When it comes to restoring both the beauty and functionality of a smile, two of the most commonly used techniques are porcelain crowns and veneers. Why? They consistently deliver beautiful, natural-looking results that are permanent and require very little maintenance. And while they have many things in common, they also have just as many differences.

The Similarities

Here are some facts that apply to both porcelain veneers and crowns:

• Both enable changes to a tooth's color and shape.
• Dental laboratory technicians use precise molds made by our office to hand-craft porcelain veneers and crowns.
• Both are made using high-quality dental porcelain.
• Neither respond to tooth whitening products — the color of the veneer or crown remains the same color as the day it was placed.
• Neither procedure is reversible once completed.

The Differences

Here are some of their differences:

• Crowns are used to replace a larger amount of tooth structure while veneers are thin shells that are placed over the front surface of teeth.
• Veneers require much less tooth preparation (reduction by drilling) than crowns.
• Crowns allow for greater change of tooth shape, while veneers allow for more minor changes.
• Crowns are generally used to restore teeth that have lost tooth structure from decay or trauma.
• Veneers are generally used where teeth are structurally healthy and intact, but color and shape change are required.
• Veneers are used mostly for teeth that are visible when smiling, while crowns can be used to restore virtually any tooth.

Want To Learn More?

To learn more, read the Dear Doctor article, “Porcelain Crowns & Veneers.” Or, you can contact us to discuss your questions or to schedule a consultation.

When you begin a smile makeover in our office, you are embarking on an exciting partnership with my laboratory technician and me. You should be full of excitement and anticipation — if you have been dissatisfied with your current smile, and you have great expectations for the results of this project. You will really like what you see in your mirror.

Being completely satisfied with your new look depends upon successful communication — between you and me and also between my dental lab technician and me. As you might expect, your perceptions of how your teeth appear are different from a dentist's perceptions. My education leads me to think of factors that untrained individuals probably won't consider, such as crown (tooth) length, midlines (how the teeth line up with other facial features) and the distance from gum to lip.

It is helpful to be able to describe what you like and don't like about your current smile, and what changes you would like to see. Using visual aids is a good idea. Bring photos and magazine illustrations to show what you have in mind. (Remember that we cannot make you look exactly like a celebrity or anyone else. The pictures are guidelines.)

Things to think about:

• The color, size, shape, alignment and spacing of your teeth.
• How much of your teeth and gum tissues show when your lips are relaxed and when you smile.
• Tooth color: bright “Hollywood” white or more natural looking off-white.

Your makeover is more likely to meet your expectations if you get an advanced view of the results. Computer imaging is one way to do this. Another is for us to make a mock-up of the proposed dental work in tooth-colored wax on models of your mouth.

Finally, a “Provisional Restoration” can be used as a test to make sure that what I envision is also what you, the patient, want to see. A provisional restoration, made from temporary materials, gives you a chance to test out the changes and make sure they work for you — that they not only look good, but they are also functional in terms of biting, chewing, speech, and gum health.

If the provisional restoration works, it is used as a blueprint to make durable and long lasting porcelains in the same design. We will take impressions of the provisional restoration and communicate the relevant information to a dental laboratory technician, who will make the final porcelain tooth replicas for your new smile.

Competent communication and a provisional restoration will put you on track to meet your expectations and obtain the most aesthetic and functional result in your Smile Makeover.

Contact us today to schedule an appointment to discuss your questions about Smile Makeovers. You can also learn more by reading the Dear Doctor magazine article “Great Expectations — Perceptions in Smile Design.”

We have noticed that there are two types of patients when it comes to enhancing a person's smile. One type, which we'll call the “Perfect Minded” patient, expects teeth that are completely regular in their arrangement and of maximum whiteness and brightness, often beyond the range of traditional guides for tooth color. They are looking for a perfect “Hollywood” smile. The other, the “Natural Minded” patient, is looking for a more natural look. This person expects a general sense of regularity and alignment of teeth with definite brightness, but not so much that the teeth are noticeable before and above other facial features. Which type are you?

The “Perfect Minded” Patient
While you expect maximum regularity and alignment of teeth along with maximum whiteness and brightness, the “perfect minded” patient requires a smile completely symmetrical (balanced from one side to the other). If we drew a vertical line down the center of your face (midline), it would fall directly between your front teeth and your smile would look just the same on each side of the line. You also expect your smile to be horizontally symmetric, so that it matches the curvature of your lower lip and the gum lines match from side to side.

The “Natural Minded” Patient
You are looking for a more subtle, natural look produced by including some minor irregularities in your look. Like the “Perfect Minded” individual, you still expect your teeth to be generally regular and well aligned but you also want to have some minor asymmetries (not matching) as you move farther back along your jaw to make your teeth look real. Your preference in tooth color is not a super shade of white, but for a tooth color that looks very natural for your facial skin and hair color.

There is no right or wrong here. What is important is to be sure to communicate your expectations to us before embarking on a program of smile redesign.

Contact us today to schedule an appointment to discuss your questions about Smile Design. You can also learn more by reading the Dear Doctor magazine article “Great Expectations — Perceptions in Smile Design.”

Your smile is one of the first things people notice, but if your pearly whites have lost their luster, chances are you might be hesitant to show them. As we age, our teeth naturally darken, and certain substances can leave teeth stained or discolored, making you appear older. One easy way to turn back the clock is to have your teeth whitened; a safe, painless, and non-invasive way of achieving a young, healthy-looking smile.

Causes of Tooth Discoloration: Exposure to high-levels of fluoride and taking tetracycline antibiotics during childhood can stain the teeth's structure. Smoking cigarettes and using chewing tobacco can also cause tooth discoloration, as well as foods containing tannins such as red wine, coffee and tea. In addition, poor brushing techniques and not flossing regularly cause bacteria to build on teeth resulting in yellow stains.

The Whitening Process: Our office can help you to achieve a brighter smile using either an in-office procedure or an at-home whitening kit. We can help determine the best treatment for your budget, time frame and individual needs. If you choose to have professional whitening done in our office, we will utilize a prescription strength gel sometimes even activated by a concentrated light source. This procedure offers immediate and long-lasting results in less than an hour. After a single treatment, teeth are typically six to ten shades lighter and with proper maintenance, can last five years or longer.

At-Home Results: For those seeking more gradual results, another option is to use custom-fit trays, which our office will make for you to use at home to whiten your teeth. This is generally less expensive, and is very effective at lightening teeth several shades, although it may take a week or longer to see optimal results.

Choosing the Best Procedure: For some people, teeth whitening may not offer adequate results. If you have thin enamel, chipped, uneven or crooked teeth, we may recommend applying porcelain veneers to restore your damaged teeth. Veneers are bonded to the front of teeth to give your smile a straighter, more uniform appearance.

Contact us today to schedule an appointment to discuss any questions you may have regarding teeth whitening. Read more about this topic in the Dear Doctor magazine article “Teeth Whitening: Brighter, Lighter, Whiter.”

If you are pleased with your smile except for that one front tooth that appears darker, then we have good news for you. Often a tooth appears darker as a result of trauma that may have occurred years ago. Your tooth may need root canal treatment or may have already had root canal treatment in the past. Regardless, you can whiten this tooth via a process called internal bleaching. And as the name suggests, the tooth can be bleached from the inside out. Here's a brief summary of how this entire process works:

1. Performing an x-ray exam: The first step is to take a radiograph (x-ray) to make sure that your root canal filling is intact adequately sealing the root canal and the surrounding bone is healthy.
2. Making an access hole: To apply the bleaching agent, a small hole will need to be made in the back of your tooth to apply the bleach. However, before doing that, the area must be thoroughly cleaned and irrigated.
3. Sealing above the root canal filling: This step is critical to prevent the bleach from leaking into the root canal space.
4. Applying the bleach: To obtain the whitening needed, it typically requires between one and four office visits for additional bleaching.
5. Applying a permanent restoration: Once your tooth has lightened to the desired color, a permanent filling will be placed over the small hole to seal your tooth's dentin. This is then covered with tooth-colored composite resin (filling material) so that the access hole is undetectable to the naked eye.

To learn more about this procedure and see amazing before and after images, continue reading the Dear Doctor article, “Whitening Traumatized Teeth.” Or, you can contact us to discuss your questions or to schedule an appointment.