Hollywood smile: botched and beautiful

When you see this picture, you may wonder how Nicolas Cage got his teeth transformed from the ugly duck style (left) to the natural and harmonic one (right)? And you might want to do the same with your teeth. And question, so you would like to know what’s been done on those shiny pearls first. Lots of celebrities pay big buck to fix their teeth. They pay their dentist a visit and tell him/her: “Here is the cash, fix ‘em”

Well, let’s take a look at how the dentist fixed Nicolas Cage’s teeth. There is this thing called “veneers”. Which is basically flakes of porcelain that have been glued to outer surface of the teeth.

In doing so, the teeth can look bigger, and of course brighter. Take a look at the picture below and see how the tooth looks like beneath the veneers. That’s right, the tooth is mowed down. In order to make the veneers the dentist drills away a big chunk of the healthy tooth tissue (friske tenner). One thing I know is that healthy tooth structure is one of the most precious things you have in your body. Cause when it’s gone, there is no getting it back and there is no healing.

Now what happens to the teeth and the veneers let’s say after 5-10 years? Veneers like everything else have a life expectancy and it’s somewhere between 5-15 years. The veneers will eventually crack, chip or break. In fifty percent of the cases when that happens, the tooth beneath has already been affected by some degree of decay because putting veneers on all your teeth will make it extremely easier for plaque and bacteria to build up where you can’t see.

This specially is the case in between the teeth where it’s almost impossible to detect before it’s already too late. So, if you are lucky the tooth can be restored and you can get a new veneer or crown on that tooth. This will probably give you 5-10 years more with that tooth. But in lots of cases the tooth must be extracted. At that point, your insurance probably won’t cover the expenses anymore. It would be like getting treatment for lung cancer if you have been smoking for 20 years. Most insurance companies won’t cover it because they will they will tell you that it’s your own fault that you have so much decay in your teeth. So, drilling away a big chunk of healthy tooth tissue is pretty much the beginning of the end for the teeth and your pocket.

Now, in most cases all you need to do, if you have dark, chipped and misaligned teeth, is to align the crooked teeth with an aligner system like Invisalign (fig. 2) and bleach the teeth after that. 

And if there are still some small defects on the teeth, it can be repaired beautifully with filling materials or otherwise called “composite veneers” or edge-bonded composite (look at the pictures below). If done by a competent dentist this will require no drilling of the healthy tooth structure. What the dentist does is to build up instead of tearing down. This is the most minimally invasive dental work there is and also the least expensive one. The life expectancy of this kind of treatment is somewhere between 10-20 years. And when these composite build-ups fail, there is usually no damage to the tooth beneath.

Cost difference: 

A traditional veneer like the ones Nicholas Cage has got cost something around 1000$-2500$ per tooth. Now that amount times 24 teeth will cost somewhere between 25 000$-30 000$ all costs included. A makeover with filling materials or called “composite veneers” costs somewhere between 250$-1000$ per tooth. Usually, this treatment is something you don’t need on all your teeth but the ones that are visible when you smile. The total cost for this treatment will be somewhere around 5 000$-20 000$.  So, you be the judge on which treatment is the best treatment.

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