Aesthetics Matter, but Health Comes First

Cosmetic dentistry has its place, but as we’ve written before, it’s too often overdone, with aesthetics taking a backseat to health.

Recently, we ran across a similar critique, written by a dental consultant for the Faculty Dental Journal. We think the message bears repeating.

In “Porcelain Pornography,” Martin Kelleher hones in on the destructive aspect of veneers and cosmetic-only crowns. After all, tooth prep for a veneer removes anywhere from 3 to 30% of the natural tooth structure, while a crown prep removes up to nearly 3/4 of structure. This has long term consequences. As Dr. Verigin notes, “The greater the number of restorative dental treatments, the greater the abuse of and trauma to the affected tooth – and the greater chance of its becoming a candidate for a root canal.

According to’s recap of Kellher’s article,

The opinion piece…asserts that the destruction of relatively sound tooth structure (enamel and dentine) to prepare teeth for veneers or crowns can rarely be justified for minor cosmetic or wear problems. There is limited evidence of long-term benefits in these circumstances of brittle porcelain veneers.

Available research suggests that after 10 years about 50% of veneers are either no longer present, have had further treatment or are no longer in a satisfactory condition.

Senior dentists are concerned that fitting porcelain veneers or crowns, on mainly sound teeth, has become so widespread that it is sometimes considered a “normal” treatment for those patients who might benefit from more conservative restorative treatments…. [emphasis added]

As Kelleher puts it, it’s vital that patients “understand that extensive porcelain veneer or crown treatment is not a risk free shortcut to a perfect smile.” Nor, we add, is it a one-time cost. As the above passage indicates, veneers and crowns eventually wear down and need to be replaced. At over $1000 a pop, this becomes a hefty investment over time.

To make a smart and informed decision about cosmetic dentistry, you’ve got to consider all the costs, actual and potential, financial and otherwise.

Sure, most of us want an attractive smile. Aesthetics do matter. But the health of your teeth should come first – not only so you can keep your natural teeth as long as possible, but also because their health affects your overall physical health and well-being. Each of your natural teeth is a vital, living organ – just as your liver, brain, lungs, heart and other vital, living organs.

We’ve said it before and we’ll say it again, the best dentistry is the least dentistry.

For more information on this approach, balancing aesthetics and health, visit our main office website.

Image by petesimon, via Flickr

Published by The Verigin Dental Health Team

A humanistic, holistic dental practice in Northern California, providing integrative, biological, mercury-free dentistry

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