Smile makeover

A smile makeover is not a single treatment. It is a plan that combines whatever is needed — whitening, bonding, veneers, crowns, sometimes orthodontics or a replacement tooth — to change how your teeth look. The result can be striking. The planning is what determines whether it lasts and whether you are still glad of it in ten years.

Cosmetic dental treatment is a health procedure, not a purchase. It carries risks, it is often irreversible, and it deserves an unhurried decision.

Makeover or reconstruction?

A smile makeover is primarily about appearance: the colour, shape, size and position of the teeth that show when you smile.

A full mouth reconstruction addresses function as well — worn, broken or missing teeth across the mouth, and a bite that no longer works properly. If that is closer to your situation, see full mouth rehabilitation.

Many people sit somewhere between the two, and the first consultation is where that gets worked out.

What can be changed

Colour — a professional clean removes surface stain; whitening lightens the enamel; discoloured old fillings can be replaced with tooth-coloured ones. Where discolouration will not respond, veneers cover it.

Shape and size — chipped, worn or short teeth can be rebuilt with composite bonding, veneers or crowns. Proportion matters: small changes in width and length alter how a smile reads.

Position — crooked, overlapping or spaced teeth. Orthodontics moves the teeth themselves; veneers can disguise mild irregularity without moving anything. They are different answers with different trade-offs, and for anything beyond mild crowding, orthodontics is usually the more conservative choice. We refer to a registered orthodontist.

Gaps — closed with bonding, veneers, or by replacing a missing tooth with a bridge, implant or denture.

Gumline — an uneven or excessive gumline can be reshaped. Where needed we refer to a registered periodontist.

The options, side by side

Read that table from the left. The further right you go, the more of your own tooth is spent, and enamel does not grow back.

The order matters

Health first. Decay, gum disease and infected teeth are treated before any cosmetic work begins. Cosmetic treatment over an unhealthy foundation fails, and it fails expensively. This may mean root canal treatment, gum treatment, or removing a tooth that cannot be saved.

Then the least invasive option that achieves the result. A clean and whitening before veneers; bonding before crowns; orthodontics before veneering crooked teeth. Every step up the ladder removes more of your own tooth, and that does not come back.

Whitening before anything that matches colour. Veneers, crowns and fillings do not change shade later. Whiten first, then match to the new colour. Whitening also needs a couple of weeks to settle before a final shade is chosen, because teeth rebound slightly from their brightest point.

What to be clear-eyed about

• Veneers and crowns are irreversible once enamel is removed. That tooth will always need a restoration from then on
• Restorations wear. Composite around five to seven years, porcelain veneers ten or more, crowns longer — but nothing is permanent, and everything eventually needs maintenance or replacement
• A prepared tooth can need root canal treatment later. Preparing a tooth stresses the nerve, and a proportion of teeth respond badly months or years afterwards
• Grinding is the enemy of cosmetic work. If you clench or grind, a night splint is part of the plan, not an optional extra
• Gum health protects the investment. Recession is the most common reason veneers are replaced, and it exposes a darker margin at the gumline
• Sensitivity is common in the weeks after preparation, and occasionally persists
• This is cosmetic treatment. It changes appearance. It does not improve oral health, and we would not claim otherwise
• Individual results vary, and no practitioner can promise a specific outcome

How planning works here

A consultation and comprehensive examination, photographs, and radiographs where indicated. A digital smile design mock-up can show a likely result on a photograph of your own teeth before anything is done, and study models let us trial the shape before it goes anywhere near your mouth.

You receive a written treatment plan with every option and its cost, and you take it home. There is no pressure to decide at the consultation, and we recommend a second opinion from another appropriately qualified practitioner if it would help.

Victorian Dental Group is a general dental practice and holds no specialist registration. Where a case calls for an orthodontist, periodontist or prosthodontist, we refer.

A realistic sequence

Anyone able to deliver a full set of veneers within a week has removed several of these steps. Ask which ones.

Questions worth asking any provider

These apply to us as much as to anyone else, and a good practice will welcome them:

• How much enamel will be removed, and what are my options that remove less?
• What happens in five years, and in fifteen?
• What is the plan if one chips, or if a tooth needs root canal treatment afterwards?
• Who makes the restorations, and where?
• Can I see and wear a trial of the proposed shape before anything is prepared?
• What is the total written cost, including reviews, the splint and any remakes?

If you are considering treatment overseas

It is a reasonable thing to weigh up, and the saving can be real. What is also real is that follow-up care, adjustments, remakes and any complication are difficult to manage from another country, and a practice here takes on responsibility for work it did not plan or place. If you go, take your full records and radiographs with you, and get the written treatment plan and materials list before anything is prepared.

Looking after it

• Wear the splint, every night, if grinding is part of your picture
• Keep your recall appointments. Margins at the gumline are where problems start
• Floss or use interdental brushes daily. The restoration will not decay; the tooth under it can
• Go carefully with very hard foods — ice, nuts in shells, bones, opening things with your teeth
• Expect maintenance. Polishing, occasional repair, and eventual replacement are part of the arrangement, not a failure of it

Cost

Depends entirely on what is involved — a clean and whitening is a different order of cost from a set of veneers. Everything is itemised in the written plan before treatment starts. Purely cosmetic items are commonly excluded by health funds; we will tell you which parts of your plan are likely to attract a rebate and which are not. HICAPS on-the-spot claiming where your fund covers the item; Afterpay and Zip accepted. See payment options.

Questions we are asked

Will it look obvious? Not if the proportions and shade are chosen with restraint. The trial smile stage exists precisely so you can judge that before anything is irreversible.

How many teeth are usually involved? Whatever shows when you smile, which for most people is six to ten upper teeth, sometimes with the lower front teeth as well. It is decided from your own smile line, not a standard number.

Can I just do a couple of teeth? Often yes, particularly with bonding. Matching a single new restoration to neighbouring natural teeth is harder than it sounds, though, and your practitioner will be honest about how close the match is likely to be.

Can I change my mind partway? At the planning and trial stages, entirely. Once enamel has been prepared, no — which is why those stages are unhurried.

Is there an age at which this is too early? Yes. Irreversible cosmetic work on young adults whose gum levels are still maturing deserves particular caution, and we would usually start with the reversible options.

Victorian Dental Group — 291 Wattletree Road, Malvern East VIC 3145 · (03) 9088 5808 · Monday to Friday, 8:00am–5:00pm · book online

This page is general information and does not replace advice from a registered dental practitioner about your own circumstances. Outcomes vary between individuals and no specific result is guaranteed. Please see our Disclaimer.