Dr. Mike Malone’s Blog

This may seem like it is coming after the fact, but I am curious about something. I recently had a smile makeover done. I thought I was going to have all porcelain veneers placed, but when I look at the backs of my teeth, it looks like the porcelain goes all the way around. Is it normal to place porcelain crowns instead of porcelain veneers for purely cosmetic reasons? I thought crowns were just for teeth that were damaged. I guess the reason this concerns me is that maybe my teeth were in worse shape than I though, if they needed crowns.

I’ve since seen my general dentist, and she seemed very impressed with the work, so I am not concerned about the quality of the workmanship. Is this standard, to have crowns instead of veneers for a cosmetic smile makeover?

Thanks for your insight,

Ben in Oregon

Dear Ben,

Porcelain crowns and veneers differ only in degree–there really is no specific line of demarcation where a veneer becomes a crown. The fee for a porcelain veneer is usually the same or nearly the same as that for a porcelain crown, because the effort to place each type of restoration is about the same.

It is actually quite common to see porcelain crowns used on the front teeth for cosmetic reasons rather than protective ones. If your teeth were not weakened or damaged, your dentist might have decided to go with crowns to control your bite.

It is surprising that the dentist did not discuss this in detail with you during the course of your treatment. Typically, smile makeovers involve a great deal of give and take between the dentist and the patient, because the dentist will want to make absolutely sure he or she knows exactly what the patient wants.

The simplest solution is simply to ask your cosmetic dentist why he decided to go with porcelain crowns rather than veneers. Crowns are the more aggressive form of treatment, and require more reduction of the natural tooth structure. Veneers require only a little bit of shaving on the front of the tooth. For that reason alone, I would expect your dentist to have a sound reasoning for choosing the crowns. Most dentists will always pursue the least aggressive form of treatment and strive to preserve as much of the natural tooth structure as possible.

Is there some kind of temporary dental appliance that gives the illusion of straighter, whiter teeth? It fits over your teeth like a mouth guard would. What is something like that called? Is it expensive? Does it take a long time to be fitted for such a device, and does it hurt?

Alan in Sacramento

Dear Alan,

The dental apparatus you are referring to is called a “Snap-On Smile”, and it fits snuggly over your existing teeth. Such a device is used sometimes for a big event like a wedding, or by actors in the theater. Though it is not durable, it can improve your smile nicely for a short time. A Snap-On Smile is considered a very temporary smile makeover, and should not be confused with porcelain veneers or crowns.

It probably takes at least two weeks, maybe a little more, to complete the entire process to get a Snap-On Smile. A dentist will make a model of your teeth, which is then sent to a dental lab in New York where the appliances are manufactured. Your Snap-On Smile should be shipped to you about two weeks after the lab receives the model from your dentist.

When you receive your Snap-On Smile, no preparation is necessary for your teeth—the appliance just snaps into place. Expect the appliance to make your teeth look bulkier and larger, and remember that it needs to be cleaned after each time you eat.

We strongly recommend that you consult an expert cosmetic dentist to help you acquire such an appliance. He or she will help you get the best results.