Cosmetic dentistry is booming in Britain. The British Academy of Cosmetic Dentistry reports rising demand across aligners, veneers, and whitening, while the UK private dental sector is projected to grow steadily through the next decade. Social media fuels much of this — influencers flaunt dazzling veneers, reality television contestants showcase quick transformations, and consumer clinics compete on price and speed.
Yet in Fulham, brothers Dr Ayzaaz Akram and Dr Shiraz Akram are pushing back. At their practice, Pure Smiles, the message is clear: beauty is meaningless if biology is compromised. “We never build on shaky foundations,” says Ayzaaz. “Health has to come first.”
The brothers describe dentistry as architecture. “It’s like building a house,” Shiraz explains. “You wouldn’t put glass walls on sand. The structure has to be solid.”
For them, that means treating gum disease, stabilising bites, correcting functional problems and ensuring long-term oral health before considering cosmetic enhancement. “Patients come in asking for veneers,” says Ayzaaz, “but if their gums are inflamed or their bite is collapsing, we have to address that first. Otherwise, they’ll be back in pain within years.”
This philosophy is at odds with parts of the market. Dental tourism in particular often prioritises fast aesthetics — shaving down teeth for crowns or veneers in days. The results, widely reported, can be catastrophic: sensitivity, infection, bite collapse. “We see patients who have spent thousands abroad,” Shiraz notes, “only to come home with mouths that need complete rehabilitation.”
The Guardian recently profiled British patients who described their veneer experiences abroad as the “biggest mistake” of their lives, with treatments leading to lasting damage and financial hardship. The Akrams are careful not to vilify all overseas dentistry, but they point out the risks. “If you treat teeth as fashion accessories, you’re gambling with biology,” says Ayzaaz.
One of their patients had sought veneers to prepare for a wedding. The procedure looked impressive in photographs but left underlying problems untreated. Within two years, the veneers were failing and decay had spread. Pure Smiles had to strip everything back, rebuild health, and only then reapply cosmetic solutions. “That patient now understands the value of health before beauty,” Shiraz reflects. “It’s not as dramatic on Instagram, but it will last decades.”
Even Invisalign, often seen as a safe and non-invasive cosmetic choice, can be misapplied. “We’ve had patients come in with aligners they ordered online,” Ayzaaz says. “The teeth moved quickly, but the gums receded, the bite collapsed. It’s dangerous.”
At Pure Smiles, aligners are handled differently. Cases are reprogrammed multiple times to ensure biological stability. “We’d rather slow things down and get it right than deliver a quick smile that fails,” Shiraz explains. The emphasis is always on predictability and permanence.
This approach reflects a larger trend. Market data suggests aligners are now one of the fastest-growing segments of global dentistry, but also one of the most scrutinised, with regulators warning against direct-to-consumer models. The Akrams see their role as offering patients reassurance that science, not marketing, drives treatment.
Central to the brothers’ philosophy is patient education. “We explain everything,” says Ayzaaz. “Not just what the treatment is, but why we’re doing it, what the risks are, what the long-term picture looks like.”
Shiraz adds that education is as much emotional as it is clinical. “Patients need to understand that dentistry isn’t about today’s photograph. It’s about whether your smile still functions in twenty years. That’s not as glamorous, but it’s the truth.”
The brothers argue that this candour builds trust. Many patients, they say, arrive sceptical of dentists after years of feeling sold to rather than cared for. Pure Smiles aims to invert that relationship by offering transparency and evidence at every step.
For Ayzaaz and Shiraz, dentistry is not just clinical but moral. “We are entrusted with people’s self-image,” says Shiraz. “That is a sacred responsibility.”
They speak often of patients who invest not just money but hope — individuals who want to feel confident at work, in relationships, in life. “You can’t betray that trust by cutting corners,” Ayzaaz insists. “The smile is too central to identity.”
Their commitment means sometimes saying no. Patients who push for unrealistic timelines or procedures that would compromise health are advised against proceeding. “We’d rather lose a case than compromise a patient’s future,” Shiraz explains.
One woman came to Pure Smiles believing her only option was cosmetic veneers. After a thorough consultation, the brothers discovered significant gum disease. Instead of rushing to cover the issue, they stabilised her gums, adjusted her bite, and then delivered a more subtle cosmetic plan. The result was not just aesthetic but transformative. “She told us she’d never imagined she could have a smile that looked natural and felt healthy,” recalls Ayzaaz.
Such stories illustrate the deeper truth of their practice: that dentistry done properly is not about instant transformation but sustainable empowerment.
As private dentistry grows in Britain, the risk of commodification looms large. Patients are vulnerable to advertising that promises fast beauty at low prices. Yet as fees rise and NHS access diminishes, the stakes for long-term health are higher than ever.
The Akrams’ philosophy — health before beauty, biology before image — stands as a corrective to an industry that can too easily chase spectacle. “Patients need to know there are clinicians who will put their wellbeing first,” says Shiraz. “That’s what distinguishes good dentistry from cosmetic theatre.”
In the end, the message is not anti-cosmetic. Both brothers believe passionately in the power of aesthetic dentistry. But they insist it must be built on a foundation of health. “The true luxury,” says Ayzaaz, “is not a smile that looks good in photographs. It’s a smile that still looks good — and feels good — after decades.”
In Fulham, Pure Smiles is proving that the most modern dentistry is not the fastest, nor the flashiest. It is the most honest. And it begins, always, with health.
To explore how Pure Smiles can help you build a smile on strong foundations, visit www.puresmiles.co.uk or call 020 7736 6276 to book your consultation.
