Appearance & Function

I cover my mouth with my hand when I smile

Smiling behind your hand is not a personality trait; it is a sign that the way you look has changed the way you behave

Moving to the back row in photos, saying little at group meals, raising your hand to your mouth when you smile. These are not character traits but a reaction to something that has changed in your mouth. On this page we explain why the behaviour changes, what putting it off costs and what the first step of an assessment is. Send us a photo of yourself smiling and your X-ray, and we will write to you within 24 hours about which options you have.

Short answer

Your hand goes to your mouth not because you are shy but because something in your mouth has changed. Teeth that become discoloured, break, drift apart or go missing turn a smile from a reflex into a controlled movement; when you smile, you think not about your own face but about what the other person will see. That is why this is not an aesthetic whim: avoiding photos, group meals and talking is a measurable loss of quality of life. The first step is to see which change has created this picture.

The real issue: Not the appearance, but the change in behaviour
Common causes: Colour, a broken edge, gaps, missing teeth
Is it urgent?: Not same-day, but the dates keep slipping on their own
Initial assessment: From a photo and X-ray, within 24 hours

Medically reviewed by Bilge Ilgın, Dentist · ImplantologyLast reviewed 2026-08-31

What your hand going to your mouth tells you

Laughing is not something you think about before you do it. You hear a joke, your face opens up by itself and nobody thinks of their teeth in that moment. By the time your hand goes to your mouth, a new link has entered this chain: a very quick calculation is made before you laugh, and the smile is adjusted to the result of that calculation. The lips part only slightly, the head turns a little to the side, the hand comes up. People who do this are often not even aware they are doing it; they just see themselves with the same closed expression in every photo.

What sets off this calculation is a detail in the mouth that really has changed. The front teeth darken over the years; tea, coffee and cigarettes work their way into the enamel. The edge of a front tooth breaks, or wears flat. The gums recede, and because the teeth are no longer the same length, the smile line is thrown off. Gaps open up between the teeth, and the front teeth tip forwards. A tooth has been taken out and the gap shows when you smile. Old fillings and crowns stay a different colour from the neighbouring teeth. A denture moves when you talk. All of these lead to a single result: you no longer let your smile go freely.

In dentistry this picture is not dismissed as a whim. There are questionnaires that measure how much oral health affects everyday life, and what they ask about is not pain: do you avoid eating, do you have difficulty speaking, are you uncomfortable being around other people, do you feel tense. Someone who avoids photos, picks the easiest thing to eat from a restaurant menu and keeps their sentences short in a job interview is answering every one of these questions. Having no pain in your mouth does not make this a smaller problem.

The place where the effect is least visible is working life. Saying little in an interview, avoiding eye contact in a presentation and cutting a smile short when meeting someone are read by the other person as a lack of confidence. The same happens in social life: invitations to group meals are turned down, because at the table you have to both talk and eat, and both show your teeth. Someone missing a front tooth cannot talk without raising a hand to their mouth. After a while, what is avoided is no longer the teeth but the very settings where people come together.

At this point almost everyone sets themselves a timetable. When the summer is over, after your child's wedding, when work quietens down a bit, when that debt is paid off. What these timetables have in common is that they never run their course; each time a date comes, a new one is written in its place, and years go by in between. The problem is not putting it off as such, but that what you are putting off does not wait. Discolouration will wait for you and can be reversed; but bone loss under the gum progresses without pain, a broken edge gets bigger where it is, and the neighbouring teeth tip into the gap left by a missing tooth. In other words, the mirror gives you an early warning, and that warning does not check the calendar.

What lies beneath the complaint you see in the mirror

Two patients who come in saying the same thing do not take the same path. What decides it is not how much the appearance has deteriorated but whether the structure that holds the tooth up underneath is still standing. This distinction becomes clear after an examination and X-rays.

The tooth can be saved

The complaint is colour and stainingIf the teeth are all in place, the gums are healthy and what bothers you is yellowing, the path is short. Tartar and surface stains are cleaned off, with whitening added if needed. The structure of the tooth is not touched here.
A single edge has broken or worn downIf the corner of a front tooth has chipped off or flattened over the years, the missing part is built up with composite. It is done in a single session and removes almost nothing from the healthy tooth.
Old fillings and crowns no longer match in colourWhen a filling done years ago stays darker than the neighbouring teeth, the problem is not the tooth but the material. Replacing it tidies up the smile in a single step.
The gums bleed and are swollenBleeding, reddened gums make a smile look worse than it is. Once the inflammation is treated, the tissue firms up and its colour returns to normal; some patients want no further treatment after this.

Saving it is unlikely to hold

The teeth have spread apart and tipped forwardsIf gaps are opening up between teeth that have stayed the same for years, underneath there is often loss of the bone that holds the teeth; drifting caused by a missing tooth further back that was never replaced, and tongue and lip habits, can create the same appearance. An X-ray and a gum examination tell the causes apart. A crown covers up this appearance but does not stop the loss underneath.
One of the visible teeth is looseNo cosmetic work is done on a loose tooth. First it is decided whether the tooth can be kept; any work done before that decision is short-lived.
Teeth are missing and the line of teeth has shiftedWhen the neighbouring teeth tip into the gap and the tooth in the opposite jaw grows into the space, what is left is no longer just a problem of appearance. The bite itself has changed, and the plan is bigger than a single tooth.
The denture moves and lip support has been lostThe lips falling in and the lines around the mouth are the result not of the denture but of the bone shrinking underneath. What needs discussing here is not the colour of the teeth but supporting the jaw again.

The first step of an assessment

The first step is not treatment but pinning down what it is that bothers you. At the end you know which change has created this picture, which options are realistic and what needs to be done first.

1
Write down what bothers you in your own words
We need to know at what moment your hand goes to your mouth: in photos, when you talk or when you eat. One patient mentions the colour, another the shape of a single tooth, a third a gap, and all three end up with different plans. What gets corrected is what bothers you, not what the dentist thinks is right.
2
Send us your photos and X-ray
Two photos taken on your phone are enough: one smiling, one talking. If you have a panoramic X-ray, add it through the form; we write to you within 24 hours about which options are on the table, and you do not need to come in for the initial assessment. The final decision is made after an examination.
3
Smile examination
We look at how far your upper lip rises when you smile, how many teeth show, whether the gum level is even across the teeth and how the midline relates to the centre of your face. We also listen while you talk: a gap in the front teeth changes the sound, and patients notice this before they notice the appearance.
4
Gums and support
We measure the pockets and look for bleeding and for whether the gums have receded. Cosmetic work done on inflamed ground is short-lived: as the tissue recedes, the edge of the crown is exposed and the work soon fails. That is why we always start with the gums.
5
X-rays and, if needed, a CBCT scan
A panoramic X-ray shows the remaining bone, decay and the condition of the roots. If a tooth is missing and implants are to be discussed, we move on to a 3D CBCT scan; the real height and thickness of the bone cannot be seen on a flat X-ray. A cosmetic decision made without imaging is made on incomplete information.

Options

These are not rivals to one another but answers to different problems. The right order starts with the least invasive, and most complaints are resolved near the top of the list.

Cleaning and whitening

Tartar and surface stains from tea, coffee and cigarettes are cleaned off; if the colour still bothers you, whitening is added. Whitening lightens the tooth's own colour. Fillings, crowns and porcelain do not change colour; they stay dark next to the whitened teeth and need replacing.

Repair and reshaping with composite

A broken corner, a worn edge or a narrow gap between two front teeth is built up with tooth-coloured composite. It is done in a single session and removes almost nothing from healthy tissue. Composite picks up stains over the years, but it can be redone when needed; this is a reversible step.

Crowns and laminate veneers

Porcelain is used for teeth whose shape and colour both need to change. The price should be stated plainly: some tissue is removed from the surface of the tooth, and tissue that is removed does not come back. If a dentist suggests crowning all your healthy front teeth, ask for the reason in writing.

Orthodontic correction

If the teeth are healthy but crowded or spaced apart, moving them back into position uses up less tissue than crowning them. It takes months. If the gaps are caused by bone loss, gum treatment comes first; teeth are not moved while there is inflammation.

Replacing missing teeth

If there is a gap that shows when you smile, none of the procedures at the top of the list will solve it. If a single tooth is missing, an implant or a bridge is discussed. If many teeth are missing, or the existing teeth have nothing left worth saving, the whole mouth is dealt with in a single plan and you move to fixed teeth.

What you need to know when deciding

We write these not to put you off but so that you can ask the right questions whichever dentist you go to. If a dentist does not tell you these things of their own accord, ask.

The timetable for putting it off keeps stretching

When the set date comes, a new one is written in its place. Meanwhile discolouration stays a reversible issue, but gum disease and bone loss progress without pain. We have often had to tell a patient how many steps a problem that could have been solved in a single session five years ago is now spread over.

Whitening does not lighten every kind of darkening

It works on discolouration that comes from the surface. In a tooth that has had root canal treatment and has darkened from the inside, the method is different: the work is done from inside the tooth. Sensitivity to cold lasting a few days after whitening is a known effect of the procedure and passes on its own.

Cutting a healthy tooth cannot be undone

Tissue removed from the surface of a tooth for a crown is never put back, and that tooth depends on a crown for the rest of its life. We often see patients who are bothered by the shape of a single tooth and have been offered porcelain on eight teeth. Nobody should move on to this step before the less invasive option has been discussed.

Cosmetic work needs healthy ground

A crown placed while there is untreated decay, active gum inflammation or a loose tooth covers the problem up. As the gum recedes, the edge of the crown becomes visible and the work soon fails. When the order is wrong, the price is paid twice.

Smoking hits in three places at once

It speeds up staining of the teeth, makes gum disease progress more severely and slows healing after implants. It is the one habit that shortens the life of every procedure done for appearance; stopping is a step that really does make a difference here.

What to expect afterwards

How long the path is depends on the procedure chosen. For a complaint that ends with a cleaning, it takes an afternoon; for a plan in which missing teeth are replaced, a few days.

The first days after cleaning and whitening
Tenderness in the gums lasting a few days and temporary sensitivity to cold are normal. For the first two days after whitening, keep away from coffee, tea, red wine and dark-coloured foods; the enamel picks up colour easily during this period. You do not need to take time off work.
With composite and porcelain
A composite repair is done in a single session, and you can look in the mirror the same day. With porcelain crowns there is an interim period after the impressions, and you wait with temporary teeth. You are the one who approves the colour and shape at the try-in; mention any detail you do not like before they are cemented, because changing it afterwards is harder.
If teeth are missing: three clinical days
In the protocol we use, the implants lock mechanically into the hard basal and cortical layer deep in the jaw. A conventional implant, by contrast, is placed in the alveolar bone at the top, which carries on shrinking after tooth loss; that is why adding bone first and waiting months for fusion come into it there. This is where the difference comes from: adding bone and months of waiting do not come into it, and at the end of three clinical days you leave with your final fixed teeth. This protocol is for the full mouth or many missing teeth; for a single missing tooth, the timescale depends on the condition of the bone and the solution chosen.
The first week and after
Some swelling and tenderness are normal and ease after the third day; if you have stitches, they are removed according to the clinic's follow-up plan. Getting used to speaking with new front teeth takes a few days, and you hear it most yourself; the person you are talking to does not notice. Care is no different from natural teeth: brushing, interdental cleaning and regular check-ups.

Message us right away if

Swelling or discharge in the gum, or a fever. These are signs of active infection, and they need to be assessed the same day, even if you are in the middle of cosmetic treatment.
A new tooth feels high when you bite. If you feel that tooth touching first when you bite, do not wait to get used to it. A surface left high strains both the tooth and the jaw joint; it is sorted out with a quick adjustment.
Sensitivity after whitening that does not pass within a few days. Short-lived sensitivity is normal; pain that becomes constant is not. In that case, call us and we will look into the cause together.

What determines the cost

We do not give a single figure on this page, because of two patients who come in saying the same thing, one leaves with a cleaning and the other with a plan covering the whole mouth, and the difference between them is large. We give you the right figure after seeing your photo and X-ray. The items that determine the price:

The source of the complaint: Discolouration, a broken edge, receding gums and a missing tooth are completely different procedures. A figure given before the cause is identified is bound to change at the clinic.
How many teeth show: How many teeth show when you smile directly determines how wide the plan is. In a patient with a high smile line, the back teeth come into the calculation too.
Treatment that has to come first: If gum treatment, fillings for decay or an extraction are needed, these are done before the cosmetic procedure and added to the total. If these steps are skipped, the result does not last.
Material and laboratory: The difference between composite and porcelain lies both in the work and in the material. We share the brand of the material we use and the scope of the work in writing from the outset.

Frequently asked questions

Is it unreasonable to see a dentist just because of how my teeth look?

No. The questionnaires used in dentistry to measure how oral health affects everyday life ask exactly these things: are you uncomfortable being around other people, do you have difficulty speaking, do you feel tense. For someone who avoids photos and does not go to group meals, there is a real loss. What is more, behind whatever is changing the appearance there is often a cause that needs treating.

Will whitening lighten my teeth?

Whitening lightens the colour of the tooth's own tissue; it works on staining from tea, coffee and cigarettes on the surface. Fillings, crowns and porcelain do not change colour; they stay dark next to the whitened teeth and need replacing. In a tooth that has had root canal treatment and darkened from the inside, the method is different: the work is done from inside the tooth. We tell you which applies to you by looking at a photo.

If I have crowns, will my teeth be cut down?

Yes, for a porcelain crown some tissue is removed from the surface of the tooth, and that tissue does not come back. That is why we suggest crowns not as the first option but once the less invasive routes have been exhausted. If the broken corner of a single tooth can be built up with composite, there is no reason to crown eight teeth.

One of my front teeth is missing and it shows when I smile. How soon can the gap be closed?

A single missing front tooth is a job for your own dentist, and nobody has to go without a tooth: the gap can be closed with a temporary solution the same day. How long the permanent solution takes depends on the bone. If the walls of the extraction socket are sound and there is no inflammation, an implant can come in early. This decision is made by looking at a CBCT scan.

I have a job interview in two weeks. What can be done in that time?

Cleaning, stain removal and whitening fit comfortably into that time. Building up a broken edge with composite is done in a single session. If a single tooth is missing, two weeks is too short for a permanent solution; but a temporary solution can be put in place so that you do not have to hide your smile at the interview. If many teeth are missing, the protocol we use is completed in three clinical days, so two weeks is more than enough. Tell us the date when you book your appointment, and we will plan around it.

My teeth have been in a bad way for years. Have I left it too late?

What you can be too late for is the number of options, not the result itself. When you wait for years, a tooth that could have been saved ends up being extracted and the bone diminishes; this means the plan gets bigger. With a patient who comes in today, what we look at is not what happened in the past but what is left. We use a protocol with which patients who have no teeth left in their mouth also leave with fixed teeth.

Is your fixed-teeth-in-three-days method suitable for me?

Our area is the full mouth or many missing teeth. If your complaint is the colour or shape of a single tooth, the answer is most likely no; for that, a cleaning, a composite repair or a single-tooth implant with your own dentist is enough. If we look at your photo and X-ray and think it is not suitable for you, we tell you that plainly in writing too. We provide implant treatment for people with diabetes; what matters is not the condition itself but whether your blood sugar is under control.

Sources

Send your X-ray and we will tell you which option is realistic for your tooth.

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Next step

Send your X-ray and we will talk through the options.

Share your CBCT or panoramic X-ray. We will write back within 24 hours on which option is realistic for your tooth.

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