Balancing the risks and benefits associated with cosmetic dentistry – a joint statement by UK specialist dental societies

Abstract

Cosmetic dentistry has become increasingly popular, largely as a result of social trends and increased media coverage. This understandable desire for the alleged 'perfect smile' needs to be tempered with an appropriate awareness of the significant risks associated with invasive cosmetic procedures such as veneers and crowns. Patients need to be properly informed that elective removal of healthy enamel and dentine can result in pulpal injury and poorer periodontal health in the longer term, particularly if they are young. The duty of candour means that they ought to be informed that aggressive reduction of sound tooth tissue is not biologically neutral and results in structural weakening of their teeth. Less invasive procedures such as bleaching on its own or for example, combined with direct resin composite bonding, can satisfy many patient's demands, while still being kinder to teeth and having much better fall-back positions for their future requirements. It is the opinion of the British Endodontic Society, British Society for Restorative Dentistry, Restorative Dentistry UK, Dental Trauma UK, British Society of Prosthodontics and the British Society of Paediatric Dentistry that elective invasive cosmetic dental treatments can result in great benefit to patients, but that some aggressive treatments used to achieve them can produce significant morbidities in teeth which were previously healthy. This is a worrying and growing problem with many ethical, legal and biologic aspects, but many adverse outcomes for patients who request cosmetic dental improvements are preventable by using biologically safer initial approaches to treatment planning and its provision.

The use of social media for professional purposes among dentists in Saudi Arabia

“…Although SM usage has to be encouraged; some boundaries and guidelines are needed; misuse represents a significant risk to the individuals using or in charge of monitoring SM use in the clinical practice. Clear policies, limitations, and aspects of service should be available for dental personnel to reduce the risks [34][35][36][37].…”

Hydrogen peroxide-based products alter inflammatory and tissue damage-related proteins in the gingival crevicular fluid of healthy volunteers: a randomized trial

“…Tooth whitening is currently a widely performed procedure, especially in the dental office. This is due to the increased awareness on that, aesthetically, white and well aligned teeth are standards of an ideal smile 1 . The techniques used for tooth whitening employ different whitening products which can be applied to the dental surface in varying concentrations and time of exposure 2–5 .…”

A review of the law of consent in dentistry

“…Whilst there is no desire to question the entire area of dentistry where aesthetics and cosmetics are the prime motivation, there is a requirement to consider how some practices might relate to the test laid‐out in R v Brown and the development of this position in R v BM. Kelleher (amongst others) questions some of the practices that have been observed in the pursuit of enhancing dental appearance . The wilful and liberal removal of healthy enamel and dentine to allow the placement of ceramic and porcelain is difficult to justify, especially when the carrying‐out of such treatment places the patient at considerable risk of acute and chronic sequelae that they would not have otherwise been at risk of.…”