​Unattractive Teeth

One of the most common reasons to visit a dentist or dental specialist is because you are not completely happy with your smile. Like many others, you may have crooked, stained, or missing teeth. These features can interfere with proper chewing, can make your teeth tougher to clean, cause more strain to your teeth, and unfortunately also affect your self-esteem and make you more self-conscious about your smile and overall appearance.   

In any of these instances, your doctor will be able to recommend a form of treatment that is the most suitable to you and your needs, and will be able to perfect your smile with the help of specialist dental tools and appliances. Therefore if you or your child have inherited or acquired some form of dental imperfection, your orthodontist may fix the alignment of your teeth or improve the facial development and appearance.   

You may complain of an unattractive smile owing to any of the following reaons:

  • Crooked teeth:

You may be unhappy about the alignment of your teeth, as you notice that your teeth are not as straight as you would like. For instance, you could have an overbite or an under bite, which are usually inherited traits but can also be caused due to other reasons, such as premature loss of “baby” teeth.  

Crooked teeth are most often dealt with at a young age while bone structure is still developing, but can be a concern for anyone at any age.

  • Stained teeth (or discolouration) 

You may notice that the outer layer (the enamel) of your teeth is starting to look stained or discoloured. This is not uncommon, but can still be quite upsetting. The main causes are smoking, tea, carbonated drinks, sports drinks, berries, sauces and sweets. This is because they contain chromogens, which are highly pigmented molecules that latch onto and discolour enamel. ​

  • ​Gap between teeth (diastema)

Gaps between two or more teeth can form unnaturally due to a number of reasons, such as if you suck your thumb or have an incorrect swallowing reflex.There are options to address these gaps for aesthetic reasons, or if necessary due to discomfort or more serious symptoms. ​

  • ​Missing teeth

There are several reasons why you may be missing a tooth or teeth. For instance, you or your child might be missing a tooth due to a congenital absence, which means there is no permanent tooth (“adult” tooth) to replace a temporary tooth (“baby” tooth). Or you may have suffered a trauma, which has caused a tooth to be knocked out. Or a dental disease has caused you to loose teeth, such as dental caries or periodontal disease. Or you may have suffered a mechanical failure, which means you are missing a tooth because you had cracked or fractured it in such a way that it needed to be extracted. Not only do missing teeth affect the aesthetic look of your smile, it can affect your diet and speech as well. Over time a missing tooth could affect the way your teeth bite together, and can also cause your neighbouring teeth to start growing in at a wrong angle. Missing teeth are most problematic when they have been lost suddenly due to trauma and this should be addressed immediately. 

However, it is not always necessary to replace a missing tooth; this space can be closed with braces by moving your own natural teeth in that space, which is why you should discuss your options with your orthodontist.​

  • Symptoms of crooked teeth: 

Crooked teeth may be associated with these symptoms: 

    • ​​Irregular alignment of teeth

    • Abnormal appearance of the mouth or face

    • Speech impediments, such as a lisp  

    • Trouble or discomfort when eating  

  • Symptoms of stained teeth:

If you notice your teeth are darker, more yellow and stained than you are ok with, you should probably address the root of the issue and make changes to prevent further discolouration.

  • Symptoms of gaps between teeth:

There usually are not any symptoms of having a gap or a few gaps, especially if due to the natural construction of your teeth and jaws. However, gaps can form over time due to bad habits and gum problems and grow bigger if not treated. Your teeth may start to become loose, and you may experience pain or discomfort, especially during eating.  

  • Symptoms of tooth loss:​

The most obvious sign that you could lose a tooth is if it feels loose or wobbly. However there are other less obvious warning signs that you could be losing a tooth:

    • ​Bleeding from the gums: If your gums bleed randomly or when you floss or brush your teeth, it could be a sign of late stage gingivitis or even periodontal disease, which could lead to one or more of your tooth becoming loose and eventually falling out. 

    • Bad breath: frequent bad breath that does not go away with cleaning and gargling can also be a sign of gingivitis or periodontal disease. 

    • Your gums seem to appear separate from your teeth: if your gums are starting to recede, this can be a sign of unhealthy gums, which can lead to tooth loss. ​​

You should go see your dentist as soon as you become concerned with staining or discolouration.

You can seek advice from our specialists working with the Teeth and Skin Service Line at The Aga Khan University. It is recommended that consultation should begin at a young age, and all kids should visit and be evaluated by an dentist by the age of 7.

If you or your child has a gap or a few gaps, you should visit your orthodontist, who will help determine whether you need treatment or braces.

Your time with your doctor may be limited, so make sure to prepare for your visit beforehand. Here are some tips to help get you started. ​ ​

  • Tests and diagnosis for crooked teeth:​

At your initial visit, your dentist will evaluate the type and extent of the problem. They will often take X-rays of your face and teeth in order to further analyse the alignment or your teeth. Often, they will also ask to make impressions of your teeth using a soft material, in order to make an exact copy of your teeth to assist with treatment.

  • Tests and diagnosis for stained teeth:

Usually, it is easy to tell if your teeth are stained, because you will notice the visible discoloration.

  • Tests and diagnosis for gaps between teeth:

You may notice spaces between your teeth, or realize you have gaps while brushing or flossing. Also, your dentist or orthodontist will examine your mouth and be able to tell if you have or are developing a gap between your teeth. They may use X-rays to further understand and diagnose the structure of your teeth. 

  • Tests and diagnosis for missing tooth/teeth:

If you have lost a tooth, your dentist will want to see you immediately to try and re-implant your tooth if possible. If this is no longer possible, your dentist will examine your teeth and suggest another form of treatment.​

  • Treatment and services for crooked teeth:

The primary means of treatment is braces, which slowly move teeth to a more desirable position by placing a constant, gentle force in a carefully controlled direction. Treatment can last from anywhere from six months to two or three years and typically involve visits every four to seven weeks. 

  • Treatment and services for stained teeth:

There are a number of measures and treatment options available for stained teeth, depending on the cause, type and depth of discolouration. These include:

    • ​​Over- the-counter teeth whitening agents: These will be weaker than what your dentist can administer, and is only appropriate for minor staining and discolouration.

    • Teeth whitening: There are a number of teeth whitening techniques that your dentist could use. For instance, they may use a bleaching gel which is applied over a specified period of time. Another technique is power bleaching, where your dentist will apply a special light-activated bleaching gel to your teeth for about thirty to forty minutes, and this will significantly whiten your teeth. Several follow up sessions may be needed, or your dentist may recommend at home options. 

    • Proper cleaning techniques: Brushing, flossing and rinsing are important to ensure good oral hygiene.  

    • Veneers: This technique improves appearance of your teeth by using ultra-thin custom-made shells made of tooth-coloured materials that are designed to fit over and cover the front surface of your teeth using a bonding method.  ​

  • Treatment and services for gaps between teeth:

Options to correct gaps between teeth include:

    • ​Dental appliances: Braces are the most common form of dental appliance, which are custom-made fixtures that use wires and bands to gently apply pressure and change the form of your teeth and pull them together. Another option includes removable retainers, which also help to bring teeth together. 

    • Veneers: This technique improves appearance of your teeth by using ultra-thin custom-made shells made of tooth-coloured materials that are designed to fit over and cover the front surface of your teeth using a bonding method. This can help to close the gap between your teeth.

    • Frenectomy: In some instances, a gap is caused when there is an abnormal growth of tissue from your gums to between your teeth (labial fermium), thus creating space between them. Thus frenectomy is a surgery where the large labial frenum that is causing the gap is removed. ​

  • Treatment and services for missing teeth: 

Your dentist will want to try to re-implant your tooth by putting it in place and splinting it to the teeth next to it for a few weeks. However, re-implanting your tooth or teeth may not always be possible, in which case there are a number of other options to replace your tooth:

    • ​Dentures: This is a removable tooth made of either metal or acrylic that is clipped onto your other teeth.  

    • Bridges: A false tooth that is permanently embedded next to your other teeth by fixing to them using special cement. 

    • Implants: a false tooth that is surgically (usually under local anaesthesia) fitted into your jawbone permanently with the aid of titanium screws that are drilled down into the jawbone. ​​

Your doctor and or nurse will give you specific instructions about the prescribed medication. Please ensure that you take or use the prescribed medicine as advised. It can be dangerous to your health if you self-prescribe. Please inform the doctor or nurse beforehand if you have experienced any adverse reactions to any medications in the past. If you experience any symptoms of drug poisoning, overdose or severe reaction please contact the Pharmacy Service at The Aga Khan University Hospital immediately. You can find the contact number of the Pharmacy Services in the ‘Important Numbers’ section on the website homepage.​


​The information provided on our website is for educational purposes and not intended to be a substitute for medical advice, diagnosis or treatment. You should always seek the advice of your doctor or other healthcare professional provider.