Dr. Bob S. Perkins

If a piece of the tooth is broken off and not the whole tooth then I would opt for bonding tooth colored acrylic to what's left of the tooth and that is a much easier way to replicate the value of the existing teeth. When you have two front teeth and one of them is fake and one of them is natural it's really hard to make those values the same. Value is the brightness of the tooth, not really the color. The color is the hue. When they're standing next to each other they better look like Siamese twins otherwise it's going to look funny so you can achieve that a little more easily if you keep as much of the existing tooth as possible then bond some acrylic to it. But otherwise if you've lost the whole tooth I would say you do an all porcelain crown or all porcelain veneer. I would say if you've ever thought about whitening before this is the time to do it. Whiten your teeth then match the new guy to the whitening because once you pick out a color to match your existing teeth, you can't go back and whiten them without having to redo the porcelain.

If you're doing them without a lab, which I have done before, it's about half as much to do composite than porcelain. I don't know about studies, only from personal experience, but for longevity I would feel much better about the bonding of the porcelain for long term resistance to leakage and everything like that. If I was the patient I think the odds of it lasting longer are much higher.

The only time it's better is if the patient refuses to wear braces. In every other case braces are better. Invisalign is much slower, much less predictable and it wasn't designed well to do certain types of movements. So a case that might take me five months with clear braces, I don't use any metal, it might take me 12 to 14 with Invisalign. If you absolutely refuse to wear braces for whatever reason, that's the only reason I would suggest Invisalign. And Invisalign costs more because you pay a giant lab fee to the company.

I think a porcelain veneer just has a different luster and it can never stain. The composites now are pretty good as far as staining but I wouldn't compare them to composite veneers. I just don't know that many labs that are doing composite veneers. There are direct veneers upon which the dentist actually places the acrylic himself. Anything with porcelain has to go to the lab so if you're comparing handmade acrylic veneers to porcelain veneers you've got to be really good at hand-making acrylic veneers. Porcelain is just the way to go if you can fit it into your budget.

That's a term that dentists made. And yes, it's like taking somebody and rejuvenating them. A smile makeover is anything that's going to, on a large scale, enhance a patient's smile. It's a comprehensive enhancement of a person's smile. It can include gum work, sometimes the best thing you can do to enhance somebody's smile is to do some gum work, that can make the biggest difference of all.