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. According to reviews, whitening at home with a low-concentration gel over a longer period gives a colour change similar to whitening in the clinic¹. 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 laminate 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 (e.max), zirconia or metal-ceramic (porcelain fused to metal).

My teeth are crowded, rotated or stick out

Orthodontics: 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 orthodontics is assessed first.

There is a gap between my teeth

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

Colour and shape together on several front teeth

Laminate veneers, if there is enough enamel and the teeth are healthy. Any tissue removal 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; in others, orthodontics 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 permanent work; 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, permanent restorations are postponed.

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. Orthodontics corrects the alignment; whitening lightens the colour. Whitening does not lighten ceramic crowns or veneers². 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, laminate veneers or crowns are used, according to what the tooth needs. These are not consecutive steps but alternatives chosen for each tooth. Laminate 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.

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 laminate 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. Some teeth that were alive at the start receive indirect restorations (crowns, partial restorations or bridge supports). In these teeth the nerve can lose its vitality. In the pooled results of 37 studies, the nerve lost its vitality in about 5 in every 100 teeth³. 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 peroxide⁴. The risk varies with the product, how long it is applied and the person. Temporary sensitivity can also follow preparation for crowns or veneers. Whitening is not done while the teeth or gums are unhealthy, and is not recommended during pregnancy or breastfeeding, or under the age of 18.
• Fracture, coming loose, staining. Over time, ceramics and composite can chip, fracture or come loose. 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 orthodontics. 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.
• Ceramic surfaces stain less than composite and keep their shape longer. In a review combining 29 studies, about 94 to 97 in every 100⁵ feldspathic, leucite-reinforced and lithium disilicate veneers 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; there are no long-term data for zirconia veneers.

Contact your dentist if any of the following happens after a cosmetic procedure:

• Sensitivity that lasts more than a week or gets worse
• 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)

Emergencies. Throbbing pain, facial swelling or a fever are not an expected result; see a dentist where you are without waiting for the clinic's reply. Go to the nearest emergency department if you have difficulty breathing or swallowing, swelling in the mouth or neck that spreads quickly, or swelling around the eye. In an emergency, call the emergency number of the country you are in; in Turkey it is 112.

Before you fly home

Make sure your bite has been checked and that you have written care instructions. Take the written record of your treatment with you for your dentist at home. If you are continuing whitening at home, make sure you know how long to use the product and whom to ask about it.

Once you are home

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. Photographs do not replace an examination, so see your dentist at home as well. In the emergencies above, do not wait for a reply.

Treatment is at our clinic in Antalya, Turkey; on this page, "we" means that clinic. 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.
• Orthodontics. Treatment runs over months and the result needs retention afterwards, so it is often simpler to have near home.
• Laminate 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 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, you receive a written preliminary plan with the appointments and how many days they need. It is based on your photographs, so the examination confirms or changes it, and with it the days and the cost. If it changes, you receive the revised plan in writing before treatment starts. You can say no, or ask to stop, at any stage. Once a tooth has been prepared, that step cannot be undone.

Flying. A 2023 review of flying after dental treatment suggests waiting at least 24 hours after restorative treatment⁶, 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 dentist at home. Talk to your own dentist before you go. They need to know the plan in case problems come up later. If you do not have a dentist where you live, 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. 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 imaging⁷.

Veneers, crowns and bonding need regular check-ups for as long as they are in the mouth. UK guidance (NICE) says the interval between check-ups should be set for each person according to their risk⁸; agree it with your dentist at home. Before you travel, check the rules of the health service or your insurer in the country where you live about care after treatment abroad.

Questions to ask before you commit. Before you agree to treatment abroad, ask:

1. Who will carry out my treatment, and what are their qualifications?
2. Are you regulated by a professional body and registered with it?
3. Are the remake and correction terms in writing, and for how long do they apply?
4. What aftercare do you provide, and who can I contact after the treatment?
5. If there are complications, who pays for further treatment, extra flights and the hotel?
6. Do you have a complaints system, and can I see a copy?

Before treatment, we give you in writing how complications are handled and the terms for remaking a veneer or crown. The full list, with our answer to each question, is on our page about dental treatment abroad.

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

• Which treatments are included: whitening, bonding, orthodontics, 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

Conservative procedures (whitening, orthodontics) often involve the whole set of teeth. For restorative procedures (bonding, veneers, 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. When you compare quotes, add travel and accommodation for each trip.