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Advanced cosmetic and general dentistry

Saving money on porcelain veneers

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Hi,

I have porcelain veneers on two of my front teeth. Over time, they have shifted a bit and I am considering having them redone as well as getting some additional ones on other teeth. Honestly, I am hoping to find a less costly way to do this since veneers are not covered by my insurance.   Could I maybe serve as a patient to a graduate student in cosmetic dentistry? I appreciate any information that you could provide.
– Audrey in Middlebury

Dear Audrey,

First, we need to clarify that there is no standard graduate program or certification for cosmetic dentistry. It is not a recognized specialty of the American Dental Association and, therefore, any dentist who has graduated from dental school can claim to be a “cosmetic dentist.” It’s up to consumers to do some research to find a dentist with the qualifications to provide results they are going to be happy with. A truly qualified cosmetic dentist will be one who: a) has taken the time to pursue advanced training in cosmetic procedures like the use of ceramics to craft porcelain veneers and crowns, and b) has the right artistic sensibility to understand that ‘one size does not fit all’ when it comes to doing a smile makeover.

Second, porcelain veneers are not the type of dental procedure that you should allow a less experienced practitioner to “practice” on you with in order to save money. It’s highly likely you would end up with a smile that looks worse (if not much worse) than the one you currently have. And, that’s not even the worst-case scenario. People have experienced problems with their bite or problems chewing or speaking after having porcelain veneers placed by an unqualified dentist.

If you are willing to travel, it might be possible to save money by traveling to a place where the costs of living (and doing business) are lower. You might be able to find an expertly qualified cosmetic dentist who would be less expensive than a dentist in your area. However, we urge you not to let the driving factor in your choice be the lowest cost.

Learn more about finding a good cosmetic dentist.

Information about quality porcelain veneers.

Snap-On Smile OK for children?

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Hi,

My 9-year-old son has a severely chipped front tooth. It is almost broken in half. We had it fixed, but the repair broke off a week later. The root is not damaged, just the tooth. I am wondering if the Snap-On Smile will work for him until he is old enough to have it capped.
– Janelle from Boston

Janelle,

This is a rare instance in which the Snap-On Smile is not a good choice.

First, by doing a Snap-On Smile you are still leaving him with a tooth that is broken. The Snap-On Smile will only fix the cosmetic issues, not the problems he will have with bite. You need to have a competent dentist fix this tooth permanently, either with porcelain or composite. And, this must be done in such a way that it doesn’t get in the way of his bite.

Aside from the dental issues, there are three main concerns when it comes to doing a Snap-On Smile for a young child:
1. Because it is worn over the teeth it will be bulky.
2. Young children are likely to lose the appliance and these are significantly more expensive than, say, a retainer.
3. At age 9, your son is in what is known as a mixed dentition stage, meaning he has both baby teeth and permanent teeth, with the permanent teeth still coming in. As a result, the fit of something like a Snap-On Smile is going to change,  maybe as often as every couple of months. The appliance may also get in the way of erupting teeth.

I would be most concerned about finding a different dentist to do the tooth repair. The first repair did not break off because of anything related to your son’s age; it broke because it got in the way of his bite and was improperly done.

I would seek out the services of a qualified cosmetic dentist—something with specific training and experience in cosmetic dental bonding—to do a permanent repair of this tooth. That may cost more than the average dental procedure, but likely less than the Snap-On Smile would have.

You can learn more about cosmetic dentistry on our main website: Lowell Cosmetic Dentistry.

How many veneers for a total smile makeover?

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Dear Dr. Szarek,
How many veneers are usually required to make all of a person’s teeth look whiter?
– Jackie  in Lowell

Jackie,
The number of porcelain veneers required differs from patient to patient, and whether you really need all of your teeth to be “whiter” or whether you want to achieve a consistent, natural, and flawless smile, which will be individual to each person (what we call a “smile makeover”). This should be determined  by consulting an expert cosmetic dentist with good artistic sense. (Read more about cosmetic dentistry.) There’s no way to say what the optimal number would be for any individual person, but here are some general guidelines:

  • If  you only need a subtle color change, you can often achieve this by veneering six teeth (and, rarely,  just four)  because the canine teeth are naturally a little darker. So, your smile can still look natural even though nothing is done to the canines.
  • If there is a distinct color difference between teeth, you need at least eight veneers on the upper, sometimes 10, sometimes 12. Have someone look at your smile from the side and see how many teeth show. Any tooth that shows from the side while you are smiling broadly, needs to be treated.
  • Lower teeth can be left somewhat darker than upper teeth. In a patient with a normal bite, the lower teeth will be overlapped by upper teeth, which creates shadows. So if they are darker than the uppers, it is usually OK, unless the patient has a smile that shows a lot of lower teeth.
  • You may be able to reduce the number of teeth that need veneers by bleaching your teeth before getting them applied. Some patients have chosen to bleach their back teeth and veneer the front ones, or bleach the lowers and have veneers applied to the uppers only.