The Truth About Extreme Smile Makeovers
Dr. Michael Zuk

In the 1990s, cosmetic dentistry was just taking off, and I wanted to be a part of it.

It was exciting, the promise of porcelain that would give everyone a beautiful smile, no matter how crooked their teeth were before the procedure. Only later on did I discover that gorgeous smiles were sometimes being produced at the expense of people’s teeth health.

Here are the facts behind the flawed procedure:

Cosmetic dentists may suggest veneers to cover up surface imperfections, but the danger in this form of “instant orthodontics” is that healthy tooth enamel is drilled away and replaced with porcelain. This quick fix looks good in before-and-after pictures, but it hides the truth: Your previously healthy teeth are now permanently weakened, setting you up for such problems as nerve damage and cracked teeth later on.

Veneers are also quite pricey -- $1,000 to $2,000 per tooth -- and are often done in sets of eight or 10.

Sometimes, people are happy with the result, but other times they are dismayed with how yellow the rest of their mouth looks in comparison. Also, it’s easy to accidentally design teeth that are too bright, too big or too thick.

Now, if you understand all the risks and your teeth are very worn down or heavily filled, veneers may be justified. Otherwise, I advocate “imperfect” as the new ideal. That’s right: slight twists, a little space and surface flaws that are almost unnoticeable at conversational distances are actually desirable. More conservative and less expensive treatment options that can give you a better-looking, healthy smile include the following:

- Shorter-term braces (straight teeth in as little as three months!)

- Clear aligners such as Invisalign

- Composite fillings that look like teeth

- In-office or at-home whitening

- Recontouring the gum line

So rather than shelling out $40,000 or more for a single complex smile makeover, find a dentist who will at least discuss with you some of these other options that preserve the integrity of your teeth while giving you a beautiful and healthy smile. The dentist will have to work harder, and it will involve more patience and visits on your part, but your oral health (and your checkbook!) will benefit.