Dr. Hall,
I am 67 and have had three sets of braces in my teens, twenties and thirties. I had orthognathic surgery 1989 for a short jawline. Great results. However my teeth have gradually crowded again, my two front teeth are prominent. I want to do veneers on my two upper side teeth to possibly make the two fronts look not so prominent. I’ve been told I have to do all six fronts. Too expensive and don’t feel like it’s necessary. This is cosmetic. I don’t feel like going through braces again I’m not sure how to send a photo.
– Deborah from Texas
(See Dr. Hall’s answer below.)
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Deborah,
I wouldn’t be able to tell whether two or six porcelain veneers would be appropriate for you without an exam, but I’ll try to be helpful.
There are two possibilities. One is that two porcelain veneers would do you just fine and your dentist is trying to get you to do more work than you really need. The other possibility is that your dentist is a highly ethical cosmetic dentist and doesn’t want to do a case that will reflect poorly on his or her reputation.
When I practiced, I was very firm in not wanting a cosmetic patient to walk out of my office with a smile that wasn’t beautiful. I believe that most ethical cosmetic dentists have similar feelings. They are passionate about the appearance of what they do, and the patient needs to love how it looks and the work needs to reflect their artistry.
I also have a comment about your teeth crowding. I had one patient, a woman in her 50s, who had a gap between her two front teeth, and I closed the gap by widening the teeth with dental bonding. Then, within a couple of years, the gap came back. I had to re-do the bonding, but this time I had an orthodontic retainer made for her and told her she needed to wear it every night because her teeth continued to move. Adult tooth movement happens, and the way to deal with that is to wear an orthodontic retainer after the treatment is completed. Most people need a retainer for a limited time, but there are some patients who need one long-term, and it sounds like you’re one of those. Had you worn a retainer consistently after your treatment in your teens, I’m guessing that you wouldn’t have needed to be re-treated.
The way to tell that you still need a retainer is to back off gradually. You wear it all the time for the time your orthodontist tells you. Then you start wearing it only at night. Then you wear it every other night, and you should be able to tell when you snap the retainer back in if your teeth have moved in the interim, because you’ll feel the pressure on your teeth. If it feels like they haven’t moved, go longer.
There are some orthodontists who will bond a retainer to the backs of the teeth and the patient wears that for the rest of their life. It sounds like that wouldn’t have been a bad idea for you.
– Dr. Hall
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About David A. Hall
Dr. David A. Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does advanced internet marketing for dentists.
Linnette says
Deborah! It’s great to see you exploring options for your smile. I hope you find the right solution that makes you feel confident without the need for more braces.