Implant + Perio Clinic

This is probably one of the most common questions patients ask during cosmetic consultations at Implant & Perio Clinic in Marylebone, near Harley Street. And honestly, I understand why. Social media has dramatically changed the way patients view cosmetic dentistry. Many people now arrive with screenshots of very white, very uniform smiles and ask directly for veneers, often without fully realising what veneers actually involve long-term. The truth is, veneers are not “bad,” and beautifully done porcelain veneers can be incredibly aesthetic and long-lasting in the right patient.

But equally, not every patient who wants veneers should automatically have veneers. In practice, I often advise patients against them. Particularly younger patients with healthy natural teeth. One of the things I feel quite strongly about is preserving healthy tooth structure wherever possible. If somebody has beautiful healthy enamel and simply wants straighter, fresher, brighter teeth, there are often far more conservative ways to achieve that. Very often, a combination of Invisalign, whitening, and small amounts of carefully placed composite bonding can create a beautiful result whilst preserving almost all of the natural tooth.

Preserving healthy tooth structure

Sometimes patients are genuinely surprised when I tell them I do not think they need veneers at all. The difficulty is that social media tends to show the final photographs, not necessarily the biology behind the treatment or what happens to restorations many years later. Well-done veneers should never look bulky, overly opaque, or aggressively artificial. The most beautiful cosmetic dentistry is usually the dentistry that still allows the patient to look like themselves — simply fresher, healthier, and more balanced.

Modern porcelain veneers can often be carried out far more conservatively than patients expect. In some cases, only minimal preparation is required. However, it is still important to understand that veneers are restorations, not “natural teeth.” Once teeth are prepared, they will always require some form of ongoing maintenance and replacement throughout life. This does not mean veneers are the wrong choice. For some patients, they are absolutely the best option — particularly where there is severe wear, significant discolouration, extensive existing dentistry, repeated bonding failure, or major shape discrepancies.

Prevention is easier than treatment

But good cosmetic dentistry should never become a one-treatment-fits-all approach. One of the things I often say to patients is that the goal is not simply to create a “perfect smile.” It is to create something that still feels harmonious with the face, the personality, the bite, and the long-term health of the teeth and gums. Increasingly, modern dentistry has moved towards more conservative treatment planning. Sometimes the best dentistry is actually the dentistry that preserves the most natural tooth structure.

In reality, many patients do not need dramatic treatment at all. Minor orthodontic movement, whitening, edge bonding, improving gum health, or simply softening asymmetries can often make an enormous difference whilst keeping the teeth fundamentally natural. At Implant & Perio Clinic, cosmetic consultations are approached individually and conservatively. The discussion is not simply:
“What looks best today?” It is also: “What is likely to remain healthy, stable, and maintainable ten or fifteen years from now?” Very often, those are two very different conversations.

About the Author

Dr Sanaz Tehrani, DDS (Germany), is Principal Dentist and Clinical Director of Implant & Perio Clinic in Marylebone, Central London.

Implant & Perio Clinic is located on Portland Place, Marylebone, near Harley Street, London W1

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