Well, first of all, I have been struggling trying to find a good dentist who I can trust to straighten my teeth. I keep hearing different things about how to solve my problem and don’t know who to believe. Here’s my situation. The tooth next to my front tooth on the right is crooked and it is in the way back. It’s really bad. I was wondering are braces my only option, or will Invisalign work? If I want to pull my crooked tooth, what other treatments are offered?
- Ken from California

Ken,
Generally, if you’re an adult and your teeth are crooked, Invisalign will work just fine. Or porcelain veneers can also straighten your teeth.

I wouldn’t let anybody pull the one crooked tooth, but you may have dentists that want to do that. Your smile will never look right with an uneven number of front teeth. Each front tooth is a different shape, and you can get away with doing a lot of things to make them look straight, but one thing that’s important is to have both halves of your smile be symmetrical, and you can’t have that with five front teeth instead of six.

And if you need a local dentist, I have tried very hard to find excellent cosmetic dentists all over the country, and feel that you can trust the cosmetic dentists we list on this website. A dentist who is on our list and therefore is an excellent cosmetic dentist, if he or she is also certified to do Invisalign, they should be able to give you the best opinion about which way you should go.

- Dr. Hall

Other links:
Click here to find a cosmetic dentist.

However my dentist suggested that I would need to do Invisalign invisible braces treatment before I put my veneers. He stated that after this procedure the drilling would be minimum. He also didn’t recommend Lumineers for my teeth, he said that they might look bulky on my teeth. I am not excited about 9-12 months treatment and additional cost of course, please tell me what do you think about my doctors suggestions and if it make any sense.I would highly appreciate your answer.

Thanks,
Julie from Michigan

Dear Julie,
Please take my recommendations with a grain of salt, because I haven’t seen your case and don’t know why your dentist is suggesting doing Invisalign first and then porcelain veneers. It could be that you have a great deal of crowding or a serious bite problem or something else out of the ordinary. Because, ordinarily a cosmetic dentist would recommend either porcelain veneers or Invisalign for a smile makeover, not both.

I like what your dentist said about Lumineers for you. It is true that they make your teeth look bulky. But I’m suspicious about the other part of what he is saying, so I’d recommend a second opinion from one of our Michigan cosmetic dentists, and this would be a way of verifying what you’re being told. When you go for the second opinion, remember to not let the second dentist know what you were told by the first dentist. That way you can get a completely independent second opinion.

Porcelain veneers from an expert cosmetic dentist can mask crooked teeth so that they look straight. I would choose the porcelain veneers if you are especially impatient or if there are problems with the shapes of your individual teeth.

Invisalign invisible braces will make your teeth actually be straight. And they are much faster than conventional braces, with treatments typically taking six to twelve months. If you are also wanting whiter teeth, it is very easy to do tooth whitening treatments while you are wearing the Invisalign aligners. The aligners can actually be used as bleaching trays. This would be the option to choose if you aren’t in as big a hurry for results.

But in most cases it would be one treatment or the other, not both.
Dr. Hall

Click here to find a cosmetic dentist who has been screened for artistic ability and advanced training.
Click here to ask Dr. Hall a question.

Linda,

Your current dentist, that you are leaving, has an ethical obligation to do everything necessary to facilitate a smooth transition to another dentist. So yes, you should be able to continue with your retainers with another dentist. You could switch even if you were in the middle of treatment.

And even if your dentist doesn’t live up to that ethical code required by the dental association, it isn’t difficult or expensive to have a new retainer made without any of the previous information. The dentist has his or her assistant take a simple impression of your teeth, pour up a model, and send it to almost any dental lab.

And the new dentist does not need to be Invisalign certified. (Though it could be helpful.)

And glad to hear you are so happy with your Invisalign treatment. In surveys of patient satisfaction with cosmetic dental and cosmetic surgery procedures, Invisalign ranks near the top.

Dr. Hall

Related links:
Read about braces in general.

But, I don’t know what to do with them! I’ve done a bit of researching about different cosmetic dentistry options but nothing seems right. I don’t need anything added to them to make them bigger than they already are.

So, what is it that I need to do? Have them taken out and get dental implants? Is there a procedure for this? And do you have a referral for a dentist in NYC?

Thanks so much. I’ve been cringing at pictures for too long now.
- Claire in Brooklyn

Claire,
Don’t have your front teeth taken out! You don’t need to be that drastic.

I would recommend going to a really good cosmetic dentist and then trusting them to find the solution. I have looked for good cosmetic dentists in Brooklyn and can’t find one, but Dr. Robert Schwartz in Manhattan is excellent and he could fix this for you. You don’t have to figure it out for yourself.

I will tell you my impressions, from how you’re describing your problem. But my disclaimer is that I haven’t seen your teeth, so don’t take this as gospel. Depending on the results of your examination, an entirely different course could be advisable.

It is possible to make teeth smaller by carefully trimming them down with diamond burs and diamond strips. From the way you’re describing your teeth, I’m guessing they could be filed down on the sides, making them narrower, and then trimmed on the biting edges to make them shorter. Then a simple spring retainer could be used to push them back in alignment with your other upper front teeth.

Or, after they are trimmed, Invisalign invisible braces could be used to position them.

If they are really huge and require a lot of trimming, porcelain veneers could be needed to cover over the exposed dentin.

Anyway, several options. But all of these would be beyond the ability and training of the family dentist on the corner. You need an expert cosmetic dentist, or you could get yourself into a big mess that becomes very expensive to fix later.

Good luck,
Dr. Hall

Related links:
Read about braces.

My question is this: how good is Invisalign when working around missing teeth? I really don’t want to have regular braces at my age. And is it likely I’ll need to have dental implants to replace those missing teeth?

Also, I have a bit of an underbite and there isn’t enough space between my top and bottom teeth to straighten only my bottom teeth. We’ll have to move the top ones out to make room.

Thanks, Marlowe in North Dakota

Dear Marlowe,

Invisalign works with missing teeth. There are other factors governing whether you are a candidate for Invisalign. Your underbite may prove to be more of an obstacle to being an Invisalign candidate than your missing teeth. And there is a reluctance to use Invisalign in cases of severe crowding.

Different dentists have different degrees of bravery in tackling certain tooth crowding cases with Invisalign. Orthodontists tend to be more conservative–they have been trained to work with wire and brackets and they shy away from the new technology. But general dentists tend to be more willing to use the Invisalign. And the cases are always supervised by expert orthodontists that are on the Invisalign staff, that work at their headquarters, so any case they approve is pretty safe.

So I’d recommend visiting a two or three Invisalign general dentists in your area and see what they say about your case.

Invisalign could close the spaces in your lower jaw, so I doubt you’d need to replace the missing teeth. It could also move your upper teeth out–that can be done. But again, it depends on the severity of your case and the actual positions of everything.

Dr. Hall

Dear D,
You usually have the Invisalign aligners checked every four weeks. That’s how we did it–we gave the patient two sets of aligners–one set upper and lower to wear now, and another set of upper and lower to put in after two weeks and we’d check them after the fourth week. But if distance were a problem, our Alaska Invisalign dentist could probably check it a little less often or check it when there was a problem. But that would depend on the complexity of your case.

The full set of aligners is made when the case is started, so theoretically, if it didn’t need any monitoring, you could take them all home and come back when you’re done. But it does need some monitoring, and sometimes it requires some shaving between the teeth at different steps.

I hope that’s helpful,
- Dr. Hall

Thanks,
Bailey in Florida

Bailey,
I can only guess what the cost would be for you without knowing more specifically about the condition of your mouth. But, generally, for protruded teeth, you would have three good options.
The first would be conventional braces. You would go probably to an orthodontist, and wear braces for two or three years. This would cost maybe around $4000. If your teeth are protruded really far, you would need surgical orthodontics, the treatment would be more complicated, and the cost would be considerably higher.
The second would be Invisalign invisible braces. Click the link to learn more about this option. This would only work if your teeth aren’t protruded too far, and it would cost about $5000, depending on where you went.
The third way would be with porcelain veneers. They would be fashioned in such as way as to make your teeth appear straight and be further back. Again this would work if your teeth weren’t protruded too far. The cost of porcelain veneers is around $1500 per tooth, and would vary depending on where you went and how many teeth are involved, which would be six to ten teeth.
Dr. Hall

Dear Jamal,
There are two good possible solutions for discolored teeth–either porcelain veneers or teeth whitening.
There are two good possible solutions for teeth that aren’t straight–braces (either Invisalign invisible braces or conventional wire-and-bracket braces) or porcelain veneers.

If your teeth are both discolored and not straight, it generally makes the most sense to get porcelain veneers and take care of both problems with one treatment. However, cosmetic dentists who do Invisalign can use the Invisalign aligner trays to double as a home tooth whitening appliance and do both treatments simultaneously.

And as far as getting this done, I would recommend you see Dr. Denis Freiden, a Memphis cosmetic dentist, even though it means a drive to another state. Mississippi is a very unfavorable state for cosmetic dentists, so they go elsewhere. We do have a Mississippi cosmetic dentist in Laurel, Mississippi, but that is at the other end of the state for you and a longer drive than to Memphis. Creating a beautiful smile takes artistic passion and artistic ability, so good cosmetic dentists are fairly uncommon.

- Dr. Hall

Sara,
Invisalign could probably close your tooth gap, but it would be easier, faster, cheaper, and better to have direct tooth bonding. But you would need an expert cosmetic dentist to do this.
Check out the information about this procedure on our tooth bonding page.
- Dr. Hall

Is it nescessary for me to have tooth whitening before porcelain veneers are applied, and is it possible to have veneers on a tooth that is slightly crooked without getting invisaline first?
- Deborah in Massachusetts

Deborah,
Cosmetic dentists will recommend tooth whitening before getting porcelain veneers because once the veneers are on, it isn’t possible to whiten them. So let’s say you’re getting eight porcelain veneers on the upper front teeth. If you whiten the lower teeth and the upper back teeth, then you will be able to get a whiter shade of veneers for the upper front teeth, because they will look more natural. But it isn’t mandatory. It all should be geared toward the result that you want. If you want the veneers to be just a little bit whiter than your existing teeth, then you won’t need to whiten your other teeth.

But go to an expert cosmetic dentist who is comfortable talking about these issues with you. General family dentists simply don’t appreciate these issues, and I don’t have much confidence in their advice on color.

As far as being able to put porcelain veneers on crooked teeth without straightening them first with either Invisalign, or regular braces – Yes, absolutely you can do this. It’s done all the time. Especially if they’re just slightly crooked, I think it’s a waste of time and money to have them straightened first and then put veneers on them. The veneers will make them look perfectly straight.
- Dr. Hall