The Architecture of a Smile
Bellen says a cosmetic dentist can do just about anything needed to improve your smile, but he stresses the work must be carefully planned. "I go though a pretty detailed evaluation before I start any work at all," he says.
Your bite -- the way your teeth fit together when your mouth is closed -- is an important consideration. "You can put porcelain on everything and not pay attention to the bite, and have everything break down," Bellen says.
That means that before any veneers or crowns go on, your teeth may need to be realigned, and you may even need jaw surgery. "I, as a cosmetic dentist, will diagnose and plan the treatment," Malone says. Then he may involve other professionals, such as an orthodontist or an oral surgeon.
When teeth need to be realigned, it's usually an orthodontist who takes care of it. And you may not need braces. Many people can have their teeth straightened with the Invisalign system, which uses clear plastic "aligners" to gradually move the teeth around. Although it is widely accepted, "You cannot use Invisalign for every case that you can use braces for," Malone says.
Often the jaw can be repositioned without surgery, but sometimes an oral surgeon may need to join the team. As part of a "whole mouth rehabilitation," as Bellen terms it, some people need to have a severely recessed or protruding jaw corrected.
How much you want done depends on how much time you're willing to commit to it, and how much money you have at your disposal. Strictly cosmetic dental work isn't covered by insurance, and the cost can be steep. Veneers, for example, may cost as little as $250 and as much as $2,000 -- per tooth.
Again, you would be paying for a lot of time in the chair. Bellen says he sometimes works on a single patient for a full eight-hour day. What's more, the end result can take many months to accomplish. "There are cases I have in progress right now that have been going on for a year," he says.
But for some, an elaborate and costly production may be worth it in the end. "People smile more when they have nice-looking teeth," Bellen says. "Your whole face brightens up."