Your man may look terrific, but not when he shows his teeth.

Dr Danny Tan, Consultant, Oral & Maxillofacial Surgery; Cl A/Prof Christi​na Sim, Senior Consultant, Prosthodontic Unit; Dr Ivan Lim​, Senior Consultant, Orthodontics; Dr Alvin Yeo​, Visiting Clinician, Periodontic Unit​, all from National Dental Centre Singapore (NDCS), a member of the SingHealth​ group, ​list the top four turn-offs in the smile category.

1. ​Halitosis​

Halitosis, or bad breath, can drastically lower a man's appeal. We are often unaware of our own bad breath, until someone drops hints about the condition, because of adaptation to the smell from continual exposure.

In as many as 90 per cent of cases, the odour originates in the mouth. The rest can be traced to gastrointestinal or nasal causes. Severe and persistent bad breath can often be traced to dental infection, cavities and gum disease. Considering that 85 per cent of Singaporean adults suffer from mild to moderate gum disease, halitosis is more common than you think – and we are not talking about the transient type that occurs with consumption of odiferous foods like garlic.

If your man has halitosis, a visit to the dentist is advisable. Some clinics have haliometers that give a quantitative measure of mouth odour. They measure volatile sulphur compounds produced by bacteria in cavities in the teeth. Of course, the underlying dental condition has to be treated. It is amazing how professional cleaning, followed by a regime of brushing and flossing, gets rid of bad breath.

There is also a place for mouth rinses in breath freshening, but its effects are transient. With "smoker’s breath", mouth rinses won’t eliminate the smell of nicotine, which together with tar can produce unsightly stained teeth. This leads to our next turn-off...

2. Discoloured teeth

Laymen generally do not notice mild discrepancies in the smile line. However, discoloured teeth are hard to miss close up. A single discoloured tooth (usually related to pulpal pathology) is more visually distracting than generalised discolouration, which occurs with natural ageing, drinking too much tea and coffee, and lifestyle habits like smoking.

There is some truth in the commonly held belief that whiter teeth brighten the smile, but too white a shade gives a "synthetic" smile. Over-the-counter home dental bleaching kits of pastes or gels with low-concentration peroxide and mouth trays lighten teeth slightly, but only with repeated use. The trays provided could be uncomfortable as they are not all customised.

Bleaching done by dentists, using light-activated dental bleaching gels is a more attractive option. In one sitting, teeth can be bleached several shades lighter. Your dentist may recommend you follow up with prescription-only home bleaching gels delivered via customised mouth trays. Some discolourations not amenable to bleaching can be corrected with veneers – a porcelain laminate, which enhances teeth aesthetically. However, this procedure usually involves cutting into tooth structure.

3. Missing teeth

A break in the smile line, such as gaps from teeth lost through decay or trauma, is unattractive. Fortunately, there are solutions ranging from dentures to fixed bridges and implants that offer superior aesthetics. Fixed bridges require cutting teeth adjacent to the gap, and using them as support. Implants are expensive, but superior in restoring function. However, they need to be surgically drilled into the bone and are not for the queasy.

4. Crooked teeth

Mild discrepancies can be corrected with veneers if you are looking for a quick fix. Malocclusions need orthodontic correction to get that "Hollywood" smile, but be prepared to wear braces for at least two to three years.

Fortunately, advances in bracket systems – ceramic brackets (not as visible as metal ones) and lingual orthodontics (brackets placed on the inner aspect of teeth) make orthodontic treatment less obvious. An alternative to braces is Invisalign treatment with a series of clear plastic plates to correct mild dental conditions. Pain and discomfort associated with orthodontics has been reduced with new types of braces with "clips" that allow teeth to slide better, which reduces pain and treatment time. Seek advice from your orthodontist for the correct braces for your needs.

Ref: W09