Your Questions Answered:
Common Issues in Cosmetic Dentistry
Q&A with Michael Feldstein, D.M.D

IMAGE: What's the difference between veneers, laminates, caps, and crowns?

Dr. Michael Feldstein: Veneers and laminates are two names for the same thing. They are a thin porcelain covering that is applied to the front surface of the tooth and can change the color and shape of the tooth. They are bonded in place and are very strong once they are bonded. In most instances, this procedure requires very little drilling of the tooth. Caps and crowns are also two names for the same thing. Crowns cover the entire tooth, not just the front surface of the tooth. They require more drilling and can also change the shape and size and color of the tooth. Crowns are necessary when the teeth have large existing restorations or there are missing teeth that need to be replaced.

IM: My teeth are crooked. Do I need to get braces to fix them?

Dr. F: Though braces aren't always necessary, many times they are the best solution. Without braces the teeth often have to be prepared (drilled on) for either crowns or laminates. This means enduring shots and going through some extensive dental work. If the teeth are structurally sound I advise patients to get the braces. This way, in the end, you have your natural teeth in a nice straight smile - ultimately, there is nothing better than your own teeth.

IM: I want my teeth to look whiter. What are my options?

Dr. F: To whiten your teeth you can either bleach them at home, or have an in-office bleaching procedure. If there are more serious problems with the teeth you can change the color with laminates or crowns.

IM: I show too much gum when I smile. Can you change that?

Dr. F: Showing too much gum is a problem many people have. This can be corrected to a certain degree, depending on how much gum is visible. Gum surgery can be performed to lift the gum up higher on the tooth so your lip covers it more sufficiently. However, if you are not planning to crown or laminate the teeth you can only lift the gum so high without exposing the root surface of the teeth, which would not be appealing when you smile.

IM: My teeth have white and browns spots. How can I fix that?

Dr. F: White and brown spots on the teeth are a common developmental problem in teeth. When the teeth were developing, they did not incorporate enough calcium or incorporated too much fluoride in the enamel, which can then cause teeth to appear mottled with brown or white spots. Sometimes these spots can be gently drilled off and the tooth then polished; in some cases bonding is required after drilling. If the spots are more extensive and deep, the teeth will need to be laminated or crowned to restore them.

IM: Can crowns or laminates discolor like my teeth?

Dr. F: Crowns and laminates are made of porcelain and cannot change color. They cannot be bleached just like your teeth. The color that is originally picked by the dentist is the color they are going to stay.

IM: I don't show any teeth when I smile. Can I get a big toothy smile?

Dr. F: If the reason that you don't show any teeth is because of excessive wear of the teeth, either through grinding (bruxism) or simply age, the answer would be yes. Perhaps not a big toothy smile, but the teeth can be lengthened and made to show more when smiling. If it is because of how the lips and jaws are aligned, then the answer would be no. IMAGE