What are the costs, benefits and drawbacks to cosmetic dentistry?

March 29, 2006 1:31 PM

I have terrible looking teeth and I'd like to fix them and finally have a nice white straight smile for the first time in my life. After doing research, it seems my options are braces (ugh, I'd be one of those dorky 35 year olds with braces), veneers, and caps (are there any other options?). What I'm curious about is the ballpark costs, benefits, and drawbacks of veneers and caps. All info online seems to be tainted by cosmetic dentists looking to make a buck.

About me and my yellow country teeth: I never had a dental plan until I was about 25, so I went to a dentist only twice in my life before that age. I found someone I liked and got my teeth and gums healthy again, but since then I've lagged a bit and my wisdom teeth (finally coming out soon) pushed my front teeth all over the place. I've cracked a lower front tooth and there is a hairline crack on one of my front top teeth from all the pushing and movement.

I'm thinking that capping everything in front of my molars top and bottom is going to be the way to go, but I'm curious what quality of life issues might arise. Will I be able to chomp into apples? Is it harder to floss capped teeth in the front (it seems harder to floss a molar I cracked 5-6 years ago and capped)? Will I constantly be worrying about losing a cap or chipping them? Does it hinder future dental work at all?

Also, what sort of ballpark cost range and time am I looking at? 5 grand? 10 grand? 20 grand? Will it be over in a matter of weeks or will the process take months?

Are veneers worth looking into? I assume they are probably cheaper, but are there more drawbacks of just having the fake front part showing?

Am I being lazy by wanting to just revamp my entire smile all at once? Is going with braces the best long-term life option that I should just suck up and endure for the next few years?

Lastly, I'm terrible at spotting fake cosmetic things in general. I can't spot a toupee, I usually believe 60 year old men still have jet black hair, and I've never noticed anything fake in hollywood smiles (aside from the whiter-than-white trend lately on TV hosts). Will my smile look fake to people?

posted by anonymous to health & fitness (21 comments total)

I can't answer all of your questions but on a recent visit to the dentist I was quoted about 1000/tooth for Veneers. So cheap - when it comes to cosmetic dentistry - I suppose is relative.
posted by Wolfie at 1:41 PM on March 29, 2006

There was an FPP about this a while back, I couldn't find it, but here's the relevent article.
posted by Floydd at 1:47 PM on March 29, 2006

a veneer involves scraping away the surface of your natural teeth. Think long and hard about getting it done. I had it done on *one* tooth, and had nightmares for years afterward that my teeth were falling out. To this day, one side of it doesn't look right from profile view. I'm almost certainly the only one who notices, but I notice. I'd get something reversable like caps.

What about invisible braces, or braces on the inside surface of your teeth? Maybe it's too late for that, but maybe not? I'd get a free consultation with a few orthadontists who work with adults (i.e. who *don't* specialize in children's work). Make sure they have good references and that their portfolio of work is impeccable - that portfolio is their *best* work, it should be perfect.
posted by lorrer at 1:56 PM on March 29, 2006

Braces and plain-jane teeth whitening is the way to go. All the other options are permanent fixtures. Braces eventually get removed.
posted by frogan at 2:08 PM on March 29, 2006

Find a good dentist who works with the Invisalign system of braces - these are clear retainer-like things that you wear all the time. That dentist can tell you if you are a good candidate for this system (not everyone is, so I'm told). They straighten your teeth, but without wires. Because you wear the retainer trays all the time, you can also look into bleaching (whitening) your teeth to get a whiter smile.
In general, I think more extensive surgery (caps or veneers) is riskier - but more research on your part may have you thinking differently.
Also, although you may not be able to spot the fakes, others can - another reason braces and whitening might work best for you (not all of us have - or would look right with - perfectly white teeth).
posted by dbmcd at 2:09 PM on March 29, 2006

Veneers are like ceramic plates for teeth - and they don't particularly look natural. Tom Cruise wore clear braces, and his teeth look great.
posted by The Jesse Helms at 2:10 PM on March 29, 2006

My teeth started to shift in my late twenties, and so I bit the bullet and opted to wear braces. (Which I'd already had once, as a teen.) I'd just moved to a new city and was absolutely convinced that I was going to be a social pariah. Quite the opposite was true: it seemed that everyone wanted to talk to me. In fact, the only time I've ever been asked out by a total stranger on the street was on my way home from the orthodontist after having them put on. Maybe there's something about being an adult with braces that demonstrates confidence? Or it's a novelty? Maybe you stand out from the crowd? Mine were clear on the top row and the usual silver on the bottom row. You couldn't really see them from more than a conversational distance.

I'm not saying it was a lot of fun to have braces as an adult, but it certainly wasn't as bad as I'd expected. And the entire experience of braces wasn't nearly as uncomfortable and frustrating as having one tooth capped.

A friend of mine had the InvisAlign braces and loved them.
posted by hsoltz at 2:22 PM on March 29, 2006

My wife had terrible teeth, the result of malpractice by her childhood dentist. We saw the Cerec system on TV and found a dentist here in Canberra, Australia that uses it.

It was about AUS$7000 for a full mouth workup - replacing amalgam fillings, repairing decay, and colour-matched ceramic caps and veneers modelled in 3D to precisely fit her mouth and teeth. It looks friggin' amazing - can't recommend it highly enough.

No idea if this sort of thing is cheaper here or in the US - if it's a lot cheaper here, might be worth taking a holiday! See here to find a practioner, or just Google around.
posted by obiwanwasabi at 2:23 PM on March 29, 2006

I had veneers done on my four front teeth, and I would recommend against if you have a better option. The procedure itself was horrible, but a big part of that was the dentist I went to. The teeth looked absolutely beautiful afterwards, and I always got compliments on my smile. However, gums recede with age. This means that eventually the edges of the veneers will show. I was told that if this happened, the veneers could be redone, easy, no problems. This is not the case, as I now understand it. Had I known this, and had I not been an ignorant teenager, I would have looked at other options.

The quality of the veneers depends hugely on who does them. I knew an anesthesiologist who always made it a point to ask patients who did their veneers when he ran across especially nice ones. (Whether a patient has veneers/etc. is a standard question.)

And cheap? No.
posted by moira at 2:33 PM on March 29, 2006

ugh, I'd be one of those dorky 35 year olds with braces

Hey, who you callin' dorky? (Besides, some people find them rather fetching -- my boyfriend jokes about finding them so adorable that he might break up with me after they come off, since he's only known me with braces.) Seriously, once I got my braces on, I've noticed how common it is for adults to have them -- and the only comments I've gotten about them have been positive (lots of people even ask who my orthodontist is, because they're considering getting them too).

Is going with braces the best long-term life option that I should just suck up and endure for the next few years?

It's certainly what I did -- I was advised that no amount of Invisalign, veneers, etc. would properly fix my teeth or my bite, and that braces (plus upper and lower jaw surgery, in my case), were my best chance at lifelong correction. (If you want to feel self-conscious, trust me, braces are nuttin' compared to having your jaw wired shut and being bruised from eyes to chin for four months.) It's been a long, expensive, and sometimes very painful process, but I can tell you I would do it all over again in a heartbeat.
posted by scody at 2:45 PM on March 29, 2006

Cerec is good for repairing a damaged tooth that needs an in lay or a crown. It's not good for the type of work the poster is considering.

I've had the Cerec work done that obiwanwasabi mentions. I've also had a more traditional crown done. Please, give me the Cerec anytime. Thanks for the link obi, I may just switch dentists to get back with one who uses it.
posted by onhazier at 2:48 PM on March 29, 2006

Yeah, don't do veneers or laminates. They can break. Painfully. And unexpectedly. Trust me on this. (It was just a fajita! Not even a particularly tough fajita!!) And every time they have to be repaired, they have to scrape off even more of the real tooth. And you'll be more cold- and heat-sensitive, and they'll never look quite right.

I don't know firsthand about caps, but if there's any chance at all that your problem can be corrected with braces, leaving the real teeth in place instead of inferior substitutes (and all the substitutes are inferior to the real thing), then get some braces.

Look at it this way: the braces, if nothing else, will be temporary. Anything else you do you'll have to live with forever.
posted by ook at 3:17 PM on March 29, 2006

I see a lot of nasty talk about veneers here. My dentist has been trying to get me to get these new veneers that are supposedly much less of a hassle to get put on, and look great. The pictures they showed me are impressive, and they insist there's no scraping, etc.

They're called Lumineers and the website does say that there is no scraping, grinding or shaving of the teeth.

They sound great, but I don't know anyone who's tried them, and right now I just don't have the money to do it. My 2 teeth that are between the front teeth and canines are for some odd reason somewhat short. As a result, if I smile just right (which happens more often than not, unfortunately), I look like I may be missing one or two teeth. I'm interested, but haven't tried.

Whatever you choose, I hope you post a followup!
posted by twiggy at 3:21 PM on March 29, 2006

People are mentioning invisalign (invisilign?), so I wanted to note that there have been 1 or 2 threads devoted to that:
http://ask.metafilter.com/mefi/27398
http://ask.metafilter.com/mefi/33624
posted by inigo2 at 3:25 PM on March 29, 2006

The other problem with veneers and caps is that not only are they initially expensive, the maintenance is also expensive. I read that veneers have to be replaced every ten years or so. So the $1000/tooth, that's $1000/tooth/decade. What if you find yourself in bad financial circumstances in 10 years and you have a dozen $1000 (+ inflation!) veneers that need replacing? uh oh.

Why not consider braces to straighten the teeth and bleaching to whiten them?
posted by clarahamster at 3:39 PM on March 29, 2006

My veneers have broken a couple of times. And yeah, it's less than pleasant when it happens, and having them fitted is less than pleasant. I'm still leery of taking a bite out of an apple. I have the odd dream about teeth falling out, which sounds nasty, but I have worse dreams about a lot of totally random stuff a lot of the time.

And, I don't get hung up on what people are thinking about my teeth when I smile, and it's worth it every day for that. On close inspection they might not look real, but they look a lot better than they did.

Take your dentists advice, get photos of what results you can expect, and think about it of course, but don't be put off it just because of minor hassles, especially if you have hang-ups about the way things are now.
posted by edd at 4:04 PM on March 29, 2006

I guess I'm the only one with a positive veneer experience, but then I also didn't really have a choice about getting them. My permanent teeth have been weak since they first emerged, and when the orthodontist removed my braces, he also managed to remove large pieces of my front two teeth in top. My regular dentist did a very nice job with the tinting and application process, and the universal reaction from the people I've told about the veneers has been that they've never noticed them at all.

That said, my cousin also got a veneer after one of her teeth were damaged in a car crash, and that one is noticeable. I think it largely depends on the skill of the dentist.

Oh, and mine seem to have been rather inexpensive when compared to the quotes above--$450 per tooth. I did have some trouble in the first couple of months, as there was a defect in the glue, but I haven't had any problems at all after the re-gluing.
posted by Trinkers at 4:07 PM on March 29, 2006

You're not alone Trinkers, I love my veneers on my two front teeth. The process wasn't particularly painful or scary for me, but I don't know that I'd want to do a whole mouth full of 'em.

I got my original old school composite veneers when I was 8 (this was the mid-'80s and my dentist told my mom it was the best/only option for minor discoloration -- in retrospect I probably didn't really need them). But everyone is right, once you have them you're stuck with them.

I had them replaced when I was 24 with gorgeous porcelain ones. When I got them replaced I was a little self-conscious for the 10 days b/w when they removed my old ones and put my new ones on. That said, I get tons of compliments on my teeth and people are really surprised they're veneers. Definitely depends on the dentist.

Oh, and no problems with flossing or eating, but I've basically had them for as long as I can remember so maybe I'm used to them.
posted by awegz at 4:23 PM on March 29, 2006

As one who has caps: I had them done more than 2 decades ago, and have only had 2 replaced. It's no fun at all having the work done, but if you take good care of your teeth & gums, they're not much different from your own teeth. I eat apples, corn on the cob, and mostly don't give them a second thought. They haven't broken, pulled loose, chipped, or anything like that.

Having said that, if your own teeth are HEALTHY, do everything you can to fix them, because you can't go back.
posted by clarkstonian at 4:31 PM on March 29, 2006

I think braces are the go. You want to do what ever you can to keep your original teeth. Most caps and veneers involve removing (or as my old boss, a dentist, used to say amputate) part or all of your teeth. CAMed ceramics (like from a CEREC) are good, especially if they are implants, but they still aint teeth.
posted by dantodd at 4:34 AM on March 30, 2006

I'm sorry for this self-link. But I *just* wrote a blog piece about my daughter's braces and my wife's teeth whitening exploits (most importantly, I show before and after pictures --aren't they beautiful!). There was simply too much synchronicity here. I had to do it.

That being said, I agree. Braces eventually come off. Well, your veneers may eventually come off too. And that's the problem. I would go with braces. As an adult you can possibly get them placed behind your teeth.
posted by Taken Outtacontext at 1:49 PM on March 30, 2006