Cosmetic Dentistry: Filling in spaces between teeth - Veneers vs crowns. (Two makeover cases.)

Dentists routinely fill in tooth gaps by placing dental crowns or porcelain veneers. And while the results of either approach will give the same cosmetic outcome, these restorations have different characteristics, and therefore different applications. These two digital makeover cases provide examples of that.

Digital smile makeover #1: Closing in gaps with porcelain veneers.

Dental history and concerns:

1) When you look at this "before" picture, most likely the first thing that you notice is the gap between this person's two center teeth. (Dentists refer to this type of space as a diastema.)

And then, to a lesser degree, there seems to be some additional spacing between these same teeth and their neighbors off to the side. (Especially on the patient's left side.)

2) As a side note, when this woman submitted her picture, she stated in her email that having orthodontic treatment (braces) was not an option that she wanted to consider.

Cosmetic dentistry solutions:

1) Which is best, veneers or crowns? - Our "after" picture shows how this person's smile might be improved by placing porcelain veneers on her upper four center teeth. Dental crowns could be used to close in the spaces too. But crowns and veneers are intended for different applications and, with this case, veneers seem to be the right choice.

(Related information: What is the difference between porcelain veneers and dental crowns?)

2) Why veneers make the better choice. - Porcelain veneers are best suited for situations where the teeth receiving them won't be exposed to excessive biting, clenching or chewing forces.

That seems to be the case here. Look at the "before" picture and notice where the lower front teeth bite against the uppers (it's on their backside). And also notice how the biting edges of the teeth that will get veneers show no signs of wear.

That suggests that these teeth will make good candidates for porcelain veneers because there is no evidence that the restorations will be exposed to extreme or excessive forces. (If they were, dental crowns would make the right choice because they are better suited for these types of conditions.)

(As explained in the link above, the underlying advantage of porcelain veneers over dental crowns is that less tooth structure needs to be trimmed away when they are placed.)

Digital dental makeover #2: Closing tooth gaps using dental crowns.

This second case illustrates a situation where dental crowns make the better choice for closing in the spaces between a person's teeth.

Dental history and concerns:

When looking at this smile, as a positive factor, the lower teeth have a reasonable appearance. The upper teeth, however, harbor a couple of different cosmetic challenges.

1) The center two teeth show a lot of wear, probably due to tooth grinding. (The worn edges of the opposing lower teeth support this theory.)

2) The center six teeth have gaps between them.

3) The lateral incisors, the teeth that flank the center teeth, seem very small (suggesting that their crown portion has been affected by some type of developmental abnormality).

Cosmetic dentistry solutions:

1) Closing the spaces using dental crowns. - Our "after" picture shows how this person's smile could be improved upon by making shape changes with his center six upper teeth.

Crowns would make the best choice for creating these changes (as compared to porcelain veneers). This is because, as you can see in the "before" picture, the biting edges of all of these teeth are chipped and worn.

This wear suggests that this person clenches and grinds their teeth. (Dentists refer to this activity as "bruxing.") And due to these conditions, dental crowns, because they have greater strength and can better withstand these types of excessive forces, offer a more lasting treatment solution than veneers.

2) Teeth whitening treatments could be an option. - We didn't really address the issue of tooth color in our "after" picture. If one is desired, however, either in-office or at-home treatments could be utilized.

This treatment would need to be completed before the dental crowns were made. (Only teeth will respond to tooth-whitening treatments, not dental crowns.)