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Star Smile Secrets: Braces or Veneers?

Crooked teeth have been a problem since 50,000 BC according to archaeologists who have found ancient Greek orthodontic appliances-the precursor to today's braces.

When it comes to modern braces, it's not just kids anymore. According to the American Association of Orthodontists, the number of adults opting for orthodontia is steadily increasing each year. Veneers too are on the rise with more than 1.6 million getting that procedure in 2006. But braces and veneers are not just a cosmetic fix, they also can be key to maintaining a healthy mouth.

Crooked teeth, in addition to being unattractive, also can increase the chances of cavities and gum disease by creating pockets in the mouth where food can get trapped. Also, a misaligned bite can be responsible for everything from painful TMJ to eventual tooth and bone loss.

A question I sometimes get is why spend the time in braces when veneers can be done so much more quickly? The answer once again has to do with the health of your teeth. True veneers require some filing down of each individual tooth to allow room for the added porcelain layer. (We're not talking about the kind that are glued over your existing teeth as these can often cause a problem by over-contouring the natural teeth). A custom veneer, made of a special porcelain ceramic, is then permanently bonded to the remaining tooth structure creating a perfectly aligned tooth. This is a wonderful procedure for weak, thin, worn down or damaged teeth because, in effect, it makes them strong and new. But it's not always the answer. Because veneers require preparation (filing) of tooth structure and need special care, I don't always recommend them purely for cosmetic reasons.

If your teeth are healthy but just out of alignment, it makes better sense (and is often less costly) to opt for braces. Getting veneers for crooked, healthy teeth might be compared to shaving your head and wearing a wig just because it's a style you like. If you have one or two teeth that are damaged or discolored, veneers can be done later, after the straightening process is finished. While braces including removable orthodontic appliances (Invisalign) generally require much more time than veneers, this approach is still the least invasive and most cost effective to insure a healthy mouth.

Regarding veneers, today, we have the technology to ones that look completely natural. But it's important to remember that creating veneers is an art as each must be individually sculpted. If the teeth are too "perfect", they can look fake (which is why some patients opt to have slight adjustments made to make their new teeth look more genuine.) Be sure to consult a dentist who specializes in aesthetic dentistry.

Dr. Gerald P. Curatola is a renowned aesthetic dentist and pioneer in the emerging field of rejuvenation dentistry, which improves patients' overall health and appearance by integrating total wellness with cutting edge oral care and restorative procedures. In addition to his private practice, research, and work as a Clinical Associate Professor at NYU College of Dentistry, he is an internationally sought after speaker, author and expert who has been featured widely in print and broadcast media. For more information, go to DrGerry.net