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Cosmetic dentistry at Vizcaya Dental Arts covers whitening, composite bonding, porcelain veneers, and the orthodontic and crown work that often goes with them. We think all dentistry should be cosmetic, so every filling, crown and implant we make is meant to look like it belongs. The treatments below are the ones done for the sake of the smile. The right plan depends on what you want to change and on why the teeth look the way they do, and the least invasive treatment that gets you there is the one we recommend.
What would you like to change?
It helps to name the concern precisely, because each one points to different treatments:
- Color. Teeth that are yellower or darker than you would like, or one tooth darker than the rest.
- Alignment. Crowding, rotation, teeth that lean or overlap.
- Shape and size. Teeth that look too small, too short, uneven in length, or worn flat.
- Gaps. Spaces between teeth, or the small black triangles that open near the gum.
- Chips, wear and missing enamel. Edges that have broken or eroded.
- Old dental work. Fillings or crowns that have discolored or never matched.
Healthy gums and a workable bite come first
Two things come before any cosmetic treatment. The first is health: active decay or gum disease is treated before anything elective, and for veneers in particular the gums must be healthy and stable before a tooth is prepared. In our experience that produces the best results and the least recession afterward.
The second is the bite. Worn and chipped front teeth very often have a bite problem behind them, and porcelain placed on top of that problem will chip too. In those cases the teeth are moved into a bite that works, usually with Invisalign, before they are restored. It takes longer, and the result lasts.
Which treatment addresses which concern
Whitening changes color only. It is the simplest treatment we offer and often the only one needed. We favor custom trays worn at night, a slow course with little sensitivity. See teeth whitening.
Invisalign changes position. If the teeth are healthy and well shaped and only crooked, alignment plus whitening gives an excellent and minimally invasive result, with nothing added to the teeth. Dr. Patricia Hong, our board-certified orthodontist, plans that treatment; see Invisalign.
Composite bonding adds shape to one tooth or a few: a small lateral incisor brought into proportion, a gap closed, a chip rebuilt, a black triangle filled. Done in the chair, usually without removing enamel, best for single teeth and limited changes. See composite bonding.
Porcelain veneers change shape, size and color across several teeth at once, when the problem is the tooth itself: worn, short, undersized or too dark for whitening to fix. Designed with a master ceramist, more durable and more lifelike than composite, and a permanent commitment. See porcelain veneers.
Crowns cover a whole tooth and are chosen when the tooth is too weak for a veneer because of large fillings or cracks. We routinely combine crowns and veneers in one smile, and from the front they look the same. See dental crowns.
Implants and bridges replace a tooth that is missing from the smile. A front tooth lost to an accident or an old failed root canal is as much a cosmetic problem as a functional one, and the shape of the gum around the replacement decides how natural it looks. See dental implants.
The order of treatment
- Alignment first, because moving teeth changes what the rest of the plan needs, and sometimes removes the need for it.
- Whitening next, so the final shade is set before anything is matched to it.
- Then bonding or porcelain, only for what alignment and color did not fix.
Some patients arrive asking for veneers and leave, after Invisalign and whitening, with a smile they like and no porcelain at all. Others finish orthodontics and whitening and find that the shape, the wear or the missing enamel was the problem all along, and for them veneers are the right final step. In both cases the simpler options were tried first.
Seeing the plan before committing
For bonding and veneers, photographs and a digital scan go to the laboratory, where a master ceramist designs the proposed teeth as a wax-up. You see it, you can ask for changes, and in many cases we transfer it into your mouth as a temporary mock-up so you can judge the shape and length on your own face. For veneers, the temporaries you wear for two or three weeks are shaped from the same design, and anything you would adjust is passed to the ceramist before the final porcelain is made.
What a cosmetic consultation involves
You tell us what you would change. We examine the teeth, the gums and the bite, take photographs and usually a digital scan, and show you what we see on the screen. You leave with a written plan that names the options, the order we recommend and what each would cost, and you decide at your own pace. Many patients come to us for a second opinion after being offered more treatment elsewhere than they felt they needed, and our plan is often the shorter one.
Who does what
Dr. Flavio Kottar plans and carries out the restorative and cosmetic work: whitening, bonding, veneers, crowns and implants. Dr. Patricia Hong, our board-certified orthodontist, plans and supervises Invisalign and braces. When a smile needs both, as it often does, they plan it together in the same office, so the alignment is designed with the final restorations in mind and the plan does not pass between two practices. The porcelain itself is made by a master ceramist at the laboratory we have worked with for years.
Natural or noticeable
Patients differ in what they want a smile to say. Some want teeth that look like naturally beautiful teeth, a little lighter, with the small irregularities and translucency that make real teeth look real. Others want a smile that people notice, brighter and more uniform. We design for you.
The years after
Every cosmetic treatment needs upkeep:
- Whitening needs a maintenance night or two a month.
- Bonding needs repolishing every year or two and is eventually redone.
- Veneers need a retainer at night and ordinary care, and in our experience serve for twenty years or more before they are replaced for cosmetic reasons.
- Orthodontic results need retainers for life.
We go through those facts at the start, because the right treatment is the one you will still be happy with in ten years.
Frequently asked questions
Does insurance cover cosmetic dentistry?
Generally not for treatment done purely for appearance: whitening, bonding and veneers on healthy teeth. It often contributes when the same tooth needs treatment anyway, for example a crown on a broken tooth or orthodontics with a functional reason. We check your benefits and give you a written estimate before anything starts.
How long does a smile makeover take?
Whitening takes a few weeks. Bonding takes one or two visits. Veneers take about a month from the design visit to bonding. If the bite or alignment has to be corrected first, Invisalign adds months to the plan, and that is time well spent, because porcelain placed on an unresolved bite does not last.
Can I just whiten my teeth?
Very often, yes, and it is where we would start. Whitening changes color without touching the teeth. If the shape and alignment are fine, it may be all you need. If they are not, whitening still comes first, so that any bonding or veneers are matched to the lighter shade.
Veneers or crowns?
A veneer covers the front of a tooth and relies on sound enamel. A crown covers the whole tooth and is chosen when the tooth is weakened by large fillings or cracks. Many smiles combine both, and the finished result looks the same from the front.
Am I too old for cosmetic dentistry?
No. Worn, shortened and darkened teeth are precisely what older patients ask us about, and restoring them is some of the most satisfying work we do. The planning is the same at any age: healthy gums first, a workable bite, and a design that suits your face.
Will my teeth look fake?
Only if that is what you want. We lean toward natural-looking results, with the translucency and slight variation that real teeth have, and a master ceramist builds that detail into porcelain by hand. If you prefer a brighter, more uniform smile, we will tell you how far we can go before it stops looking real, and the choice is yours.
