Cosmetic Dentistry: Options for Your Smile Makeover

Cosmetic dentistry covers everything from brightening the color of your teeth to changing their shape, alignment or the gum line around them. The right choice depends on what bothers you about your smile, so this guide sets out what each treatment is good for, and where it isn't the answer.

Start With a Healthy Foundation

Cosmetic work lasts only as long as the teeth and gums underneath it. Any decay or gum disease is treated first, and we'll tell you if something needs attention before cosmetic treatment makes sense.

Professional Teeth Whitening

Suits: teeth that are healthy and well shaped but stained or yellowed.

Whitening is done in the office in one visit, or at home with custom trays and professional gel. It lightens natural teeth only — crowns, veneers and fillings stay the same color — and gray discoloration from some medicines or an old injury responds less well. See our guide to professional teeth whitening.

Cosmetic Bonding

Suits: small chips, small gaps and minor discoloration on one or a few teeth.

Tooth-colored composite is shaped directly onto the tooth and hardened with a light, usually in a single visit, with little or no tooth removed. It is the most conservative option, but composite stains and chips more easily than porcelain and needs touching up over the years. See cosmetic bonding.

Porcelain Veneers

Suits: front teeth with several issues at once — color, chips, uneven shapes or sizes, small gaps, or slight misalignment.

Veneers are thin, custom-made shells bonded to the front of the teeth. Treatment usually takes a few visits:

1. A consultation about what you want to change
2. Preparing the teeth by removing a thin layer of enamel
3. A scan or impressions so the veneers can be made
4. Bonding the finished veneers and checking your bite

Porcelain resists staining well. Because enamel is removed, veneers are a lasting commitment for those teeth. See porcelain veneers.

Invisalign® Clear Aligners

Suits: crooked, crowded or gapped teeth, where the position of the teeth is what bothers you.

Clear aligners move the teeth themselves, rather than covering them. Straight teeth are also easier to clean. Many people whiten after aligner treatment, or have bonding or veneers once the teeth are in place. See living with Invisalign® clear aligners.

Gum Recontouring

Suits: a "gummy" smile, or an uneven gum line that makes teeth look different sizes.

A small amount of excess gum tissue is removed to even out the gum line and show more of each tooth. It is often planned before veneers, so the new tooth shapes can be designed around the final gum line. See gum recontouring.

Aesthetic Crowns

Suits: a tooth that is heavily filled, cracked or badly discolored, where a veneer wouldn't be enough.

A tooth-colored crown covers the whole tooth, strengthening it as well as improving how it looks. See aesthetic dental crowns.

Side by Side

Putting It Together: A Smile Makeover

A smile makeover combines treatments in a sensible order. A common sequence is: treat any decay or gum disease, move the teeth with aligners if needed, whiten, then place bonding or veneers matched to the new shade, with gum recontouring planned before veneers where it's part of the plan. See cosmetic smile makeovers.

What Happens at a Cosmetic Consultation

• We listen first. You tell us what you'd like to change, and what you like as it is.
• We examine your teeth and gums, because cosmetic work needs a healthy foundation.
• We set out the options that genuinely fit, with the time and cost of each, and no pressure to decide on the day.

Common Questions

Which cosmetic treatment should I start with?

Usually the most conservative one that meets your goal. Whitening often comes first, because bonding and veneers are matched to the shade of your natural teeth and don't whiten afterwards.

Are veneers permanent?

Porcelain veneers need a thin layer of enamel removed, so a tooth that has had one will always need a veneer or a crown. With good care they last many years, and they can be replaced when needed.

How long does a smile makeover take?

From a single visit for bonding to several months if clear aligners come first. We'll set out the order and timing at your consultation.

Does insurance cover cosmetic dentistry?

Treatment done purely for appearance usually isn't covered. Where a treatment also repairs damage, such as a crown on a broken tooth, some plans contribute. You'll get a written estimate before anything begins.

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