Bonding vs. Veneers vs. Porcelain Crowns vs. Braces vs. Whitening
By Howard Glassman, D.D.S.
Cosmetic dentistry is the big buzz word in dentistry today and has been for a number of years. Making your smile look beautiful is the motivating factor for many dental patients. There are quite a few different methods and techniques used to achieve this end, but they fall into a few main categories.
Although there is a lot of overlap, usually these techniques each have a specific purpose that is used in specific circumstances. Often more than one treatment is used to achieve the ideal result. Let's look at each of these techniques and see what they can accomplish.
Sometimes a person will have very nice teeth in every way except color. They are well shaped, spaced, and formed, but over the years they have yellowed a little (or a lot!). Tooth whitening would be the treatment of choice.
In the old days (more than 7 or 8 years ago), the only way to handle this would have been to cover the teeth completely with bonding, veneers, or (up to a few years before that) crowns. Now, luckily, whitening of discolored teeth to a brilliant radiance is strictly routine. We have the take-home trays or the in-office Zoom! Whitening, both of which are very effective.
This will not work, however, if the color comes from deep within the tooth as in tetracycline staining which usually gives the dark brown or grayish colors.
What if there are other problems such as minor spacing, chips, old discolored fillings, or the deep discolorations described above? Bonding comes into play.
This is an acrylic resin material that comes in a number of shades, consistencies, and strengths to fill in holes or spaces, cover discolorations, and generally reshape teeth however needed. It can make almost any set of teeth look perfect. This is "direct bonding" which means it is placed directly on the teeth, shaped, cured, smoothed and polished. You leave with your gleaming new smile the very same day.
One drawback is the longevity. Bonding does tend to stain and/or yellow as the years go by.
Next on our list is porcelain veneers. These are thin facings of porcelain that are bonded to the front of teeth. They perform many of the same functions as direct bonding but with some notable differences.
First, being porcelain instead of resin, they look more lifelike and last longer without staining. They can also cover more areas of missing tooth with better strength than bonding.
One drawback here is that they do require more of the tooth being drilled away than does bonding, and two appointments are necessary.
What if the teeth are severally broken down, or some even missing? Porcelain crowns to the rescue. This is especially true of the newer generation of all porcelain crowns.
A crown covers the tooth completely on all sides. It can replace any missing tooth structure, widen teeth to fill spaces, make crooked teeth look straight, change the color, and even anchor a "bridge", to replace missing teeth. Crowns are the heavy duty industrial strength cosmetic treatment that can change almost any problem (except one- see below) into that movie star smile.
Now, what if one or more teeth are just too far apart, too angled, too twisted, or too overlapped for even crowns to take care of? Orthodontics (braces) to the rescue!
By actually moving teeth around and changing their position and angles, this final cosmetic problem can be overcome.
Often times a combination of techniques is utilized for a complete makeover. It is not uncommon to first do some "ortho" to get things in the right position, then whiten the teeth to brighten up the shade, then do whatever combination of bonding, veneers, and crowns is necessary for total perfection.
Advice: Find a cosmetic dentist that utilizes all the above techniques to get the best result. Most general dentists do not do braces. This may not be suggested then if it’s not done in that office, even though it may be the ideal treatment for you.
I hope this clears up a little about what these different cosmetic treatments are, and what they’re used for. By properly utilizing all these various treatments, anyone can have that perfect smile no matter what you have to start with! Come in for a cosmetic consultation to see what cosmetic dentistry can do for you.
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