Smile Makeover: A Guide to Cosmetic and Restorative Procedures

If you’re considering a smile makeover, it’s worthwhile to learn about your options. Photo: William R. Hummer, DDS ©2018

As an outward signifier of confidence and temperament, your smile says a lot about you. That’s why, if your smile has imperfections, you may experience negative consequences. Fortunately, these days most smile defects are easy to remedy, thanks to innovative dental techniques and procedures. This process of correcting a defective smile is often referred to as a “smile makeover.”

A smile makeover may entail one or more of the following measures:

• Restoring missing teeth
• Repairing damaged, decayed or misaligned teeth
• Adjusting an uneven or disproportionate gum line
• Correcting an improper bite
• Replacing old, unattractive dental treatments

Cosmetic dentistry and restorative dentistry in harmony

A smile makeover may sound like a solely cosmetic enterprise, but it’s often more complex than that. In fact, smile makeovers are where the spheres of cosmetic dentistry (improving aesthetics) and restorative dentistry (restoring tooth function) often converge. In some cases, cosmetic measures like teeth whitening or recontouring are sufficient; in others, restorative measures like crowns or implants may be required. Often, a smile makeover involves both of these dental disciplines.

In this article, we’ll cover the wide range of smile makeover procedures available today. We’ve divided them into categories of “cosmetic smile makeover procedures” and “restorative smile makeover procedures.” Bear in mind that some procedures fall into both categories; however, we’ve attempted to classify them as accurately as possible.

Notes on cost and longevity
Directly below each procedure, you’ll find basic estimates of timeline, cost and longevity. There are a couple of caveats worth noting:

• In terms of cost, insurance has not been factored in—and insurance can greatly affect one’s actual out-of-pocket cost. Additionally, costs can vary significantly depending on circumstances; therefore, these estimates should not be considered definitive.
• The actual longevity of a prosthetic or procedural effect is greatly influenced by the patient’s lifestyle and oral hygiene routine. Patients who are diligent about hygiene, reducing sugar intake and using protective devices like mouth guards may see a longevity that far exceeds the estimate. Likewise, patients who are negligent about such measures may see a longevity that falls short of even the lowest estimate.

Cosmetic smile makeover procedures

Cosmetic dentistry is primarily concerned with improving or restoring the aesthetic appearance of one’s teeth, gums and overall smile. In this section, we’ll cover the following cosmetic smile makeover procedures:

• Teeth whitening
• Tooth recontouring
• Veneers
• Braces/clear aligners
• Periodontic procedures

Teeth whitening

Timeline: 1 hour for in-office; 1 week for at-home

Cost: $400-$600 for in-office; $200-$400 for at-home

Longevity: Permanent; however, lifestyle choices may require further treatment

The simplest of smile makeover procedures, teeth whitening is an easy and affordable technique for restoring the natural color of your teeth. Over time, substances like coffee, wine, cigarettes and certain foods can cause teeth to become discolored. Teeth whitening utilizes chemical bleaching agents to break up the stained enamel and reveal your teeth’s natural hue beneath.

There are different levels of teeth whitening, including in-office and at-home treatments. At an in-office treatment, the dentist will insert a cheek retractor into the patient’s mouth to expose the teeth. The dentist will then apply the whitening product (typically a peroxide-based gel) to the teeth and activate it with a curing light or laser. Following activation, the gel will remain on the patient’s teeth for 15 to 30 minutes, then (typically) be reapplied. The number of reapplications (if any) during a given whitening procedure may vary depending on the particular type of treatment used. By the procedure’s end, the patient’s teeth should be roughly four to eight shades whiter.

Some people choose to do at-home treatments, using custom-fit trays cast by their dentists. While less expensive than in-office treatment, at-home whitening is far more time-intensive, as the person must perform the procedure for roughly an hour each day for a week. However, by the end, the person should see a substantial improvement in their teeth’s coloration.

There are also less expensive, over-the-counter teeth whitening treatments you can buy from your local drug store. However, these products are far less effective than professional treatment. In other words, you get what you pay for.

The effects of tooth whitening are essentially permanent. However, if you smoke or ingest food and beverages that stain the teeth, you may need additional treatments in the future.

Tooth recontouring

Timeline: 30-60 minutes (1 office visit)

Cost: $50-$300 per tooth

Longevity: Lifetime

Tooth recontouring (also known as enameloplasty) is a technique used to reshape slightly crooked or uneven teeth and give them a more symmetrical appearance. In some cases, this involves strategically altering teeth to create the illusion of straightness—for example, changing the way light hits them to create shadows. One potential disadvantage of tooth recontouring is that it’s irreversible. Additionally, its effects are limited—after all, you can only remove so much of a tooth before issues with sensitivity arise. However, tooth recontouring remains a viable and economical option for correcting minor aesthetic irregularities.

Veneers

Timeline: 2-4 weeks (2 office visits)

Cost: $900-$1,500 per tooth for porcelain; $500-$800 per tooth for composite

Longevity: 10-15 years for porcelain; 5-7 years for composite

Veneers provide a simple and efficient fix for discolored, chipped, worn, broken or misaligned teeth. A veneer is a thin, ceramic shell that’s bonded to the front of a damaged tooth to alter its color, shape, size and/or length. Veneers can be made from porcelain or a composite resin material; however, porcelain’s superior stain resistance and natural look make it the best option for a smile makeover.

Prior to installation, a veneer needs to be designed and manufactured. To begin, the dentist will remove an amount of enamel from the tooth surface roughly equal in thickness to the incoming veneer (usually about half a millimeter). Next, the dentist will take an impression of the tooth, which will serve as the basis for the veneer’s design. The impression is sent to a laboratory, where a technician will design and manufacture the veneer. The turnaround time for the finished veneers is typically two weeks.

At the time of installation, the dentist will roughen the tooth (to promote bonding), cement the veneer to the tooth and apply a curing light to harden the cement. Lastly, the dentist will remove any excess cement, assess the fit and make any needed final adjustments.

As with tooth recontouring, a potential drawback of veneers is the need for enamel removal, which is irreversible and may cause teeth to be more sensitive to cold and hot food and drinks. However, due to their durability and simple installation, veneers can be an ideal solution for the right application.

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