Q & A with Dr. V

In answer to your question, porcelain veneers would be a great option for you in achieving a more symmetrical, even, and brighter smile. The amount of veneers you need depends on how widely you smile. In most cases this is 8 or 10 veneers. In your case, because we would be shifting the midline of your teeth to align with the midline of your nose 10 would be best as a starting point. The procedure takes multiple office visits. It starts with a planning phase where take impressions and photographs and we get a mockup from the lab where we can create a trial smile. You can actually see in our mouth what your smile with veneers would look like. Then after your teeth are prepared you wear temporaries for a few weeks and come in for your final restorations to be cemented permanently. This is definitely a shorter course of treatment than orthodontics or Invisalign and can achieve are more dramatic result in terms of changing color shape and overall aesthetics. Good luck! Follow us for more information.

There has been so much advancement over the years with the material we use for restorations. Whereas before metal/porcelain restorations were standard now all-porcelain restorations are the gold standard for aesthetics! In smile transformations, this is a very common questions. The short answer here is that the material used is generally the same. A veneer covers the front surface and a crown extends 360 degrees around the tooth using the same exact material in most cases. Smile design is not just about creating a beautiful smile but function as well. In determining where a crown or veneer will be placed we look at things like bite and wear and existing decay.

We always have a blueprint for the smile before we start. The way we do this is take impressions and photographs and send them to the lab. The lab will then do a 'wax-up or a mock-up in wax of the smile before we start. Once they look at the function of your smile and how your teeth come together they can determine where placing a crown or veneer would be best. Since the materials are generally the same, it isn't a major concern in terms of the aesthetics of the smile. It has more to do with function and longevity. That's something your dentist and ceramist can help decide.

My recommendation would be Invisalign or ortho first to correct your malocclusion. See an orthodontist or talk to your dentist about correcting this first with clear aligners like Invisalign. They are completely different than conventional braces with brackets and wires. A lot more comfortable and easier to keep clean. Then once you are finished, your dentist can evaluate your smile after your teeth are in the proper position for veneers if you are still unhappy with the overall aesthetics. This is a very common treatment sequence--first ortho and then veneers.

Typically in planning a smile design case we get a mockup or wax up on a model first. That is then used to fabricate temporaries. Adjustments can be made at this phase to make sure you are comfortable with the aesthetics and bite/function. Then the finals are made to replicate these. So there are usually many checkpoints along the way to ensure you are happy with your veneers. Then the finals are looked at with try-in temporary cement before cementing them. If however you are not comfortable with them after giving yourself a few weeks to adjust to them they can definitely be slightly shortened or recontoured. Talk to your dentist. There are options to make sure you're comfortable!

Congratulations on making a positive improvement to your smile! Porcelain restoration are the aesthetic standard now and most dentists will do metal-free dentistry whenever possible. My recommendation for the front tooth would definitely be the Emax. It transmits light so much better and has a better aesthetic quality to it. The zirconium substrate is normally used where you need more strength, such as if you're grinding your teeth. If that is the case you can layer Emax on top. Discuss the options with your dentist. In my experience, the lab is usually able to get a very nice custom shade match for one tooth. Single teeth in the front can be tricky to match because of all the nuances in color we have in our teeth but a good ceramist will be able to do it with ease. You do not have to get veneers on all your adjacent teeth unless you are unhappy with the shape, size or sever discoloration of them. Typically, occasional in-office whitening and at-home maintenance with whitening trays or strips will keep the color of your smile even and most people don't notice a difference.

Be patient! Starting any type of dental treatment (whether it be with braces, Invisalign, or other treatments) will not be completely comfortable at first. The first few days of having something foreign in your mouth are always an adjustment. The trays take a few days to really settle in and fit well. Bite on gauze or cotton throughout the day. Doing this the first few days may help seat the trays properly. Pressure and time are what move teeth. After a few days if you're still uncomfortable it's possible there are some sharp edges they need to be adjusted. You can ask your Invisalign dentist to smooth out the edges of the tray or an at home remedy we sometimes recommend is using a clean nail file and gently smoothing out a rough spot.

Hello and thank you for reaching out in regards to your dental concerns. Unfortunately, there isn't much of an alternative besides partials (other than more costly implants/crowns/bridges). Have you tried to look at a nearby dental school for treatment? Some dental schools can help you at little to no cost by being one of their patients. This may require a bit more time on your part, but it may be a good option for you and you'd be helping a future dentist as well! And don't worry, every dental student is supervised by a treating dentist so you'll be in trusted hands. Just a suggestion! Alternatively, if you haven't already spoken to your dentist about payment plan options, be sure to do so.There are many medical/dental financing companies that can allow you to make payments. You may qualify for this on your own or by using a co-signer, but it's a wonderful option you may want to look into if you haven't already.

So sorry to hear about your aligners. We always tell our patients the best way to clean your aligners is to use a tooth brush and toothpaste to clean them, Invisalign cleaning crystals, or FreshGuard(denture cleaner found at local pharmacy stores with lukewarm water. Since it is your first set, call your Invisalign provider and have them order you a replacement aligner. There should be no extra cost to you, but every office has their own policy. If this were to happen to you again or if you lost a tray during your treatment please remember to wear your last active aligner to hold your teeth in place until you receive the replacement tray.