any work that cannot be undone. The final colour, shape and appearance of the gums may differ.

It bothers me only a little

Doing nothing is an option. If there is no underlying disease, how your teeth look is a matter of preference, and leaving them as they are is a valid choice. An examination tells you whether anything needs treating for health reasons.

When other treatment is needed first

Active decay, gum disease and uncontrolled clenching are dealt with first; in teeth that are still developing, final veneers and crowns are usually postponed. Clenching and grinding are also assessed before veneers are suggested. Australian government health information (healthdirect) notes that veneers may not be suitable if you grind or clench your teeth³. At the examination you are also asked about your medical history, including medicines and smoking.

If more than one procedure is needed, the order affects the result and how much healthy tooth tissue is removed:

1. Health first. Decay, gum disease and bite problems are resolved before cosmetic procedures; a restoration placed while disease continues is at higher risk of failing early.
2. Then procedures that can be reversed or do not cut the tooth. Orthodontic treatment corrects the alignment; whitening lightens the colour. The colour of ceramic does not change later, and whitening does not lighten crowns or veneers¹. If your natural teeth are to be whitened, discuss it before the colour of any crowns or veneers is chosen.
3. Restorative procedures last. Once the alignment and colour are settled, any remaining flaws in shape are corrected. Bonding, porcelain veneers or crowns are used, according to what the tooth needs. These are not consecutive steps but alternatives chosen for each tooth. Veneers and crowns are made only on the teeth that need them, after the result has been seen at the trial stage.

When this order is skipped, more teeth may be treated than needed, with more tissue removed.

In British media, "Turkey teeth" is a loose label for extensive cosmetic dental work, such as a full row of very white crowns or veneers. The concern raised with it is that healthy teeth were given more treatment than they needed. A good plan avoids this: the least invasive option that meets your goal comes first. The written plan should state the treatment for each tooth, and you can ask why any tooth needs a veneer or a crown. What each one removes is explained on our dental veneers and dental crowns pages.

If you are travelling for treatment, ask where and when any treatment needed first will be done, and how that changes the number of trips.

Risks

• Irreversible loss of tissue. Preparing a tooth for a full crown removes enamel from every surface, and often some of the dentine beneath. For a porcelain veneer, a more limited layer of enamel is usually removed. Removed tissue does not grow back; the tooth will depend on a restoration for life.
• The tooth's nerve. A tooth can have a healthy nerve (pulp) when it is given a crown, a partial-coverage restoration or a bridge support. In such teeth the nerve can later lose its vitality, which means it dies. In the pooled results of 37 studies, the nerve lost its vitality in about 5 in every 100 teeth⁴. This figure comes from published studies, not from our own records. The certainty of this evidence is low. The figure is pooled over the studies' different follow-up periods. It is not a personal risk, a yearly rate or a measured rate of root canal treatment. If the nerve loses its vitality, root canal treatment is needed to keep the tooth.
• Sensitivity. Temporary sensitivity is the most common side effect of whitening. A network meta-analysis of 77 studies found the risk higher with 20–22% carbamide peroxide and 14–16% hydrogen peroxide gels than with 2–4% hydrogen peroxide⁵. The risk varies with the product, how long it is applied and the person. Temporary sensitivity can also follow preparation for crowns or veneers. The NHS says whitening is not done if you are 17 or younger, or if you have unhealthy teeth or gums⁶. It also says whitening is not recommended during pregnancy or breastfeeding⁶.
• Fracture, coming loose, staining. Over time, ceramics and composite can chip, fracture or come loose. Biting nails or very hard things raises the risk. The edges of ceramics can discolour, and composite can stain and roughen. Repair or replacement is then needed.
• New decay. Bonding, veneers and crowns do not protect the tooth from decay. New decay can start at their edges.
• Risks specific to orthodontic treatment. Shortening of the root tips, white spots and decay on the enamel where brushing is difficult, and gum recession can occur. Keeping the result needs long-term, sometimes lifelong, retention and regular check-ups.
• Gums. Restorations with poorly fitting edges can lead to gum inflammation and recession.
• Expectations. Visual designs are not a promise; the result depends on the real condition of the teeth.

Benefits

• The option that fits the concern often gives a result without cutting the tooth, or by cutting it very little.
• A plan in the right order can avoid unnecessary restorations and help keep tooth tissue.
• Composite is easier to repair if damaged, but ceramic is more resistant to stains and wear⁷. A review combined 29 studies of feldspathic, leucite-reinforced and lithium disilicate veneers. About 94 to 97 in every 100⁸ were still in place after an average of about 10 years. This figure comes from published studies, not from our own records. Staying in place does not mean staying free of complications. The review found no long-term data for zirconia veneers.

Contact a dentist if any of the following happens after a cosmetic procedure. While you are in Antalya, that is the clinic; once you are home, it is usually your own dentist in the UK.

• Sensitivity that does not settle, or keeps getting worse
• Toothache that lasts more than 2 days⁹, or that does not go away when you take painkillers
• Pain when biting, or a feeling that the bite is high
• A fracture, crack, movement or loss of a restoration (keep the piece, and do not glue it back yourself)
• Bleeding, recession or a dark line at the gum along the edge of a restoration
• White patches or burning on the gums after whitening (stop home whitening until you have spoken to your dentist)

Throbbing pain, swelling of the face that keeps getting worse, or a high temperature are not an expected result. See a dentist where you are without waiting for the clinic's reply. If you think you have a dental abscess, do not wait. An abscess does not go away on its own and needs urgent treatment by a dentist¹⁰. In England, the NHS advises asking for an urgent dentist appointment or getting help from NHS 111¹⁰. If you do not have a dentist or cannot get an emergency appointment, it says to call 111 or use 111 online. Elsewhere in the UK, check the urgent dental care route where you live.

Emergencies. The NHS lists the following as needing urgent medical help¹⁰. Do not wait for a dental appointment or for the clinic's reply. In the UK, call 999 or go to A&E. In Turkey, the emergency number is 112.

• Difficulty breathing, speaking or swallowing
• A lot of swelling inside your mouth
• Swelling around your eye or in your neck⁹
• Pain in the eye, or sudden problems with your sight
• Difficulty opening your mouth

Before you fly home

Make sure your bite has been checked, and that you have written care instructions and a written record of your treatment. If you are continuing whitening at home, ask in writing which dentist is responsible for the home course. Ask how long to use the product, how strong the gel is, and whom to contact with questions. Tell your dentist in the UK what you are using; the UK rules on whitening products are on our teeth whitening page.

Once you are back in the UK

Brush twice a day with a fluoride toothpaste, and clean between your teeth every day. If a problem comes up that is not urgent, write to the clinic and send photographs. A dentist in the UK, usually your own, is the one who can look at it in person. In the emergencies above, do not wait for a reply.

The options on this page fit a trip in different ways.

• Whitening. In the clinic it usually takes one appointment. Whitening at home goes on for weeks, so most of it happens after you leave. Your dentist decides the product and how long to use it. If bonding, veneers or crowns follow, your dentist decides whether to wait after whitening, and for how long. Ask how this fits into the trip.
• Bonding. Usually one appointment, with no laboratory work. It is checked regularly and may need polishing, repair or replacement over time, so it is often simpler to have near home.
• Orthodontic treatment. Treatment runs over months and the result needs retention afterwards, so it is often simpler to have near home.
• Gum contouring. Reshaping the gum, and sometimes the bone, is surgery; crown lengthening is one form of it. In studies of crown lengthening, the gum edge may move back part of the way while it heals, mostly in the first three months¹¹. We have found no research that settles how long to wait before final veneers or crowns, so ask whether gum contouring means a second trip. Ask your dentist how it fits into the days of the plan and when you can fly. Its risks are set out on the cosmetic gum contouring page linked above.
• Porcelain veneers and crowns. Usually more than one appointment, with laboratory work between preparing the teeth and fitting the restorations; you may wear temporary restorations in between. The teeth are prepared under local anaesthetic.

The number of days in Antalya depends on which options are chosen and how many teeth are treated. It also depends on whether decay, root canal or gum problems need treating first. Before you book, ask for a written preliminary plan based on your photographs and any X-rays you send. It should set out the appointments and how many days they need. It is not a diagnosis or a final treatment plan. The General Dental Council says you should always be assessed by a qualified dentist before being given a treatment plan and cost estimate¹². For cosmetic treatment, that assessment is the examination in Antalya. It confirms or changes the preliminary plan, and with it the days and the cost. If it changes, ask for the revised plan in writing before any tooth is prepared. You can say no, or ask to stop, at any stage. Once a tooth has been prepared, that step cannot be undone, and the tooth needs a restoration. Ask what would happen if treatment stopped at that point. Ask before you book what you pay if the examination shows the plan does not suit you, or if you decide not to go ahead.

Veneers, crowns and bonding are not finished when you fly home: they need check-ups for as long as they are in the mouth. All of these treatments are also available from dentists in the UK, and a UK opinion and written plan give you something to compare. In the UK, whitening is private treatment, not available on the NHS⁶.

Flying. A 2023 review of flying after dental treatment suggests waiting at least 24 hours after restorative treatment¹³, and longer after surgical procedures. These times assume there is no pain, swelling or bleeding where you were treated. The authors note that the research is limited and comes mainly from military aviation. Treat it as a starting point for your dentist's advice, not as a rule.

Your treatment is provided by our clinic in Antalya, Turkey, and carried out there by the clinic's dentists. Cosmetic treatment can combine several kinds of procedure, so different parts of a plan may be done by different dentists.

In Turkey, as in the UK, a dentist does not have to be a specialist to carry out cosmetic treatment. Turkish law authorises every dentist¹⁴ to diagnose and treat the teeth, the gums and the tissues of the mouth and jaw. It ties the specialist title to a specialist certificate¹⁴, issued and registered by the Ministry of Health¹⁵. The law sets nine dental specialties¹⁴, among them orthodontics, periodontology (the gums), prosthodontics and restorative dentistry. In the UK, dentists do not have to join a specialist list¹⁶ to practise a specialty. They may use the title "specialist" only if they are on the GDC's list, and the GDC has no specialist list for cosmetic dentistry¹⁶.

Ask who will plan your treatment and who will carry out each part of it. Ask what their titles are, where they qualified, and whether any of them holds a Ministry-registered specialist certificate. Ask for the answers in writing.

Your own dentist

The General Dental Council suggests talking to your own dentist¹² before you go. They need to know the plan in case problems come up later. Once you are home, a problem with a veneer, crown or bonding is usually first seen by a dentist in the UK, often your own. If you do not have one, it helps to find one before you travel.

Ask for a written record of the treatment to take back to them. It should show what was done to each tooth, and the materials and products used. Ask for copies of your X-rays too. In Turkey, the health tourism regulation entitles international patients to an itemised bill. On request, they also get free copies of the records of the materials used, the tests and the imaging¹⁷. The NHS lists exchanging medical records and arranging aftercare back home¹⁸ among the things to consider before treatment abroad.

Veneers, crowns and bonding need regular check-ups for as long as they are in the mouth. National guidance in England (NICE) says the interval between check-ups should be set for each person according to their risk¹⁹ and discussed with them.

What the NHS does and does not do

If you later need NHS dental care in England or Wales, having been treated abroad does not by itself shut you out of it. An NHS dental practice that accepts you for a course of treatment, not only an urgent appointment, provides clinically necessary treatment, with your consent. That may not be the same as the cosmetic work you had done. However, the free repair or replacement²⁰ an NHS practice can give for its own work does not apply to work done by another provider. The NHS also states that it is not liable for negligence or failure of treatment¹⁸ when you have treatment abroad. On the NHS England routes that fund planned treatment abroad, you cannot get reimbursement for dental treatment²¹.

The NHS guidance quoted here is for England, and for England and Wales where stated. Scotland and Northern Ireland have their own NHS rules, which this page does not cover. If you live there, ask your dentist how they apply to you.

Travel insurance

The NHS says that most travel insurance policies will not cover you for planned treatment abroad, so you may need specialist cover¹⁸. Tell your insurer about your plans before you book.

The General Dental Council lists questions to ask before treatment abroad¹². Below are its questions, some of them combined, with what this page can answer today and what to ask for in writing. The last question is one of our own.

1. Who will carry out my treatment, and what are their qualifications? The treatment is provided by our clinic in Antalya, Turkey. Ask for the name of each dentist who will plan and carry out your treatment. Ask where they qualified and what their titles are (see "Who carries out the treatment?").
2. Will the dental team speak English, or will you provide a translator? Ask who will explain your plan and your consent form to you, and in which language.
3. Are you regulated by a professional body and registered with it? The GDC notes that it cannot guarantee that other countries have an equivalent regulator¹². In Turkey, a health facility needs an authorisation certificate¹⁷ from the Ministry of Health to treat international patients. Authorised facilities appear in a register the Ministry publishes²², so you can check it yourself. The authorisation belongs to the facility, not to the dentist, and it says nothing about the result of your treatment. Ask for the treating dentists' own registration details as well. See health tourism authorisation.
4. Is the work guaranteed, are the terms in writing, and for how long do they apply? This page makes no guarantee. Ask for the clinic's written terms for remaking a veneer or crown and for handling complications, and read them before you commit. Check how long they apply, what they exclude, and what they say about a restoration that fails after you are back in the UK.
5. If there are complications, or I am unhappy with the result, what happens and who pays for further treatment, extra flights and the hotel? Is further treatment included in the cost? Ask for the answers in writing before you commit. A remade veneer or crown usually needs laboratory time, so it can mean another trip.
6. What aftercare do you provide, and who can I contact after the treatment? For a problem that is not urgent, you write to the clinic and send photographs. Check-ups, and problems that need someone to look in your mouth, are with a dentist in the UK, usually your own. Ask which channel to use, in which language, and how quickly you can expect a reply.
7. How many times have you carried out this treatment, what are your rates of success and complications, and can you give references? The figures on this page come from published studies, not from our own records. We publish no figures of our own yet, and this page carries no patient reviews or before-and-after photographs. Ask for the clinic's figures in writing, and how they were collected.
8. Do you have insurance to cover this treatment? In Turkey a facility treating international patients must take out complication insurance for surgical and interventional procedures carried out in an operating theatre¹⁷. That does not by itself tell you whether your treatment is covered, so ask which procedures in your plan, if any, fall under it. Ask too, in writing, whether the clinic or the treating dentist holds insurance for complications or errors, what it covers and whom it protects.
9. Do you have a complaints system, and can I see a copy? Ask for it before treatment. The GDC says it cannot resolve complaints or help with refunds²³; its investigations concern the dentists on its own register. Turkey's health tourism regulation makes the facility responsible for complications and medical malpractice arising after the health service it provided¹⁷.
10. If the examination shows that the plan does not suit me, what happens, and who pays? You can say no, or ask to stop, at any stage; once a tooth has been prepared, that step cannot be undone. Ask before you book what you pay for the examination and any X-rays, and what happens to any payment if you do not go ahead.

The NHS names warning signs to think about before booking any treatment abroad. They are a hard sell, a lack of information, pressure to make a quick decision, no discussion of possible complications, and no mention of aftercare²¹. Apply them to this clinic too. For cosmetic treatment, add one of our own: a plan that proposes veneers or crowns on healthy teeth without a reason for each tooth.

This page does not show prices. A treatment plan is prepared for you after an examination. The main factors that shape it are:

• Which treatments are included: whitening, bonding, orthodontic treatment, gum contouring, veneers or crowns
• How many teeth are treated
• The material and how it is made
• Treatment needed first: decay, gum treatment, root canal treatment
• The trial stage, temporary restorations and review appointments
• The number of trips the appointments need

Whitening and orthodontic treatment often involve the whole set of teeth. For bonding, veneers and crowns, the cost rises with the number of teeth treated. Ask for the plan in writing, showing which procedure is recommended for which tooth, why, and what is included. Ask too who pays for further treatment and extra travel if there is a complication. Ask whether the examination and any X-rays are included. When you compare quotes, add travel and accommodation for each trip.

If you are comparing with a quote from a UK practice, compare what each one includes, tooth by tooth: which treatment, and which material.