Part one: crooked teeth
Over the next 2 blogs I want to address the alternative options for crooked or missing teeth. We will look at the different ways that can be used to deal with orthodontic problems rather than braces and the advantages and disadvantages of using them. This should help make clearer the options and alternatives to brace treatment and give guidance on the most suitable treatment for you.
In this first blog we will cover the options for crooked teeth.
Alternative treatment 1: Build up the teeth with composite filling or veneer
One of the quickest ways to make your teeth look straighter is to cover the front surface with tooth coloured composite filling material or a porcelain veneer. This will mean that when you or other people look at the teeth from the front they will look straight.
What are the advantages of this approach?
Time is really the biggest advantage – you get the outcome you want in a matter of weeks rather than 12-18 months or more of orthodontics.
If you have the teeth built up with composite filling, if the shape or colour isn’t quite right they can be adjusted more easily than a porcelain veneer. Composite is probably the most reversible treatment option as well.
Good quality restorative treatment can look amazing, like natural teeth
If you have any marks, defects or fillings already present then it is a great way to cover that
What are the disadvantages of this approach?
Although the teeth will look straighter they won’t feel straighter and for some patients this can still be annoying. We have treated patients who initially went for this approach and were not 100% happy. They ended up having the veneers removed and had braces to correct the position of the teeth. Be sure of what it is you want to achieve. If all you are concerned about is the look then this may be a good option for you.
From the front – these patients’ teeth look straight and uniform, however when you look underneath the veneers they are very bulky in order to disguise the crooked teeth and the teeth are still crooked.
Cost – if you want a really good balanced look, you may find that you are paying a lot more than brace treatment. It is very difficult to make 1 tooth veneer match the other teeth so it may be recommended that you have 6, 8 or 10 teeth done to get the best result, even if only one is crooked.
You need a really competent dentist to deliver the treatment – this is really difficult for patients to know – the only way is to do your research. Ask to see examples of their work and don’t be afraid to seek out someone who specialises in this kind of treatment. It is worth the investment, but it’s a big one to make.
You will have to have some preparation to the tooth – It will be very minor removal of enamel from the facing surface of the teeth – this will be done with the dental drill.
If your teeth are set back from the rest of the teeth that build up or crown will be very bulky – you will be able to feel with your tongue.
It’s not a one off treatment – even with great dental materials, skilful dentists and good maintenance all dental work will have a finite lifespan. So if you go down the route of veneers or build-ups, then be prepared to have to have them remade at least every 10 years. Your teeth will also become yellower with age so they may match initially and then appear lighter than the rest a few years on. This will either mean having to whiten your teeth at some point or replacing the veneers or build ups so they match. Also bear this in mind if you have your teeth whitened before you undergo the treatment – it is not the natural colour for your teeth so you will have to keep whitening your teeth possibly every 6-12 months to maintain the result.
You may still need orthodontics to improve the tooth position to get the best outcome.
Porcelain is brittle and veneers are thin so unfortunately they can fracture and chip. This can’t easily be repaired and will mean a whole new veneer will need to be placed.
Alternative treatment 2: Crown the teeth
This is also an option for crooked teeth and is more likely to fix the bad position of the teeth relative to the others.
Again like veneers and build ups you can get the result in a matter of weeks.
Potentially a good option if your teeth are marked/discoloured or heavily filled.
Even with minimal preparation you have to have tooth drilled away to make room for the crown to fit onto the tooth. This is probably the most destructive option and commits you to have the same treatment for ever after.
Like veneers it may be costly especially if they need to crown or veneer the adjacent teeth to get the best looking result.
Crowns also will have a finite lifespan and you need to be aware that replacing them periodically will be necessary.
There are possible issues long term with the health of the tooth. Some heavily prepared teeth may lose the nerve over time due to the proximity of the preparation to it, meaning not only a root treatment will be necessary, but also a difficult procedure for the dentist due to the crown. Sometimes the crown has to be removed and there is a risk of damaging the underlying tooth in the process.
What are the benefits of straightening the teeth with braces
The main benefit is that you are moving the teeth into the right position, therefore there is less need for dental work to be done. The legacy of this is that you don’t have worry about replacing the dental work over the years and this may save you a considerable amount money.
If you need a combination of both orthodontics and dental treatment to get the best result then this will minimise the work needed, and create a more natural looking tooth.
The only maintenance will be wearing retainers or maintaining the bonded retainers behind the front teeth. The cost of replacement of the retainers is affordable too.