title: 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.
authors.affiliation: Kings College Hospital, Denmark Hill, London, SE5 9RW.
authors.forename: A
authors.initials: A
authors.lastname: Alani
authors.affiliation: British Society for Restorative Dentistry and Consultant in Restorative Dentistry, Kings College Hospital, Denmark Hill, London, SE5 9RW.
authors.forename: M
authors.initials: M
authors.lastname: Kelleher
authors.affiliation: British Society for Restorative Dentistry and Consultant in Restorative Dentistry, Eastman Dental Hospital, 256 Gray's Inn Road, London, WC1X 8LD.
authors.forename: K
authors.initials: K
authors.lastname: Hemmings
authors.affiliation: British Endodontic Society and Specialist in Endodontics, Eastman Dental Hospital, 256 Gray's Inn Road, London, WC1X 8LD.
authors.forename: M
authors.initials: M
authors.lastname: Saunders
authors.affiliation: British Endodontic Society and Specialist in Endodontics, School of Dentistry, University of Manchester, M15 6FH.
authors.forename: M
authors.initials: M
authors.lastname: Hunter
authors.affiliation: Restorative Dentistry UK Consultant and Specialist Group and Consultant in Restorative Dentistry, Newcastle Dental Hospital, NE2 4AZ.
authors.forename: S
authors.initials: S
authors.lastname: Barclay
authors.affiliation: Restorative Dentistry UK Consultant and Specialist Group and Consultant in Restorative Dentistry, Manchester Dental Hospital, M15 6FH.
authors.forename: M
authors.initials: M
authors.lastname: Ashley
authors.affiliation: Dental Trauma UK and Consultant in Restorative Dentistry, Kings College Hospital, Denmark Hill, London, SE5 9RW.
authors.forename: S
authors.initials: S
authors.lastname: Djemal
authors.affiliation: British Society for Restorative Dentistry, Consultant in Restorative Dentistry, Morriston Hospital, Swansea, SA6 6NL.
authors.forename: K
authors.initials: K
authors.lastname: Bishop
authors.affiliation: Restorative Dentistry UK Consultant and Specialist Group and Consultant in Restorative Dentistry, Eastman Dental Hospital, 256 Gray's Inn Road, London, WC1X 8LD.
authors.forename: U
authors.initials: U
authors.lastname: Darbar
authors.affiliation: British Society of Prosthodontics and Consultant in Restorative Dentistry St Georges Hospital, London, SW17 0QT.
authors.forename: P
authors.initials: P
authors.lastname: Briggs
authors.affiliation: British Society for Paediatric Dentistry and Consultant in Paediatric Dentistry at Queen Mary's University, Bart's and the London NHS Trust, E1 1BB Joint statement by British Endodontic Society, British Society for Restorative Dentistry, Restorative Dentistry UK, Dental Trauma UK, British Society of Prosthodontics, British Society for Paediatric Dentistry.
authors.forename: J
authors.initials: J
authors.lastname: Fearne
mesh_terms: D000293:Adolescent; D000367:Age Factors; D003188:Composite Resins / Q000009:adverse effects; D003442:Crowns / Q000009:adverse effects; D003729:Dental Care / Q000009:adverse effects / Q000592:standards; D003801:Dental Veneers / Q000009:adverse effects; D004955:Esthetics, Dental; D006801:Humans; D018570:Risk Assessment; D012953:Societies, Dental; D009626:Terminology as Topic; D014073:Tooth Bleaching / Q000009:adverse effects; D006113:United Kingdom
chemical_list: D003188:Composite Resins