Smile Makeover

The steps can vary between clinics. Where a trial is possible, the order below lets you try the planned look before anything is done that cannot be undone. It also helps you choose the route that removes the least tooth tissue. How the appointments fit a trip is covered in "If you live in the UK: appointments and travel".

The list below runs roughly from the options that remove the least tooth tissue to those that remove the most. Orthodontic treatment and gum reshaping do not fit neatly on this scale, because some plans involve an extraction or surgery on the gum and bone. It is not a ladder: each treatment answers a different problem, and not all of them need to be done.

1. Whitening. Considered for a colour concern, once the cause of the discolouration has been assessed. It can cause temporary sensitivity and gum irritation, and it does not lighten existing fillings, crowns or veneers¹. It does not give the same result on every kind of discolouration. Yellowish teeth usually respond well, brownish teeth may respond less, and greyish teeth may not lighten at all. The effect is not permanent; the teeth partly return to their earlier colour over time, and the treatment can be repeated. Whitening does not lighten ceramic, so natural teeth whitened afterwards may no longer match veneers or crowns. If they are planned, discuss whitening before their colour is chosen. After whitening, your dentist decides whether to wait before bonding, and for how long.
2. Bonding (adding tooth-coloured composite to the tooth). Small chips, worn edges, small gaps and reshaping a single tooth; the tooth is usually not cut.
3. Orthodontic treatment. Crowding, rotated teeth and gaps; it corrects the alignment without making the teeth smaller for covering, takes months and needs retention afterwards. Some plans need limited reshaping of the enamel between the teeth, or an extraction. The risks of shortening of the root tips, white spots on the enamel and gum recession are assessed separately. "Correcting" crowded teeth with veneers or crowns means removing a great deal of tissue from the teeth.
4. Gum reshaping. When too much gum shows, the cause is assessed first. It may lie in the gum level, the supporting bone, the position of the teeth, the jaw or how the lip moves. In suitable cases, the gum, and the supporting bone where needed, is reshaped surgically; in others, orthodontic treatment or different treatments are considered. The possibilities of sensitivity, exposure of the root surface and the appearance changing over time are discussed in advance.
5. Porcelain veneers (also called laminate veneers). When the colour and shape of several front teeth are to change together, and there is enough enamel. Enamel is usually removed, and removed enamel does not grow back, so the treatment cannot be undone².
6. Crowns. Whether a crown is needed depends on the sound tissue left, any cracks and the chewing load. A root canal treatment or a large filling does not on its own mean a crown is needed. Options that remove less tissue, such as fillings and onlays (restorations that cover part of the chewing surface), are considered first. Where too little sound tissue is left, a crown may be the right choice. A crown on a sound tooth only for appearance is not the first option. More detail: Dental crowns.

The comparison table that sets the options side by side is on the dental veneers page. All of these treatments are also available from dentists in the UK, and a UK dentist can give you an independent opinion before you decide.

Where it may be suitable

• Adults with healthy teeth and gums and a specific concern about how their teeth look
• People with more than one problem (colour, shape, alignment) who want to know in which order to solve them
• People who want to replace earlier fillings or crowns that no longer match

Where another treatment is needed first

• Active decay or gum disease: treated first.
• Uncontrolled clenching and grinding: this increases the risk of ceramics breaking. It is assessed first and protection such as a night guard is agreed; for some people, veneers may not be suitable.
• Marked misalignment: orthodontic treatment is assessed first; covering it with veneers or crowns removes a lot of tissue from the teeth.

When it is not the right choice, or not yet

• Veneers or crowns for people who only want a whiter colour on sound, straight teeth: whitening is considered first, because it does not cut the tooth. It does not reach the same shade on every kind of discolouration. The plan may end with whitening alone.
• Teeth that are still developing: in young patients, final veneers and crowns are usually postponed.
• Pregnancy and breastfeeding: cosmetic procedures that are not essential, whitening in particular, are postponed until after this period.
• People whose expectations do not match the condition of their teeth: where a trial is possible, it gives an idea of the achievable look. The plan is then discussed again on that basis.

Every plan gives a reason for each tooth. A single-line offer such as "veneers on the front 20 teeth" should be explained if it includes sound teeth. The same applies to a plan sent before an examination, from photographs alone.

Risks

The risks belong to the treatments in the plan; the detail of each is on its own page.

• Loss of tissue that cannot be undone. Preparing a tooth for a full crown removes enamel from every surface, and often the dentine beneath it. For a veneer, a more limited layer of enamel is usually removed. The tissue removed does not grow back²; from then on, the tooth needs a restoration to protect it.
• The nerve of the tooth. Teeth that were alive at the start and then receive indirect restorations, such as crowns, partial crowns or bridges, can lose their vitality. This means the nerve inside the tooth dies. In the pooled result of 37 studies with different follow-up periods, this was seen in about 5 in every 100 teeth³. This figure comes from published studies, not from our own records. The certainty of the evidence is low; the figure is not a personal risk or a risk for a particular year. The more crowns there are, the more teeth are exposed to this risk. If the nerve dies, root canal treatment is needed to keep the tooth; the figure above is not a root canal treatment rate.
• Fracture and debonding. These are the main reasons ceramic veneers fail⁴; clenching and grinding increase the risk.
• Colour mismatch. The colour of ceramic cannot be changed later; teeth that are not covered change colour over time, and a difference can appear.
• Decay and gums. A crown or veneer does not protect the tooth from decay. New decay and gum inflammation can develop at the edge of a restoration that does not fit well or is not cleaned well enough. The gum can also recede. New decay is among the main reasons restorations are lost in the long term.
• Repair and replacement. Restorations do not last for life; over time they may need repair or replacement, which has an additional cost. The more teeth are treated, the greater this burden becomes.
• Expectations. A digital design is a visualisation; the real result depends on the condition of the teeth, the gums and the bite. Images presented as a promise are misleading.

Benefits

• Planning the problems together rather than one by one aims to avoid unnecessary or conflicting procedures.
• Where a trial is possible, it lets you assess the planned look before any tooth is prepared, and change your mind.
• A plan done in the right order can end with the option that removes the least tooth tissue.

No result is guaranteed for life. The figures below come from published studies, not from our own records. The effect of whitening fades over time⁵ and the teeth partly return to their earlier colour. About 94 to 97 per cent of the feldspathic, leucite-reinforced and lithium disilicate veneers studied were still in place⁶ after an average follow-up of about 10 years. There are no long-term data for zirconia veneers. The great majority of single crowns on natural teeth are still in place after five years⁷.

Still being in place does not mean free of complications. A restoration still in place may have needed repair, and in time it may need replacing. The result depends on the condition of the teeth, the bite, your habits and your care.

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 a plan that gave healthy teeth more treatment than they needed. A smile makeover plan is where this can happen, so 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. The British Dental Association says patients "should be aware of the risks and alternatives to the treatment desired⁸". What a veneer and a crown each remove is explained on our dental veneers and dental crowns pages.

Before you agree to a plan, ask:

1. What is proposed for which tooth, and why? Ask for a reason for each tooth.
2. Is doing nothing, or waiting, also an option? For healthy teeth, the consequences of not treating and of postponing should be discussed too.
3. Why is a less invasive option not enough for this tooth? The answer should rest on the condition of the tooth, not on the package, the material or the time available.
4. Is there a trial stage? Can you try the planned look in your mouth before any tooth is prepared?
5. How much tissue will be removed, and from how many teeth? This is decided by a clinical examination and restorative planning; X-rays are used when clinically needed. A plan made from photographs alone is only a preliminary assessment, not a firm plan.
6. Could a root canal treatment be needed? For teeth where crowns are planned, the condition of the nerve is assessed in advance.
7. How many days, and how many trips? Ask whether the proposed time is enough for the treatments, the trial, the try-ins and the reviews. Has it been shortened to fit a trip?
8. What happens afterwards? Ask in writing who will deal with a fracture, a debonded restoration or sensitivity, and how, once you are back in the UK.

If you are undecided between two plans, getting a second opinion is normal, for example from your own dentist in the UK. Ask for your photographs and X-rays.

Care depends on the treatment carried out. The shared principles are:

• Brush twice a day with a fluoride toothpaste. Clean the edges of restorations and between your teeth every day.
• Do not bite hard objects with your front teeth; if you clench or grind, a night guard may be recommended.
• The colour of whitened teeth partly returns over time. Whitening does not lighten ceramic. Bonding composite is less stain-resistant than ceramic², but ceramic too can discolour along its edges over time. Colour differences between restorations and your natural teeth are assessed at check-ups.
• If you have had orthodontic treatment, wear the retainer for as long as your dentist recommends.
• Keep up regular check-ups with a dentist in the UK, usually your own; the edges of restorations, the gums and the bite are assessed.

Contact a dentist if any of the following happens after treatment. 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 too high
• A break, crack or movement in a restoration; a crown or veneer coming off (keep the piece, and do not glue it back yourself)
• Bleeding, recession or a dark line in the gum at the edge of a restoration

Throbbing pain, facial swelling 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. You also need a written record of your treatment and a way to reach the clinic. If a night guard or a retainer is part of the plan, make sure it has been handed over. 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 and whom to contact with questions.

Once you are back in the UK

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. If you do not have a dentist, use the urgent dental care route described above for urgent problems (in England, NHS 111). In the emergencies above, do not wait for a reply.

Your treatment is provided by our clinic in Antalya, Turkey, and carried out there by the clinic's dentists. A smile makeover can combine several kinds of treatment, 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 dentist¹¹ to diagnose and treat the teeth, the gums and the tissues of the mouth and jaw. It ties the specialist title to a specialist certificate¹¹, issued and registered by the Ministry of Health¹². The law sets nine dental specialties¹¹, among them orthodontics, periodontology (the gums), prosthodontics and restorative dentistry. In the UK, dentists do not have to join a specialist list¹³ 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 dentistry¹³.

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.

The treatments in a plan 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.
• 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. If it comes first in your plan, veneers or crowns follow later.
• Gum reshaping. This is surgery on the gum, and sometimes the bone; 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 months¹⁴. We have found no research that settles how long to wait before final veneers or crowns, so ask whether gum reshaping means a second trip. Your dentist tells you how it fits into the days of the plan and when you can fly.
• 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. Where a trial is possible, it comes before any tooth is prepared.

The number of days in Antalya depends on which treatments 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 estimate¹⁵. For a smile makeover, 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.

A smile makeover is not finished when you fly home. Veneers, crowns and bonding need check-ups for as long as they are in the mouth. Smile makeovers are also planned by dentists in the UK, and a UK opinion and written plan give you something to compare.

Flying. A 2023 review of flying after dental treatment suggests waiting at least 24 hours after restorative treatment¹⁶. It suggests longer after surgical procedures, such as gum reshaping. 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 own dentist

The General Dental Council suggests talking to your own dentist¹⁵ 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 abroad¹⁵. 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 regulator¹⁵. 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. Before you travel, check that a UK dentist will see you for this, and tell them about the plan. 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 a smile makeover, 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 the plan includes: whitening, bonding, orthodontic treatment, gum reshaping, 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

For comparable treatments, the fewer teeth are treated, the lower the cost and the fewer teeth lose tissue. Ask for the plan in writing, showing which procedure is proposed for which tooth, why, and what is included. Ask too who pays for further treatment and extra travel if there is a complication. 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.