Should I get Invisalign or crowns?

Question

I am 47 yrs old & I have healthy teeth but a big gap between the two front teeth. One dentist has suggested replacing the top front 6 teeth with 6 crowns, but this seems invasive - especially if I have healthy teeth. Can Invisalign close a gap this big, & if so, approx how long would it take. I would like a rough idea before I start paying for Invisalign consultations/xrays etc.

Lance Timmerman, DMD, MAGD · Answer

If cost is a major factor, then Invisalign is the best.  If a restorative option is possible, I would suggest porcelain veneers instead of crowns, as they are more conservative.  One advantage with veneers is the ability to avoid "ortho relapse", when teeth that were moved tend to move BACK.  Retainers are worn to keep teeth straight, but many people stop wearing them after a short while and the teeth migrate.  With veneers, the teeth tend to stay put, and there is the added benefit of changing the size, shape and color.

	However, if you ARE thinking of porcelain (crowns or veneers) and changing color, then you MUST do the number of teeth that show in your smile (and 6 is NEVER enough).

Wendy S. Spektor, DDS · Answer

You have a great smile!!!  You need a orthodontic evaluation to see if Invisalign will solve your space issues.  You may have a tooth size discrepancy which means that even if you do braces or Invisalign, you may need veneers as well.  You can whiten if the Invisalign or braces will solve your space issues and your end result is better without much treatment.  I would never do crowns if you have virgin teeth and just want spaces closed.  Another suggestion is to do bonding.  Whiten your teeth and 'bond' on plastic to close your spaces.  It is a much less invasive procedure and can be very successful.  If you ever want to do veneers, you still can.  Hope that helps-

Ashkan Haeri, DMD · Answer

Depending what your expectations are, Invisalign can easily close the gaps. Looking at the pictures it may take close to a year.  If further esthetic improvements are needed then cosmetic veneers may be used to reshape the contour of your smile.  Detail smile and bite analysis is needed for optimal results. However, invisalign usually improves the outcome of any cosmetic case.

Michael Ayzin, DDS · Answer

Invisalign can close space this big without any problems.  It might take no more then a year. Looking at your picture though I believe the best solution would be what we call a combination of Invisalign to align teeth into proper space following with porcelain veneers to make a perfect smile. Your teeth appear to be very slender. If you choose to go that route, Invisalign treatment can be shortened to 5 month, and a whole treatment goals can be done within 6 month.

	In the presence of the gap, in order to acheive the best and most optimal smile results I would consider a combination trreatment.

	Hope this helps.

Chad Colson, DMD · Answer

Judging from the photo you submitted, it appears that you definitely have a tooth-size, arch-width discrepancy, meaning that you will still have space left somewhere even if you close the gap completely between the front two teeth.  I see patients with the same situation as yours quite frequently, and most of them still choose to orthodontically reposition the teeth (with ClearCorrect, Invisalign, or traditional orthodontics) and leave the space behind the canines ("eye" teeth).  This space can often be closed with composite resin bonding.

	It really depends on what your ultimate goal is and how much space you will be left with.  If the space is your main issue, ortho is the solution.  If you don't like the space or the shape or shade of your teeth, restorations may be a better solution.  Sometimes a combination of the two is best.

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