Cosmetic dentistry vs. Braces - Which makes the best choice?

Here's a digital smile makeover that can help to give you an idea of the relative advantages and disadvantages of having your teeth just look like they've been straightened by placing dental crowns and/or porcelain veneers, or really realigned using orthodontic treatment (braces).

Case issues and concerns:

When we look at this person's "before" picture, these are the cosmetic problems that we notice.

This person's teeth are crooked. There's tooth crowding on the top and tooth spacing on the bottom.

There are some chips and wear showing on the biting edges of the teeth. It's quite likely that this damage is directly related to her malocclusion (the way her teeth come together).

The gum line across the upper front teeth is irregular. Her right center tooth (central incisor) is positioned relatively too high and the lateral incisor next to it somewhat too low.

(Compare the level of the gum line on the teeth on the right and left sides and you'll see the imbalance.)

Misaligned teeth.
Ideal results created by having orthodontic treatment.

Photo submitted by website visitor.

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Treatment solutions:

While each of the above issues listed above is cosmetic in nature, collectively they're not really issues that are best corrected by "cosmetic dentistry" techniques (placing dental crowns, porcelain veneers, etc...). Instead, the ideal approach for treating this case would be orthodontic treatment (braces). Here's why.

Treating this case orthodontically. -

In a nutshell, a braces approach would simply involve realigning the teeth. Then, after that's done, straightening their biting edges either by placing dental bonding, or just trimming them with a dental drill. (This is what we've illustrated in our "after" picture.)

As a side benefit (and a pretty important one in terms of creating the "perfect" smile), having orthodontic treatment would also resolve the gum line discrepancy across the upper front teeth.

a) Treatment time. -

As a disadvantage of this approach, it would probably take between one and two years to complete this case. And it's easy to see why someone might have objections to having to endure braces for that amount of time. But considering all of the different types of orthodontic techniques and options (including Invisalign invisible braces) that are available nowadays, this argument seems to carry less and less weight. In comparison, placing crowns and veneers would be the "instant gratification" approach, although it usually does take a few weeks to have them made and placed.

b) Cost comparisons. -

The cost of the orthodontic treatment could be a concern. But getting results even approaching what we've illustrated in our "after" picture by placing some combination of crowns and/or veneers would involve at least eight teeth. That means that the cost of both treatments would be at least somewhat similar (many thousands of dollars).

We should point out that a braces approach would only involve substantial costs now. Long-term maintenance could be expected to be simple and cheap (wearing a retainer, possibly somewhat infrequently, and repairing any bonding that had been placed on an as-needed basis).

In comparison, a "cosmetic dentistry" approach involving crowns and veneers would involve placement costs now, and then again some years later, and then probably yet again... You have to realize that no "permanent" dental restorations really last forever. Especially when their cosmetic appearance is a major consideration.

c) Other disadvantages of a cosmetic dentistry approach. -

Anyone considering having their teeth "straightened" by placing crowns and veneers needs to understand that doing so probably involves trimming away healthy tooth structure. And doing so does have the potential to cause unexpected consequences. (Lumineers can be a non-invasive option, at least for some teeth, but they don't always make the best choice.)

There is also the issue that placing restorations on teeth can make it more difficult over the long term to maintain the health of the gum tissue around them. This should be a major consideration for people who are lax in their brushing and flossing habits.

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Input from site visitors.

You should consider submitting your picture.

Danielle, The whole idea with this section of our website is that people submit pictures of their smiles. We then edit the picture, giving the person an idea of what types of changes might be made. They then show the picture to their dentist and they explain to them what exactly can be done and the cost.

A lot of the smile makeovers we've done have been pictures taken on even cell phones, so if you'd like to submit yours for consideration please do (it's free, all we ask is a good quality picture).

Short of that, you might search through our categories of makeovers for a smile that's similar to yours and explains what might be done.

As for prices, we do have pages that outline dental costs, but we are a US-oriented website.

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