Traditionally if you wanted to get that perfect smile you had no choice but to visit an orthodontist. Increasingly, however, general dentists trained up in the application of clear aligners can do the job for you.
It’s just one of the advanced services on offer at Azure Dental in Blackrock, Co Dublin. It was founded by Dr Sarah Flannery, a dentist with more than 20 years’ experience working, in 2021 in response to the rise in demand for the latest technology in dentistry, including more minimally invasive general dentistry procedures and wider options for cosmetic services such as veneers, implants and composite bonding.
Flannery, whose primary dental qualifications come from Trinity College Dublin, has a three-year masters in aesthetic dentistry at King’s College London, and specialises in “smile makeovers”.
“Clear aligners can be life-changing in terms of how they work,” she says. Traditional braces use a wire arc to pull all your teeth into the desired position, often taking years. With clear aligners, which are more like an invisible retainer, you get a new one every couple of weeks as your teeth move into the required position. In the meantime you can take them out for brief periods, such as to eat.
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“Clear aligners are so much less invasive and a very gentle way of moving teeth. You can move them one at a time. A very minor correction could take just seven weeks,” she says.
It’s particularly helpful for people who had “train tracks” in the past but who over time stopped wearing their retainers at night. “Teeth always want to return to their original position so with clear aligners you will have to wear retainers every night.”
In most cases she can achieve a person’s “perfect smile” within seven to 14 week. “There isn’t a week goes by that someone doesn’t come in to say that they are getting married in six months, what can they do about their teeth,” she says.
All treatments start with a consultation to make sure the teeth are healthy, and to ensure there is good oral hygiene. “From there I take photos both inside the mouth and from the outside to ask the person what it is they would like to change. Then we tailor a programme for each person. It could be that there is a little crossover in their front teeth or overcrowding. Typically we will opt for a package that includes 14-week clear aligners, some whitening, and some composite bonding, adding to the tooth, to achieve the length and shape they want.”
For example, some people have barrel-shaped teeth, that are wide in the midsection and taper at the bottom. “Often they would like to keep them the same shape all the way down, in which case we can just add to the tooth, to make them perfect and straight,” says Flannery.
In some cases a tooth might be worn down from grinding at night. “Grinding is a massive problem that can cause huge wear. The causes can be multifaceted but stress can be a cause, as can overcrowding, or where some of your teeth aren’t aligning properly.”
In some cases building up the canine teeth can solve the problem. “Their most important role is to protect the other teeth, and sometimes they get ground down through grinding. We can restore them so that they can protect the other teeth or we can introduce a night guard. Alternatively we can inject Botox into the masseter muscles in your cheeks, which can prevent grinding,” says Flannery.
Composite bonding can help create straight teeth on the spot. “If, for example, one tooth is set back slightly we can use composite bond to add to the front surface of the tooth to help make them all straight or just generally to disguise discrepancies so that the tooth is perfect.”
The use of porcelain veneers is another alternative. It’s something younger people in particular are keen on, often influenced by reality TV shows or social media, but while porcelain veneers are sometimes the best solution for a patient it is something that should only be done where there is no alternative, says Flannery.
“We only do them when we have to because veneers mean we have to shave a little off the tooth, and that is irreversible. Also porcelain teeth only last 10 to 12 years, and so will have to be replaced, which is something young people might not be aware of.”
Azure Dental also offers facial aesthetic injectables. While most people associate products such as Botox with evading wrinkles, it can also be used to improve your smile. “If you have a gummy smile Botox in your upper lip will relax it, and stop you showing so much upper gum when you smile, for example,” says Flannery.
Ireland has seen a massive increase in uptake of orthodontics, says Paul O’Dwyer of Portman Healthcare Ireland, a dental chain with five clinics in Ireland. Clear aligners are just one of a number of innovations in the area.
“The technology has moved in other ways too. For example, with impression-taking instead of using impression material in the mouth we are now capturing that using intraoral photography and scanners, without any particular material being in the mouth. That makes it a lot more comfortable and a lot more accurate,” he says.
Artificial intelligence software is on the cusp of having a major impact too. “For analysing best-treatment pathways, understanding what the patient’s needs are, monitoring oral and gum health, all those things are coming down the tracks.”
