Media item: a radio segment following a cosmetic dental case

Media item: radio segment following a listener through cosmetic dental treatment

Programme: The Carrie & Tommy Show

Date broadcast: 27 August 2018

This page records the media item. The audio and its content are the property of the broadcaster and are not reproduced here. The individual featured is not identified here, and no clinical detail about them is stated.

Why the person is not named

A participant who consents to a radio segment has consented to that broadcast. That is not consent to be used as advertising material, and republishing a named person's satisfaction with their treatment on a practice website is a testimonial about clinical care — prohibited under section 133 of the Health Practitioner Regulation National Law. Whether someone is a patient, and what was done, is also health information protected under privacy law.

There is a further problem specific to this format. A radio segment following someone's treatment is entertainment built around a transformation. It compresses months into minutes, shows the result at its best, and cannot convey the maintenance, the failure modes or the lifetime commitment. Presenting it as an illustration of what a patient can expect creates exactly the unreasonable expectation of benefit the same provision prohibits.

So what follows is the honest version.

What a "smile makeover" actually is

There is no clinical procedure called a smile makeover. It is a marketing term for a combination of treatments across the visible teeth — usually eight to ten upper teeth, sometimes twenty or more across both arches. Typically some mixture of:

• Whitening of the natural teeth
• Porcelain veneers or crowns on the front teeth
• Composite bonding to reshape or repair
• Gum contouring where the gum line is uneven or teeth look short
• Orthodontics, where alignment is the underlying problem
• Replacement of missing teeth — implant, bridge or denture

The cost is substantial, and the figures discussed publicly in cases of this kind are consistent with the real range for extensive porcelain work. Fees are not regulated in Australia and vary widely between practices.

The things that are not in the segment

It is largely irreversible

Preparing a tooth for a porcelain veneer removes enamel permanently. That tooth needs a veneer or a crown for the rest of its life. Ten prepared teeth is ten teeth committed. There is no going back to the original teeth, ever.

Minimal-preparation and no-preparation veneers exist and suit a narrower set of cases. Ask specifically how much enamel will be removed from each tooth, and whether a no-prep approach is possible in yours. There is a measured answer to compare against. Edelhoff and Sorensen, in The Journal of Prosthetic Dentistry in 2002, weighed the tooth structure removed by each preparation design and found that veneer and resin-bonded preparations removed approximately 3% to 30% of the coronal tooth structure, against approximately 63% to 72% for all-ceramic and metal-ceramic crowns — a metal-ceramic crown preparation taking 4.3 times as much as a facial-surface-only veneer. Their conclusion was that veneer preparations require “approximately one-quarter to one-half the amount of tooth reduction of conventional complete-coverage crowns.” Two qualifications matter and are usually dropped: the study was in vitro, by gravimetric analysis on typodont resin teeth, and on anterior teeth only. It is the right order of magnitude for a front tooth, not a measurement of yours.

It is not permanent

Veneers and crowns chip, debond, stain at the margins, and eventually need replacing. No authority publishes a veneer lifespan in years, so the useful question is not how long do they last but what proportion is still in service at a given point. The published survival figures are these:

• A 2021 systematic review in the Journal of Clinical Medicine pooling 25 studies and 6,500 porcelain laminate veneers put 10-year cumulative survival at 95.5% when fracture, debonding, secondary decay and the need for root canal treatment were all counted as failure. Counted separately, the 10-year figures were 96.3% for fracture, 99.2% for debonding, 99.3% for secondary decay and 99.0% for needing root canal treatment. Note what that 95.5% does not mean: it is survival, not appearance — a veneer that was repaired or repolished still counts as surviving.
• Longer follow-up thins out quickly. One cohort reported 98% at 5 years, 96% at 10, 91% at 15 and 91% at 20 — but only 82 of its veneers were observed as far as 20 years, patients with heavy grinding and poor gum prognosis were excluded at the outset, and only teeth with at least 80% of their enamel remaining were veneered. Another, from Innsbruck, reported 94.4% at 5 years, 93.5% at 10, 85.7% at 15 and 82.9% at 20, and a third 93% at 10 to 11 years falling to 73% at 15 to 16.
• Composite veneers are a different proposition. A pooled analysis of randomised trials put resin composite laminate veneer survival at 88% (95% CI 81% to 94%) over follow-up of roughly two to eight years. In the cleanest head-to-head — Mazzetti and colleagues' 10-year practice-based evaluation, 2022 — composite carried a hazard ratio of 4.00 (95% CI 2.74 to 5.83) for failure against ceramic, with annual failure rates of 4.1% versus 1.2% at 10 years. The trade is real in both directions: composite fails more often, and it is also repairable and removes less tooth.

So a large case in your thirties is not one payment. It is that payment, then replacements at intervals nobody can predict for you individually. That arithmetic belongs in the decision, and it is almost never in the segment.

Failure is usually biological

The common reason a veneer fails is not the porcelain breaking. It is decay at the margin, or gum recession exposing the join between tooth and ceramic — which shows as a dark line and cannot be polished away. The systematic review above records the mechanical side too: across 6,500 veneers, fracture was the most common complication, followed by debonding, with both more common in the first years after cementation — so the early failures and the late ones have different causes, and a case that survives its first two years is past one hump, not all of them.

Grinding breaks ceramic

Untreated bruxism will fracture porcelain, sometimes within months. A night guard is part of the plan, not an upsell, and any case that does not address a grinding habit first is being built on a fault. It is worth knowing that the most favourable long-term survival figures in the literature come from cohorts that excluded heavy grinders before treatment began — which is to say those numbers describe the best-selected patients, not the average one.

The gum matters as much as the tooth

Active gum disease must be treated before cosmetic work — sometimes with deeper cleaning or a periodontist. A perfect veneer on an inflamed or receding margin looks wrong regardless of how well it was made.

Orthodontics is frequently the better answer

Where the real complaint is crooked teeth, moving them removes no enamel at all. Making crooked teeth look straight with veneers requires cutting into the prominent ones — sometimes enough to need a crown, occasionally enough to devitalise the tooth and require root canal treatment. The Edelhoff and Sorensen figures above are the reason that distinction is not a quibble: on their measurements, the difference between veneering a tooth and crowning it is the difference between removing under a third of the crown of the tooth and removing about two-thirds of it.

Orthodontics takes 18 to 30 months and requires lifelong retention. It does not commit the tooth to a lifetime of restorations. A plan that goes straight to ten veneers without discussing alignment deserves a second opinion.

The sequence that avoids expensive mistakes

1. Full examination and diagnosis — decay, gum health with pocket charting, radiographs, wear, cracks, and the bite. Cosmetic work on an unstable foundation fails.
2. Treat disease and manage grinding first.
3. Consider orthodontics if alignment is the underlying issue.
4. Whiten before, never after. Porcelain and composite do not lighten.
5. Diagnostic wax-up, then a temporary mock-up worn in your own mouth before any enamel is touched. This is where changes are free. After preparation they are not.
6. Written plan — number of teeth, material, preparation involved, total cost, what a remake at try-in costs, what happens if one fails within a year, what proportion of cases like yours is still in service at five and ten years, and maintenance required.
7. Take it away. Get a second opinion. Elective cosmetic dentistry is never urgent, and feeling rushed is a reason to pause.

On images and advertising

Advertising a regulated health service may not use testimonials about clinical care, may not create an unreasonable expectation of benefit, and may not be misleading including by omission. It also may not offer a gift, discount or other inducement to attract someone to the service, and may not “directly or indirectly encourage the indiscriminate or unnecessary use of regulated health services.”

Before-and-after images are permitted but conditioned. AHPRA's Guidelines for advertising a regulated health service set out when such images are “less likely to be misleading”, and the list is worth reading against any gallery:

• “the images are as similar as possible in content, camera angle, background, framing and exposure”
• “the posture, clothing and make-up is consistent”
• “the lighting and contrast is consistent”
• “there is an explanation if images have been altered in any way”
• “the referenced treatment or procedure is the only visible change to the person being photographed.”

Those are the conditions the regulator actually states. A photograph taken two weeks after fitting shows a result at its best and says nothing about ten years, which is a fair thing for a viewer to want to know even though AHPRA does not require the date.

And the images driving demand are mostly not achievable: phone cameras and retouching routinely whiten and reshape teeth, and the flawless uniformity that photographs well is precisely what reads as artificial in daylight.

Common questions

Would whitening alone get me most of what I want?

For a lot of people, yes — and it is the only option on the list that removes no tooth structure at all, which makes it the right thing to try first rather than the consolation prize. The ADA defines whitening as products “designed to penetrate the teeth and bleach intrinsic and/or extrinsic tooth discolourations”, and its position is that they are “safe and effective when used by or under the supervision of a dentist and according to the professional directions for use”, with “transient tooth sensitivity and soft tissue irritation” as the commonest side effects.

What it will not do is change shape, close gaps, or alter any existing crown, veneer or filling — peroxide has no effect on those, so an existing front restoration will simply look darker afterwards and may need replacing to match. If the complaint is really colour, whitening is the cheap, reversible answer. If it is shape or alignment, it is not. See teeth whitening.

Should a dentist ever say no to a case like this?

Yes, and the regulator effectively requires it. Section 133 prohibits advertising that “directly or indirectly encourages the indiscriminate or unnecessary use of regulated health services”, and AHPRA's explanation of that limb is that such encouragement “can lead the public to buy or use a regulated health service they do not need and is not clinically indicated or provides no therapeutic benefit”, adding the sentence that does the work: “Any health intervention involves inherent risks.” The ADA frames the treatments the same way — “Crown, bridge and veneer treatments are elective treatments.”

One related fact worth having when you are comparing providers: the ADA states plainly that “A dentist cannot be registered as a Cosmetic Dentist in Australia”, and that this work is done by a general dentist or by a prosthodontist. “Cosmetic dentist” is a description, not a registration category, so it tells you nothing about training. The AHPRA public register at ahpra.gov.au does.

It is a third of the price overseas. What am I actually risking?

A thinner set of safeguards rather than automatically worse work — and we will be straight about the bias in that answer. The ADA's Policy Statement 2.2.6 holds that “Overseas elective dental treatment carries the risk of adverse oral and general health outcomes with long term problems which may be difficult to resolve on return to Australia”, that records of overseas treatment “are unlikely to be available to those providing subsequent treatment in Australia”, and that professional indemnity insurance, which Australian practitioners must hold, “may not be the case in overseas clinics.” That document is a policy position, not evidence: it publishes no complication rates, because none exist.

The honest counterweight comes from the researchers themselves. A 2025 British Dental Journal study of dental-tourism reporting notes that “professional narratives can be vulnerable to bias” — dentists warning about dental tourism have a commercial interest, and it says so. That study is also a useful corrective on geography: the “Turkey teeth” framing is a United Kingdom pathway, while the published destinations for Australian dental tourists are Indonesia and Thailand. Ask the same questions you would here — veneer or crown, how much tooth is removed, is there a trial stage, who reviews it in six months — and see the risks in detail.

Once they are on, what does maintenance actually involve?

More than most people are told, and the ADA states the principle in one line: “Having a crown, bridge or veneer does not mean no treatment will ever be required again for the tooth or teeth.” Its home-care instruction is unglamorous — “Brush twice per day with fluoride toothpaste and clean between your teeth every day” — and it matters more than on an unrestored tooth, because the failure that ends a veneer is usually decay or recession at the margin rather than the ceramic breaking.

Two specific things to plan for. Marginal discolouration is a recognised outcome — pooled data put severe marginal discolouration at 2% (95% CI 1% to 10%) — and one study reported significantly more of it among smokers. And healthdirect names the mismatch problem that catches people years later: “your other teeth may become discoloured, no longer matching your veneers.” The veneers hold their colour; the teeth beside them do not, and peroxide will not bring them back into line.

Related reading

• Cosmetic Dentistry and Is it time for a smile makeover?
• I want a smile makeover. Where should I start?
• 3 myths surrounding veneers, debunked
• A cosmetic dentist explains what to expect when getting veneers
• Turkey Teeth: the real risks of getting veneers overseas
• More coverage in Our Media

Practical details

Smile Solutions, Level 1, 220 Collins Street, Manchester Unity Building, Melbourne VIC 3000. Phone 13 13 96, or theteam@smilesolutions.com.au. Monday–Friday 8.00am–6.00pm, Saturday 8.30am–1.30pm, Sunday by appointment.

Every practitioner's registration can be verified free on the AHPRA public register at ahpra.gov.au.

This page records a broadcast and its date, with general information. It identifies no individual and states no person's treatment. It is not a diagnosis, a treatment plan or a promise of any particular clinical outcome. Third-party broadcast content is not reproduced.

Smile Solutions trades under ABN 28 193 514 103.