There is little doubt that a genuine smile is a truly wonderful thing. However, the research shows that a lot of us are self-conscious about our teeth – and yet we're still not very good at looking after them.

A survey carried out by OnePoll found that 57 per cent of Americans feel so insecure about the appearance of their teeth, they hide them when smiling or laughing. Proving this dental angst isn’t confined to America, Mintel report that 30 per cent of Brits are unhappy or very unhappy with their teeth and 69 per cent believe having visibly damaged teeth impacts emotional wellbeing. Yet, despite these concerns, it’s evident we’re not quite there yet in terms of looking after our teeth. Almost one in five people only visit the dentist when something is wrong (FYI, men are worse than women on this), 29 per cent admit to not having seen the dentist at all in the last six months and only 63 per cent of people actually clean their teeth twice a day.

That said, things are changing, slowly but surely, which is why the global cosmetic dentistry market is now valued at $18.79 billion (£14.52 billion) and is expected to reach $32.73 billion (£25.29 billion) by 2026. According to cosmetic dentist and international lecturer Dr Rhona Eskander, “The days of going to the dentist and just blindly doing as we are told are long over. We’re far more involved in every aspect of our lives and appearances now and we’re used to being in control of every decision that affects our health and beauty.”

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An Instagram-perfect smile

When it comes to our teeth, this means we have higher expectations than ever; the current trend is for super straight and shockingly white teeth and – perhaps, not so shockingly – it’s being fuelled by social media. “People want to look like they’re filtered,” says Eskander. “There are many Instagram and Snapchat filters that make your nose smaller, your lips fuller and your teeth bigger and brighter. People are addicted to seeing this version of themselves and they want to look like that in real life, despite it not actually being achievable.” It is for this very reason that Instagram announced in October that it would be removing all augmented reality (AR) filters with plastic surgery effects. Whether this move has any kind of real impact on how people – especially young and impressionable adults – see themselves and what they aspire to look like remains to be seen.

But, what about the rest of us? Surely the majority of those considering some kind of cosmetic dentistry are only looking to improve on what they’ve already got? After all, the Ross Geller-esque teeth we see on Instagram and reality TV aren’t for the faint hearted. “I think the majority of us are coming round to a more natural look,” says Eskander. “Whether we’re talking facial fillers or cosmetic dentistry, tweakments are the way forward and that’s very much my own aesthetic; my work is minimally invasive.”

Top of the cosmetic trends

At the top of everyone’s list is straightening, says Eskander. “People are still choosing fixed braces, in particular the kind that sit behind the teeth. They’re discreet, but the downside is they’re expensive and they can cut up your tongue.” As far as Eskander is concerned, Invisalign – the clear retainer that can be popped in and out of the mouth – is the gold standard. “You wear Invisalign for 22 hours a day and it straightens your teeth. It’s that simple. Despite being around for years, we’re seeing a lot of innovation with Invisalign. Moving on from messy moulds, Invisalign uses iTero, a piece of technology that scans the teeth and shows within just one minute what the results will be at the end of the treatment. In a digital world where we expect everything to be instant, this is brilliant, because it allows me to show patients what they can expect from the start.”

And the tech advancement just keeps on coming. The same kind of imaging technology we see in Deepfake videos (if you haven’t seen the video of Bill Hader morphing into Tom Cruise, you must) is set to change orthodontics. “Your smile isn’t static so we need to make sure we’re thinking about what your smile will look like as you’re moving, talking and laughing before starting treatment,” says Eskander. Digital Smile Design is a technique that uses pictures and videos of you to virtually bring your new teeth to life and superimpose them onto your face as the ultimate try-before-you-buy. Invisalign will be launching the technology soon and it’s thought to be a game-changer.

Caution: don’t be lured into signing up for direct-to-consumer at-home straightening kits. Your teeth need to be assessed in real life by a dentist before you can be confident that your gums and teeth are suited to aligners. “There have been a few cases where people have actually pulled out their own teeth because they had gum disease and were not suitable for treatment,” warns Eskander.

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Healthy teeth via dental tech

Cosmetic dentistry can’t work miracles, so if your foundations are weak, you won’t see the results you might be hoping for. Twice-daily brushing (minimum) and flossing are non-negotiable if you don’t want to see decay set in, but if it does, new dental tech is proving to be an efficient detection tool. “iTero scans the teeth and detects decay – without x-rays. You can just imagine how useful this is if you’re pregnant and can’t have an x-ray. It’s pretty amazing,” Eskander says.

If you have ever tried to fib your way through a dental examination, you’re in for a shock. Not content with just cleaning, the latest electric toothbrushes connect to an app on your phone so that you can see at a glance where your brushing routine may be falling short. Toothbrushes like Oral-B Genius X with Artificial Intelligence (£340) and Philips Sonicare FlexCare Platinum Connected (£270) use motion sensors to analyse your brushing technique and report back on areas where improvement is needed. One day soon, Eskander believes dentists will be able to use this information too. “Your dentist can collate your data via the app and then create a tailored programme for your own needs.”

Watch out for natural alternatives

Like most sectors of the health and beauty industry, oral care is feeling the impact of consumers looking for natural and organic products. However, unlike your skincare routine, your at-home dental regimen is unlikely to benefit from natural products. Charcoal toothpaste, for example, should be avoided at all costs.

“People have just become way too health obsessed, to the point that they embrace every fad going,” says Eskander. “Charcoal has its benefits – for example, it’s used in hospitals to counteract the effects of poison – but it doesn’t have a place in your dental routine. At worst, it’s too abrasive and strips away your enamel, damaging your teeth and staining white fillings, and because it’s black you tend to scrub harder to remove it. At best, it does absolutely nothing, making it a complete waste of money.”

The future of teeth

The holy grail of dentistry is a tooth that can regenerate itself. If this sounds like science fiction, you might be surprised to know that the technology is well on its way to reality. Researchers at King’s College London are looking at ways to mobilise stem cells in the teeth to repair damage and even regenerate tissue. They’re a long way off from human trials but maybe, just maybe, in a decade or so, fillings, caps and crowns will be a thing of the past. That’s definitely something to smile about.

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