The short version
- Start from what is wrong, not from the treatment you have heard of.
- Color alone is whitening. Shape as well is veneers.
- A damaged but present tooth is a crown, which costs less than replacing it.
- Genuinely crooked teeth are orthodontics, and it comes before cosmetic work.
- Health problems are treated before anything cosmetic goes on top.
- Color only
- Whitening
- Shape too
- Veneers
- Damaged
- Crown
- Missing
- Referred out
People arrive asking for a treatment when what they have is a problem. Matching the two saves money more often than it costs it.
Start from what is actually wrong
| The problem | The treatment |
|---|---|
| Only the color has changed | Whitening |
| Shape, chips, gaps or worn edges as well | Veneers |
| A tooth is damaged but still there | A crown |
| Teeth are genuinely crooked or the bite is affected | Orthodontics |
| Too much gum shows, or the gum line is uneven | Gum contouring |
| A tooth is missing | Implant, referred out |
That table does most of the work. What follows is why each row is what it is.
Only the color is wrong
The teeth are well shaped, well aligned and sound, and they have darkened.
Whitening. It is the cheapest treatment here and the right one, and anything more is spending more to fix less. See in-office teeth whitening.
The shape is wrong too
Chips, gaps, uneven lengths, worn edges, or discoloration whitening will not lift.
Veneers. A thin shell over the front of the tooth resets color and shape together, which is the only treatment that does both at once. See what dental veneers are.
The tooth is damaged
Cracked through, heavily filled, broken below the visible surface.
A crown, which encases the whole tooth rather than covering its front and carries the bite load. A veneer on a tooth that needs a crown is a repair that fails. See dental crowns.
This is also the row people most often get wrong in the expensive direction, by assuming a damaged tooth must be replaced when it can be saved.
The teeth are in the wrong place
Genuinely crooked, crowded or badly spaced, with a bite that is affected.
Orthodontics moves teeth over time. Veneers do not move teeth; they change the surfaces the eye reads, which suits a cosmetic complaint and not a structural one.
The sequencing matters here more than anywhere. Cosmetic work done before the teeth are in position gets done twice.
Too much gum
A smile where the gum dominates, or where the gum line sits at different heights over adjacent teeth.
Gum contouring, with a soft tissue laser, usually in under an hour. See gum contouring.
The tooth is gone
Implants replace missing teeth: a post placed in the jaw carrying a replacement. Nothing cosmetic substitutes for a tooth that is not there.
Dr. Back treats the teeth you have; a case that needs implants is referred to a specialist.
Where cases overlap
Most real cases are not one row of that table.
Teeth that are both stained and slightly uneven can go either way, and the answer depends on which bothers you more and what you want to spend. Teeth that are chipped and also crowded may need orthodontics first and veneers afterwards, in that order.
Three sequencing rules cover nearly everything:
- Health before cosmetics. Decay and gum disease are treated first. Cosmetic work over an untreated problem conceals it.
- Position before surface. Orthodontics before veneers, or the veneers get remade.
- Color before porcelain. Whiten the natural teeth first, then match the veneers to their final shade.
What settles it
An examination. Not a photograph, not a price list and not a web page, including this one.
Dr. Back looks at the teeth, the gums and the bite, and says what the case calls for, which is regularly the less expensive option.
Sarasota Smile Design is on Clark Road in Sarasota, an easy drive from Nokomis, Osprey and Venice, open Monday to Thursday.
Call 941-927-5411, or see what the practice treats.
