If you have read any of our case of the month articles in the past, you will know that we love the Social 6 lingual brace. We have been using this brace for over 16 years to straighten teeth in Fulham and across Europe ( yes, people do travel for this!). The major advantages are that the brace is placed on the inside of the teeth making it the only invisible brace on the market. Treatments are also super quick at usually 3-4months and certain tooth movements are made for lingual braces. Just check out our case of the month for June 2026 below and all will be explained.

A missing tooth or teeth can be a major dental issue for most people with aesthetic and functional problems. This is not a good look at the front of the mouth but even from the side, a large gap can ruin a smile. Teeth are designed for a certain reason , whether that be for biting and tearing food ( front teeth) or chewing ( molars). The loss of even one tooth can impact on everyday eating habits and long term issues with the bite. For example, teeth will slowly move into the space left by an extracted tooth by either drifting in sideways or the opposing tooth moving up or downwards ( over eruption). This can dramatically impact on how one eats and damage the other teeth in the long term. The answer is to the replace the tooth in good time!

Most dental implants are made from titanium which is classified as a biocompatible material. However, reports have suggested that 0.6% of the population may have a hypersensitivity or allergic reaction to titanium and this would not be a suitable material. Increasing, we are hearing that patients would like to avoid any form of metal within the mouth as a personal choice akin to not having amalgam fillings. This is perfectly acceptable and there is an alternative option with zirconia ( zirconium dioxide) implants. These are metal free dental implants that are white in colour and hence are aesthetically pleasing. We use zirconia a lot in dentistry and the material is routinely used for crowns on back teeth and crowns for implants. We have never come across an allergic reaction to zirconia nor seen any form of hypersensitivity. Zirconia is bioinert meaning it does not release any ions like some metals can which reduces the risk of an immune response.
 

One of the most common causes of discoloured teeth is due to a 'dead tooth' or a tooth that is root filled. All of our teeth are supplied by nerve and blood supply. Now when a tooth needs a root canal treatment, this supply called the pulp is removed which can lead to the deposition of blood products within the tooth which is then absorbed by the tooth leading to a darker colour. On a back tooth, this may not have any major issue but on a front tooth is a different matter altogether!
 

To answer this question, we really need to differentiate the two treatments as they are two different treatment entirely. 

Composite bonding is an additive process. In simple terms, we carefully sculpt composite resin over the teeth in question. This can be used to treat chipped, fractured, uneven and gappy teeth. Composite can also be used to replace old fillings on front ( or back) teeth. The great advantage of bonding includes:

1. Treatment is completed in one visit; an instant smile transformation!
2. Minimally invasive. There is little, if any, drilling of the underlying teeth needed.
3. Biologically safe for the teeth and gums. There is no risk of damage to the nerve.
4. Composite can be easily maintained.
5. More affordable than porcelain veneers or ceramic crowns.
6. Composite will protect the underlying teeth from further wear and tear.
 

Our case of the month for July involves a treatment to whiten a discoloured lower front tooth. We will often come across darker teeth when they have undergone a root canal treatment due to the loss of the nerve and blood supply. Often the degradation of blood products from the pulp tissue within the dentinal tubules cause the tooth dentine to be gradually discolour and give that inherent grey/ dark appearance. This can be quite unsightly especially on a front tooth. For back teeth, in almost every case, we will need to place a crown once a tooth has been root filled to maintain function. This will also improve the colour as the ceramic cover the dark dentine. However, for front teeth, crowns are not always needed as the access for the treatment is on the inside of the tooth and when done under microscope, can be extremely minimal. So how do we whiten the tooth?
 

Composite bonding is a well know and popular technique that we have been using for over 15 years. The process is generally minimally invasive, requires very little tooth preparation, no needles or anaesthetic and is more affordable than other cosmetic dental options such as porcelain veneers. The procedure can be used for a number of treatments including closing spaces between teeth especially front teeth.
 

We love to create new smiles with the most modern technology and techniques available that are kind to the teeth, are natural and long lasting. In many cases, E-Max porcelain veneers will give the best aesthetic and functional results. This is especially the case when teeth already have been filled and are now starting to show discolouration or are worn and chipped. Porcelain veneers will completely transform a smile by creating new outer surfaces for the teeth. This is shown superbly by our case of the month for February 2024.

Most celebrities and television personalities have porcelain veneers on the upper teeth. If you take a close look, the lower teeth are often slightly darker and a little uneven!
 

Porcelain veneers are one of the most popular ways of transforming a smile. Veneers are outer facings that cover the tooth/teeth to repair issues such as chips, fractures, asymmetry, discolouration or protect old fillings. The transformation of a smile can be life changing. A smile is one of the first things that is evident on a person and this can radiance confidence and self-belief. The treatment for veneers is not a straightforward one and requires careful planning and execution to achieve an outstanding result. Our case of the month highlights the beauty of this treatment and the process that is involved.
 

One of the main aesthetic challenges we face as dentists, is a dark discoloured front tooth. This usually results from after a root canal treatment which may be needed for a variety of reasons but is usually from trauma. The reasons for the discolouration do vary. This could be from remnants of the pulp tissue being left within the root canal system and then decomposing within the tooth permeating into the dentine. There can also be rupture of the blood vessels within the pulp allowing blood products to seep into the dentinal tubules and discolour the tooth as this degrades. Another common reason is not so well known. Studies have shown that another factor could be the result of not removing all of the root canal sealant material once the tooth has been treated. van der Burgt TP, Mullaney TP, Plasschaert AJ. Tooth discoloration induced by endodontic sealers. Oral Surg Oral Med Oral Pathol. 1986;61:84–9. [PubMed] [Google Scholar] [Ref list]

The chromophores resulting from the disintegration of root canal sealer remnants penetrate through the dentinal tubules into the coronal tooth structure gradually causing progressive discoloration. The key factor is that most root treated teeth do appear darker than non root treated teeth and when this is on a front tooth, it is a major aesthetic issue.