There is a lot of confusion around this type of dental restoration and cosmetic dentistry in general. People will see dramatic before and after photos of celebrities or on social media, but very little is said about what was done to get there.
Most patients we see for cosmetic dentistry consultations come in with a photo of someone who had cosmetic dentistry done (usually a celebrity), say “I want this!”. Their assumption is that the person had veneers done, that maybe it took a couple of appointments, and cost a few thousand dollars. However, those big changes you see often take months or years to complete, even for celebrities!
There are 3 main aspects to cosmetic dentistry. They may be used alone or in combination to achieve those “wow” results:
- Whitening (see whitening ebook I wrote on this)
- Orthodontics is a very important part of cosmetic dentistry. It involves moving teeth with braces or Invisalign to a more ideal position, and also allows us to correct bite problems that may compromise the longevity of the veneers.
- Porcelain restorations (porcelain veneers and crowns).
In our experience, the top 3 things people get disappointed by when they come in asking for veneers are:
- Porcelain veneers are not a simple “magic” fix: they cannot cover up significant tooth alignment or discoloration problems. They are also not something that can be done in a few one hour appointments!
- Need for orthodontics: When a patient has significant tooth alignment or bite problems it is not possible to do veneers without first moving the teeth. In these cases to do veneers without ortho would involve significant removal of tooth structure, and/or the teeth sizes and proportions would be way off. No one likes to hear that they should have orthodontics, but in these types of cases we insist on doing it because in the end you get a more stable, long lasting, beautiful result. We refer to the top specialists in the city for this, so our patients are in good hands.
- Cost: a single porcelain veneer costs around $1500/tooth. Porcelain veneers are one of the most challenging dental restorations to do. To achieve a long lasting result, they need to be done with the highest quality materials, technique and precision.
As dentists we have the responsibility of delivering beautiful smiles while respecting the teeth and informing patients of the risks involved for every treatment plan. My goal is always to accomplish a patient’s esthetic goals without harming or compromising the strength of their teeth. This is what dentists mean by “Minimally Invasive Dentistry” – we are not harming the teeth or increasing risk of problems down the road to achieve a patient’s cosmetic goals.
For this reason I do all of my own mock-ups for patients on their models in wax first, and add to the teeth wherever possible so that we are removing the minimum amount of tooth structure. I often do this in the evenings at home, and my 3 year old son loves to sit at the table and watch me!
Here is an example of a case we treated with 4 Veneers:
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