Cosmetic Dentistry: Which Treatment Is Right for You?

What can cosmetic dentistry change?

Cosmetic dentistry can address many of the things patients notice when they look at their smile: discoloration, uneven edges, small chips, spaces between teeth, differences in tooth size, crowding, worn teeth, old restorations, and missing teeth.

But two people who dislike the same thing about their smiles may need completely different treatment.

A dark tooth may need whitening, internal bleaching, bonding, a veneer, or a crown depending on why it is dark. A space may be improved with bonding, orthodontics, or veneers. A tooth that looks too short may actually be worn, or its proportions may be influenced by the surrounding gum tissue.

That's why I don't like starting with a procedure. I want to understand what you see first, then determine why it looks that way.

Your cosmetic treatment options

These are some of the treatments we consider most often when someone wants to improve their smile. They overlap, but they are not interchangeable.

Professional teeth whitening

Whitening is often the simplest place to begin when the primary concern is tooth color and the teeth themselves are otherwise healthy and attractive.

It can brighten natural enamel without changing the shape or structure of the teeth. Existing crowns, veneers, and tooth-colored fillings may not respond to bleaching the same way natural enamel does, so their color has to be considered when we're planning treatment across the entire smile.

Cosmetic bonding

Bonding uses tooth-colored composite resin to make relatively small changes to a tooth. It can be especially useful for chipped edges, small spaces, minor shape differences, or a tooth that simply looks a little out of proportion.

One of the things I like about bonding is that it can often be quite conservative. The tradeoff is that composite does not behave exactly like porcelain over time. It can stain, wear, or chip and may eventually need maintenance.

Porcelain veneers

Veneers allow us to change several characteristics at once, including color, shape, proportion, symmetry, and the appearance of certain spaces or worn edges.

They make the most sense when the amount of change a patient wants is greater than whitening or conservative bonding can predictably provide.

Good veneer treatment is not about making every tooth identical. It is about designing a smile that belongs to the person wearing it. Tooth proportions, translucency, surface texture, facial features, lip position, and the neighboring teeth all matter.

Invisalign

Sometimes the problem is not the shape of the teeth at all. It is their position.

Invisalign can be used to address certain spacing, crowding, and alignment concerns without covering otherwise healthy teeth.

There are also cases where orthodontics is only one part of the plan. Moving the teeth into better positions first may allow us to be considerably more conservative with bonding or veneers afterward.

Dental implants

A missing tooth creates a different cosmetic problem because there is no longer a tooth to whiten, bond, straighten, or veneer.

A dental implant can replace the missing tooth while also restoring function. In the front of the mouth, planning involves much more than simply placing an implant. The position of the implant, gum contours, neighboring teeth, and final crown all contribute to whether the replacement looks natural.

The best cosmetic dentistry should make you notice the smile, not the dentistry.

Which treatment is right for you?

I usually think about cosmetic treatment in terms of the problem we are trying to solve and how much dentistry is actually necessary to solve it.

There are also plenty of situations where the best plan uses more than one treatment. We might straighten first and bond afterward. We might whiten the natural teeth before choosing the final shade of a veneer or crown.

The goal is not to use as many cosmetic procedures as possible. It is to use the right amount of dentistry to create a result that looks natural and makes sense long term.

Choosing a cosmetic dentist

Cosmetic dentistry involves technical dentistry, but it also involves judgment. That judgment is often what separates a result that simply looks new from one that looks like it has always belonged there.

Look at a dentist's actual work. Pay attention to whether the smiles all look the same or whether the treatment seems to change with the patient.

Look at tooth shape, texture, translucency, symmetry, and how the teeth relate to the lips and face. Natural teeth have character. Beautiful cosmetic dentistry should preserve some of that character rather than erase it.

I also think you should feel comfortable hearing that you don't need something.

If whitening will accomplish what you want, you should know that before discussing veneers. If moving a tooth could preserve healthy enamel, that option deserves a conversation. And if a tooth is already heavily restored and would benefit from more comprehensive treatment, you should understand why.

I go into this in more detail in what to look for when choosing a cosmetic dentist , including the questions I think patients should ask before committing to treatment.

You can also read our guide to cosmetic dentistry and smile transformation for another look at how different treatments can work together.