Is it possible for an adult to correct extremely crooked teeth with veneers, or should they see an orthodontist?
Are Porcelain Veneers Recommended for Really Crooked Teeth?
Doctor Answers 19
Crooked teeth may need ortho prior to veneers
If your teeth are very overlapped or crowded, it is best to get orthodontics to correct this prior to veneers. This allows for less tooth structure to be removed and a much better esthetic result. It also allows for a healthier periodontal situation beacuse the teeth will be more easy to clean and trap less plaque
Porcelain Veneers and Crooked Teeth
Correcting severely crowded or "crooked" teeth can be accomplished both orthodontically or restoratively. The risk in correcting them restoratively lies in the severity of the crowding. If the teeth are rotated too severely, they will be at risk for needing endodontic treatment (root canals) performed. This is relative to the amount of tooth structure that would need to be removed during the restorative process to achieve the desired esthetic outcome. Usually these restorations are porcelain crowns vs. veneers.
My suggestion would be to consult a restorative dentist that is well trained in smile makeovers (cosmetic dentistry) and express these concerns. I always suggest (and prefer) orthodontic treatment to correct severe crowding, whether it is the only treatment rendered or it is adjunctive to eventual restorative treatment. Aligning the teeth allows for a more conservative approach to the restorations (i.e. veneers).
Porcelain Veneers do have limitations
Whenever something is changed in the body, we have to ask ourselves if it is working within the parameters of nature or against them. This can help us come to the best solution for a problem. Veneers can definitely correct poorly aligned teeth, even "severely crowded" teeth but with some drawbacks.
1) For long-term success with veneers, the veneer should be bonded primarily to the outer layer of the tooth which is enamel. When teeth are severely crowded and rotated we have to shave a lot of enamel away to create enough room to build the veneers with a straighter alignment. This means that the veneers are being bonded to the second layer of tooth called dentin. Dentin bonds usually do not last as long as enamel bonds. Are you willing to replace your veneers more often by doing this treatment?
2) When the teeth are crowded, the roots of the teeth might be tipped in unfavorable angles. Although the teeth may look straight, forces of biting and chewing may be directed along the roots in damaging ways which could lead to periodontal problems.
If you do orthodontics either in place of veneers, or to line up the roots and teeth more favorably and then place veneers, less enamel will be removed and the veneers will last longer.
Check with your dentist and orthodontist to find out what they feel would be the treatment that is in your best interest and leave you with the healthiest and most durable result.
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Get an Ortho consult before
Even though veneers can do amazing things, I would not consider them on severely crowded teeth before having a consultation with an Orthodontist. You want to make a decision knowing all your alternatives. Like Dr. Jablow said, if you get your crowding corrected before you do the veneers, the tooth structure to be removed is going to be much less and the gum health much more improved. You could also avoid the veneers all together if the shape and color of your teeth are fine. On the other hand, if having braces or Invisalign is not posible, veneers can do the trick under the hand of an experienced Dentist. Just make sure you know exactly what you are getting into and make a decision knowing all the alternatives.
Dental veneers for crooked teeth.
Dental porcelain veneers can be used to correct crooked teeth, something called "nstant orthodontics". This type of treatment can result in a beautiful smile, but there is often very aggressive preparation of tooth structure in order to idealize the result.
Orthodontics on the other hand can move the teeth and re-align them which is much more conservative. This takes more time and does not change the shape of colour of teeth, something that porcelain veneers will do.
Best thing is to discuss both options as they relate to your situation with your doctor.
Porcelain Veneers vs Teeth Straightening
It is possible to correct crooked teeth with porcelain veneers. However if the degree of crowding is severe enough, there may be a need to straighten the teeth first through orthodontic treatment before undergoing porcelain veneers. A large number of my patients undergo orthodontic treatment prior to placement of the porcelain or dental veneers. This doesn’t necessarily mean braces for 2 years - we can often achieve the desired amount of movement through a relatively short course of Invisalign treatment for example.
When the teeth are better aligned to begin with, it allows placement of the porcelain veneers without aggressive tooth reduction. It also results in a better aesthetic outcome, as the dental veneers will all be a similar thickness, shape and size.
Consider a little bit of Invisalign first
Veneers and crooked teeth
Are Porcelain Veneers Recommended for Really Crooked Teeth?
Really Crooked Teeth - porcelain veneers or braces?
There are many things to consider when considering which of the two can or should be done to correct really crooked teeth, braces or porcelain veneers?
Your first question, is it possible to just do veneers? The answer for most adults is yes. But you also asked what is best, and most dentists and orthodontists would argue that orthodontics would be the best alternative. But, be aware that orthodontics is not without its downside. Many times for adults treatment can vary between 9 to 30 months. And, almost always a long term use of retainers will be necessary to prevent relapse, or the teeth going back to their original crooked position. Many orthodontists will tell the adult patients that they will need to wear a night time retainer for the rest of their life if they want to keep them straight. And, there was one study that said that 100% of all adult orthodontic patients eventually get relapse to some degree.
In my cosmetic dental practice I have treated many adult patients who not only had crooked teeth, but also didn't like the color, size or shape of their teeth. Also they didn't want months to years of treatment. Porcelain veneering enabled us to treat these patients in several weeks, and because we didn't actually move their teeth, they didn't need to wear retainers.
I don't think there is only one best way to treat my patients, either braces or veneers, as I do refer many patients to orthodontists. However, I feel many times porcelain veneers is the best option for my patients and I like to inform them of all the pros and cons, and let them make informed decisions on how they would like to be treated. After all, it is their mouth and smile!
If you would like to see a number of examples of how cosmetic dentistry corrected patients with crooked teeth without braces, go to the link below, and go through and read about the patients and their treatment. I think you'll be enlightened about the benefits of cosmetic dentistry!
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.