Veneers or Braces/Invisalign?

Throughout my career, many of my patients have desired straighter, whiter teeth. Studies have shown that people generally feel more confident and are happier with straight teeth. The question that usually arises is, do we use porcelain veneers to make the teeth look straighter and whiter, or do we use orthodontics (Invisalign or braces) to straighten teeth? Each case is different, but let us explore the pros and cons of each method.

Some dentists will use a term called “Instant Orthodontics” to raise interest in using veneers to “instantly” (usually it takes a few weeks) make teeth look straighter and whiter. This method can be worthwhile as long as the patient already has mostly straight teeth. If there are only minor rotations or crowding, veneers can achieve an instantly straight-looking smile. You have to be very careful with this type of treatment, because even though it is possible to make severely misaligned teeth look straight with veneers, it comes at a price. In order to make crooked teeth appear straight with veneers, you have shave more of the crooked tooth away so that the lab technician creating the veneers has enough space to make everything appear straight. This can lead to teeth nerves that need root canals and can also create a situation that makes it very challenging to clean effectively between the teeth. I have seen too many cases that were done this way and the patient usually ends up with a lot of additional dentistry in the future that could have been avoided if things were set up better.

That leads us to a discussion about the benefits of Invisalign (or braces) to help straighten teeth before placing veneers. Invisalign is a wonderful tool to help straighten teeth with thin, clear trays that you take out when eating. Most people never even know you’re wearing them all day and you don’t have to put up with a mouthful of metal (braces). I have used Invisalign on many cases to set-up the teeth in a better position so that when I shape the teeth for veneers, I can be more conservative in my reduction of tooth structure. This allows me to bond the veneers to enamel, which greatly increases the strength of the bonding and retention of the veneer.

There are some companies who like to tout “No-Prep Veneers” and lead patients to believe that you can just simply bond veneers to the patient’s existing teeth without any tooth reduction. This is only possible if the patient has naturally small teeth or teeth with spaces in between them. I have seen many of these cases done where the dentist did not prep the teeth and just bonded the veneers over the teeth, and they often look fake or bulky and they also trap plaque along the gumline where the veneer and tooth interface is. I am a big fan of being as conservative as possible, but you have to consider each case and discuss the different options with the patient so that everybody wins.

I have found that the best results happen when I am thorough and make measurements and photos of the patient’s face and teeth. We then make impressions of the teeth and send them to our lab to create a wax-up of what we want the end result to look like. This allows us to preview the case together and ensure that everything will work as planned. We also use a mold of the wax-up to create the patients temporary veneers. This allows the patient to wear temporary veneers for several weeks and “test-drive” the length and shape of the teeth before we place the final veneers. I have found this takes all of the guesswork out of the equation and ensures a successful outcome for the patient and dentist.

Feel free to get in touch with us if you have any interest in Invisalign and/or in porcelain veneers! We’re always here for you.

Photo credit: AspiraDental.com

All the best,

Dr. Steve Cook