“Straightening” teeth by placing porcelain veneers.
When it comes to straightening their teeth, patients who have a slight to moderate degree of tooth misalignment are often attracted to the possibility of placing a set of porcelain veneers, as opposed to having orthodontic treatment (braces).
We’ve taken the “before” picture of this case and created two digital smile makeovers for it. The one on this page illustrates how the smile could be improved by way of placing porcelain veneers.
A second simulation shows the results that might be expected if some type of braces (traditional, removable) were used. With each approach, we discuss some of its relative advantages and disadvantages.
Case issues and concerns:
The initial request from this person was simply one where they wanted to see what they would look like with “straight” teeth.
From the limited information available to us by viewing the ‘before’ picture, we developed the following impression.
Overall, this seems to be a healthy mouth. (The gum tissue looks good. We don’t see any obvious dental problems or missing teeth.)
There is a generalized tooth misalignment, both top and bottom.
To a very minor extent, the outline shape of some of the teeth (mostly their biting edges) might be improved upon.
Lightening the teeth a little might make a nice improvement.
“Before” photo submitted by website visitor.
1) An approach involving porcelain veneers.
Our “after” picture illustrates the types of results that might be expected if porcelain veneers were used to change the apparent alignment of this person’s teeth.
The way this is done is as follows.
- When veneers are made, protruding aspects of offending teeth can be
trimmed back modestly.
- And the thickness of veneers placed on recessed teeth can be made relatively thicker.
In combination, these two changes can create the illusion of straighter teeth, without the need for orthodontic treatment.
Just because it can be done, doesn’t mean that placing veneers is our favorite solution for this case. We prefer the idea of realigning the teeth with braces. Here are some of the reasons why.
A) Oversized teeth.
Teeth whose apparent alignment has been improved by placing thick veneers may become grossly oversized. With this case, imagine how much bulk must be added to the lower center tooth to bring it forward into alignment.
B) It can be difficult to get a “perfect” result with veneers.
Look at the alignment of the lateral incisors in our “after” picture. In the “before” picture, these teeth stick out somewhat. And in our “after” picture they still do a little bit.
That’s because we’ve tried to simulate that there are limitations regarding how much tooth structure can be trimmed away when veneers are placed. And with some cases, that makes it difficult to create the “perfect” alignment.
The veneers for adjacent teeth could be made thicker, so to even things out. But relatively bulky veneers can be awkward for the patient, and possibly detrimental to the long-term health of their gums.
C) It can be expensive to get a “perfect” result with veneers. (In more than one way.)
Now, take a look at the “after” picture again and take note of the “V”-shaped spaces on the lower arch. (They’re off to each side of the four center teeth. You may need to compare this makeover with the one below to understand what we’re referring to.)
Sure, restorations could be placed that could fill in these spaces. But the question always remains, how many teeth will need to be treated to effectively mimic the overall regularity and evenness of teeth that have been realigned using braces? In reality, it may turn out to be a fairly large number.
If a large number of teeth are treated, it means increased costs, both initially and due to
maintenance (both planned and unexpected) that’s required over the years. (Yes, you have to expect that your veneers will need to be replaced at some point during your lifetime, possibly more than once. No “permanent” dental restorations really ever end up lasting forever. Especially when their cosmetic appearance is a major concern.)
As an advantage, the veneering approach is the “instant gratification” and “least effort” method. Orthodontic treatment can take 1 to 2 years and is a bit of a lifestyle inconvenience.
In terms of limiting the number of veneers needed (and minimizing treatment costs), a person may decide that the relatively lesser appearance achieved by treating fewer teeth is perfectly satisfactory to them.