Are braces, crowns or veneers right for you?

Source: Best Health Magazine, March/April 2010

Maybe you missed getting braces as a kid, or that gap-toothed smile that looked adorable in university isn’t sitting right with you anymore. If so, it could be time to go to the dentist for some cosmetic work.

Of course, not everyone wants or needs perfectly straight white teeth. But if you do, braces, veneers or crowns can help, says Dr. Ira Kirshen, a dentist and president of the Ontario Dental Association. ‘These three procedures are extremely safe and beneficial.’

What’s involved? ‘We determine if the teeth are too big or small [for the client’s facial proportions]; too white or not white enough; and, most importantly, if the position of the teeth is proper in relation to the lips and face,’ says Dr. Sol Weiss, a Toronto dentist. Here’s what else you need to know.

What you need to know about crowns

They’re ideal if: You have a damaged, cracked or badly chipped tooth, a very large broken filling that can’t be replaced or significant wear from grinding or clenching, or if you need to replace an old crown.

What are they? Also known as ‘caps,’ crowns protect teeth from further damage while making teeth more aesthetically pleasing. They encompass the entire unhealthy tooth (the original tooth is filed to make room for the crown), and can change its shape and position. Today’s crowns are made from a variety of materials including porcelain over a zirconia base, or solid porcelain (avoiding the old-generation problem of metal shine-through, or the black line around the tooth where it meets the gum). A crown can be made in myriad shades, says Weiss, then ‘fine stained’ to add trans­lucencies and white spots to make it look as natural as possible.

What’s new: Some dentists now make crowns in their offices, eliminating the need for multiple appointments. Typically, though, crowns are made by an outside lab.

Time commitment: You wear a temporary crown for about a week before getting your permanent crown.

Expiry date: Most crowns will last 10 to 15 years, though they may last longer.

Cost: $900 to $2,500 per tooth, depending on individual circumstances.*

What you need to know about veneers

They’re ideal if: You want to change a tooth’s shape, size, position or colour, says Weiss. However, Calgary dentist Gordon Chee cautions, ‘Sometimes we have to resolve any bite problems first.’

What are they? A veneer is a thin wafer of porcelain that covers the front of a tooth. When determining how many teeth a patient will need to have coated, dentists consider how the teeth fill out your smile. ‘Most people need eight to 10 veneers,’ says Chee.

What’s new: Some dentists now have digital impression machines that scan a patient’s teeth. This can be emailed to the dental lab, making the process faster.

Time commitment: Veneers can take 10 days to create and require removal of part of the tooth’s enamel. You’ll wear temporary veneers while your permanent ones are being prepared. Galan says he prefers to have clients wear the temporary veneers for a couple of weeks to ensure gums heal properly before applying the more permanent ones (during the process of removing enamel, gums can become irritated). A quicker option is ‘no-prep’ veneers, which use a simple bonding solution to affix to the teeth. But they can also pop off unexpectedly, and aren’t a good option for covering discoloured teeth.

Expiry date: Ten to 15 years. Smoking and caffeine stain natural teeth more than veneers; avoid both so the colour of your teeth and veneers continue to match for several years.

Cost: $1,000 to $2,000 per tooth.*

Tip: ‘Ask your dental hygienist to use a gentle polishing paste during checkups,’ advises Dr. Edward Lowe, a Vancouver dentist and the editor of the Canadian Journal of Cosmetic Dentistry. ‘A coarse polishing paste will take away the shine.’

What you need to know about braces

They’re ideal if: The teeth aren’t in the correct position’if they’re turned or rotated ‘or if the bite isn’t correct.

What are they? Braces are a metal device that exerts a steady pressure on the teeth to correct alignment and bite-related problems, including underbites and overbites. Most dentists don’t do braces, but work closely with an orthodontist.

What’s new: As an alternative, many dentists offer Invisalign‘clear, computer-designed, removable teeth aligners that you change every two weeks until your teeth are properly aligned. However, traditional braces are better for more complicated situations.

Time commitment: Two to three years for braces and about one year for Invisalign. Afterwards, you’ll need to wear a retainer regularly to prevent your teeth from returning to their original position.

Cost: Both braces and Invisalign range from $2,500 to $9,000, including checkups.*

*Note: Prices are approximate and vary from province to province. Final cost may also vary based on the medical professional, individual needs, laboratory charges and whether provincial, private or employee benefits coverage exists for the procedure.

This article was originally titled "Grin and Bare ‘Em," in the March/April 2010 issue of Best Health. Subscribe today to get the full Best Health experience’and never miss an issue!’and make sure to check out what’s new in the latest issue of Best Health.