Seeing 3 Orthodontists, One Dentist, and One Cosmetic Dentist- What Do You Think Is Thbe Right Treatment For Me? (photo)

In the process of seeing if braces, invisalign, or veneers are the way to go. Issues are deep bite, bridge on bottom, 2 veneers on either side of two front teeth. I broke 2 back teeth recently-old fillings and need those fixed too. Seen 3 orthodontists, 1 cosmetic dentist, and 1 dentist, all suggest different treatments-I am confused! Would like to have my smile widened if possible(braces or veneers?)and bottom teeth better aligned (possible?). Would have the 2 veneers replaced after treatment.

Doctor Answers 4

Deep Bite Means Ortho is the Priority

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If you saw 5 orthodontists you might get 5 opinions, but probably ALL of them would suggest braces.The deep bite is the problem and is best fixed with braces not invisalign. Once the deep bite is fixed then your restorative treatment can be finalized. It is however important that your bridge be removed and a temporary be placed that will allow better planning of your dental arches. The lower bridge may need to be changed a few times during your course of treatment. Finally, the last thing to do after all the teeth are in alignment, would be to finalize the bridges, crowns and veneers. You must demand that the practitioners you choose will communicate with each other and with YOU!

Baltimore Oral & Maxillofacial Surgeon

Orthodontics vs. Restorative/Cosmetic Dentistry

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If orthodontics is done properly to widen your smile and lessen your overbite, expansion of the arches will be needed.  This will create more spaces than you currenty have so you need an orthodontist and cosmetic dentist to plan your case together, rather than one against the other as you will need both modalities.  Definitely do not have orthodontics if they are going to try and bring all your teeth together and close the spaces you have from the missing teeth.  This will not give you a great smile or improve your bite.  Otherwise if your bite does not cause discomfort for you or the combination treatment is out of your budget, simply pursue the restorative/cosmetic dentistry approach.

New Porcelain Restorations Needed

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After looking at your photos, it seems to me that you need a considerable amount of restorative work done.  I see several old amalgam fillings on some of your back teeth that should be replaced with composite fillings or porcelain bonded restorations.  I would address these first, then consider your options for improved aesthetics.  The aesthetic part could be accomplished with new porcelain veneers or orthodontics.  Find a cosmetic dentist to consult with and then decide.  Good luck.

Your seeing different dentists - What to do?

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Ok, lots here to ponder.  I looked at your photos and I will tell you that it is difficult to determine treatment off of photos only.  It also depends on whether you have TMJ issues, a bite problem, pain, etc...  But, if you are trying to widen your smile, if it is very minor widening then you can do it with crowns or veneers.  If more, then you will need an orthodontist to widen.  You most certainly need a cosmetic dentist because there are many esthetic issues going on here.  You must know that this is not going to be cheap.  There are too many issues at stake here. If money is an issue then you are definitely going to want to go to your general dentist and go from there.

If I were you, I would approach it this way:

1. Go to a very reputable cosmetic dentist and get a thorough evaluation.  He will guide you through what needs to be done and if he feels there is a need for a specialist to get involved then he will get you in touch with one that he knows is on the same page as he and they can work together - VERY IMPORTANT. 

2.  If you go to a specialist, then follow the recommendations that he and the cosmetic dentist give you. 

Remember, once you start making suggestions for a change and try to cheapen the work, it may become a difficult situation to handle by the dentists.  I hate to put finances into this but I will tell you ahead of time this is not a cheap thing to do. Get the thorough evaluation and go from there.  You need to see someone who does this type of work all the time.  Not a dentist that "Dabbles" in cosmetics.  Good luck and after you rthorough evaluation, you should have a better idea of what is right!


Keith Blankenship, DDS
Jacksonville Dentist

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.