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Dealing with My Tooth Gap without Spending a Fortune

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I have a small tooth gap that has always bothered me. My dentist suggested Lumineers because it doesn’t have to remove any tooth structure. When I saw the price, my eyes bugged out. Are there other options for me? That cost more that my car. Granted it’s not a fancy car, but still…

Kevin

Dear Kevin,

Lumineers for a small tooth gap is a MAJOR overtreatment. Now if you were to tell me that you were looking for a complete smile makeover, then we might consider something like this. However, it wouldn’t be Lumineers. They are just a brand of porcelain veneers. This particular brand is highly marketed to inexperienced cosmetic dentists. Because this type of smile makeover is a highly advanced procedure, I wouldn’t allow an inexperienced cosmetic dentist to do it at all.

You said you’re only looking to deal with a small tooth gap. In that case, I would recommend two possibilities depending on your final goals— Invisalign or Dental Bonding.

Closing the Gap with Invisalign

Invisalign aligners

Example of an Invisalign Aligners

These will actually close the gap. It’s like having Invisible braces, so if you had any other misalignment, you could take care of that at the same time too. It has an additional benefit of allowing you to straighten and whiten your teeth simultaneously as well.

The aligners can double as teeth whitening trays, which means you won’t need your dentist to make those. All you’ll need is for him to sell you the professional strength teeth whitening gel, which does not cost much at all. This will give you a mini smile makeover at a fraction of the cost.

Closing the Gap with Dental Bonding

Before and after images of dental bonding on a chipped tooth.

Dental bonding uses a composite resin for to close in the gap. The example above is composite bonding used on a chipped tooth. Be aware that, like porcelain veneers, these also have to be done by an advanced cosmetic dentist. I would not let your current dentist do it. The bonding will last a few years and then need to be replaced.

You’ll also need to be aware that once dental bonding is placed, the color cannot be adjusted, so make sure you are happy with the color of your teeth before you have your bonding done.

If all you are wanting to do is close a gap, I would choose between these two options. If you’re wanting a complete smile makeover, to change the shape, size, and color of your teeth, that is when porcelain veneers would be the right option.

This blog is brought to you by a gentle dentist in Kalamazoo, Dr. Susan Dennis.

Front Teeth Are Too Large

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I’ve been trying to find a way to make my teeth look better. My two front teeth are bigger and more forward than the rest of my teeth. I feel like I look a bit like a beaver. I’ve been given lots of advise from different people and none of them quite make enough sense. I’m about to just give up and have them removed and then replace them with dental implants. But, honestly, I’m hoping you have a better options for me.

Tanya

Dear Tanya,

Invisalign Aligners

Whatever you do, please do not remove your teeth and replace them with dental implants. You will not have to do anything so drastic. You do have a lot of options. You could have the teeth trimmed and then have them moved into place with Invisalign aligners. Another option is to have porcelain veneers placed on your teeth.

I have not examined your teeth, so it would be unethical of me to tell you which procedure is the right one for you. My best suggestion is that you find an expert cosmetic dentist, let them examine your bite, then let them determine what your best options are.

There are many factors that will determine the best treatment options. Even if it is the right procedure, the dentist needs a lot of training and experience in placing them. Occlusion of your teeth is important. If a procedure is not done well, it can throw off the way your teeth are meeting together.

This is where a dentist without the right training can cause you a lot of problems. You want to make sure that nothing will throw off your bite. If it does, you can end up with something like TMJ Disorder because a dentist without real training in cosmetic dental work did the procedure they like the best.

This blog is brought to you by Kalamazoo Gentle Dentist Dr. Susan Dennis.

Can a Teenager Get Invisalign?

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I had a great experience with my Invisalign treatment. My daughter also needs to have her teeth straightened but she is not keen on the whole braces thing. Is it possible for teenagers to have Invisalign treatments to fix their teeth? She’s 15 and her her teeth are in good health, just a bit crooked.

Melissa

Dear Melissa,

Braces / Invisalign comparison

I am glad that you enjoyed your Invisalign treatment. It has an extremely high patient satisfaction rate. As for your daughter, yes, it is possible for your daughter to also straighten her teeth with Invisalign. Before you decide, though, I want you to ask yourself a few questions. You know your daughter better than anyone, so you’ll know if this is a good option for her.

As you know, this treatment is heavily reliant on patient compliance. She will need to wear the aligners for the prescribed amount of time. This will mean leaving them in unless she is having her meals or brushing and flossing her teeth. If you think she is willing to do that, then that is a good sign that she would do well with the treatment. You would also want to make sure that she is not prone to losing things, as she will have to keep up with her aligners.

There is an Invisalign teen program that has additional aligners as part of the program in case they are lost, but it is more expensive, so if you can go with the adult program it will work in your favor.

I don’t know if you kept your last pair of aligners, but if you did, then you can use them as teeth whitening trays. This will allow you to get your teeth whitened at a fraction of the cost. All your dentist will need to do is provide you with the professional strength whitening gel.

This blog is brought to you by Kalamazoo Dentist Dr. Susan Dennis.

Retainer After Invisalign Treatment

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I finished my Invisalign treatment and am in the process of moving. I’m wearing the last pair of aligners now. Is there a procedure for this? Do I just be done with the aligners or do I need to find an Invisalign provider for some post-treatment?

Dani

Dear Dani,

Braces / Invisalign comparison

Almost everyone needs to wear a retainer for a period of time after their orthodontic treatment. Otherwise, your teeth could shift out of position again. They need time to truly adjust to their correct position. You have a few options. First, you could find an Invisalign dentist who can help you with an Invisalign styled retainer. Another option is to see a regular dentist who can give you a basic retainer. They are simple and any dentist can do them. A third option is to use your final aligner as a retainer, but you’ll need to do it systematically.

First, wear the aligner all the time, as you’ve normally been for a month. Then, try wearing it every night for a couple of months. From there, try every other night. You’ll need to pay attention to whether your teeth are shifting about this point. You do that by noticing if they are a little more difficult to get back in. If that happens, then you need to go back to wearing them every night for a few weeks and then you can try again.

Once they’re stable at that time distance, you can try them again wearing them every few days at night, then eventually once a week. Take each step slowly making sure to check for shifting. Once you feel you’re done, you can stop wearing them, but keep them around to periodically check.

You can also use your final aligners as teeth whitening trays. Just ask your dentist to provide you with the gel and then wear it while you’re doing your retainer time until you have a teeth whitening level you are happy with.

This blog is brought to you by Kalamazoo Cosmetic Dentist Dr. Susan Dennis.

Solution for a HUGE tooth gap

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I have an 8mm tooth gap and want to improve my smile. I told my dentist that I didn’t want to get braces, so he is suggesting that I get Lumineers. That’s pretty expensive, but if you think it is a good solution I’ll fork the money over.

Brittany

Dear Brittany,

Invisalign Aligner

I’m very glad you wrote. Whatever you do, do NOT get the Lumineers. First, the size of your tooth gap is large enough to fit an entire other tooth in there. It would take one of the top 1% of cosmetic dentists in the country to get it to look right. I don’t think your dentist is an expert cosmetic dentist. This has more to do with the fact that he is recommending Lumineers.

This is a brand of porcelain veneers that is highly marketed to inexperienced cosmetic dentists as being easy to place. They say this because they can be placed without tooth preparation. Though, most smiles will look bulky without some minimal tooth preparation. Those who are skilled cosmetic dentists often do not like the Lumineers brand. This is because they require dentists to use their lab, which is not known for its beautiful results and would prefer to use their own ceramist.

I don’t think you’re going to need Lumineers or any brand of porcelain veneers for your situation. There are now ways to straighten your teeth without traditional braces. I recommend you get Invisalign. These use clear aligners, as pictured above. No one will even know that you are straightening your teeth, even at a conversational distance. This will allow you to straighten your teeth in half the time of traditional braces.

There is an additional bonus to using Invisalign. The clear aligners can double as teeth whitening trays if you are interested in that procedure, allowing you to straighten and whiten your teeth simultaneously at a fraction of the cost. Your dentist can provide you with the whitening gel that you can wear in the aligners at your convenience.

This blog is brought to you by Kalamazoo Dentist Dr. Susan Dennis.

How Often Do I Need To See a Dentist for Invisalign?

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I want to straighten my teeth as well as whiten my them but I live three hours from the closest Invisalign dentist. That means six hours just driving, not including the appointment time, gas, food, etc. I also have a two year old that I would need to find care for. How often do I really have to see a dentist if I were to get Invisalign?

Laurie

Dear Laurie,

Invisalign Aligner

Under normal circumstances, you would see your Invisalign dentist once a month. Your dentist will provide you with two sets of aligners. You wear each set for two weeks before switching them. One important note. When you first put on the aligners, you will find that they feel pretty snug. After a couple of days, the aligners will then become loose. That does not mean to switch them out. It means those teeth are now in their next position. However, you need to leave the aligners in for the full two weeks so that the bone has time to integrate with the new position of the roots. If you switch them out too soon, you will end up with your teeth coming loose. Use them for the entire two weeks and you will not have problems with integration.

Given your unique circumstances, the dentist may be willing to give you two months of aligners at a time. Bear in mind that if the treatment needs adjustment you may have to come in sooner. Each human body is unique and like the people that inhabit those bodies, they don’t always work according to plan. This is true whether you are using traditional braces or Invisalign.

So you know, there is a side benefit to using Invisalign. The aligners can double as teeth whitening trays. This means you can get your teeth straightened and whitened at the same time for a fraction of the price. Your dentist can simply provide you with professional strength teeth whitening gel to wear in the aligners at your convenience.

This blog is brought to you by Kalamazoo Dentist Dr. Susan Dennis.

Can I Switch Invisalign Dentists?

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I’m about halfway done with my Invisalign treatment. While I am really loving the Invisalign, I really hate the dentist. I’ve tried to just ignore his crude comments and his political diatribes, I really did. I just have gotten to the point where I dread going. I need to finish this treatment. Is there a way to switch dentists within the Invisalign group or will they make me stay with this dentist?

Pamela

Dear Pamela,

Invisalign Aligner

I’m sorry that your dentist has been so repugnant. That type of behavior really has no place in a medical practice.

The good news is that you do not have to stay with this dentist. It is not up to the Invisalign company which dentist you use. You can easily switch dentists at any point during the treatment.

In fact, your dentist is under an ethical obligation to facilitate a smooth transfer to the next dentist. This includes providing all of his notes as well as diagnostics. When I say it is an ethical code, I mean by the American Dental Association, so if he doesn’t cooperate you could report him to the dental board.

It will be easy enough for you to pick up your Invisalign treatment with the next dentist. The treatment is already designed, it’s a matter of just continuing from where you left off. Just make sure you keep wearing your aligners until you’re settled with the new dentist.

I don’t know if your other dentist mentioned that you can whiten your teeth and straighten them at the same time. This is because your Invisalign aligners can double as teeth whitening trays. All you need is for your dentist to provide you with the whitening gel and you can wear that in your aligners at your convenience.

This will be a little way to treat yourself to a mini smile makeover.

This blog is brought to you by Kalamazoo Cosmetic Dentist Dr. Susan Dennis.

Does Invisalign Work with Missing Teeth?

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My whole life I have been embarrassed about my smile. They always been crooked and had baby teeth long after their recommended expiration date. Things have not improved. Not only do I have two genetically missing teeth (which have now lost the baby teeth), but now I have a damaged tooth that will need to be extracted. I really want to fix my smile, including straightening it. I’m going on the assumption I will need to replace these missing teeth. Do you know if Invisalign is good at working around missing teeth or will I need to go with the metal wires that come with regular braces?

Gina

Dear Gina,

Invisalign Aligner

Invisalign does fine working around missing teeth. There are other factors that determine whether or not you are a good candidate. You may find that dentists are more comfortable doing this than orthodontists. This is because orthodontists went to school to learn braces and have been a bit slow in embracing the technology, though they are starting to come around.

You are correct that you will need to replace the missing teeth. Invisalign will open up the space needed to replace them, but if you don’t actually replace them, your other teeth will start drifting or tipping into the extra spaces. The best tooth replacements are dental implants, but you can talk to your dentist about all of your options.

You will find another hidden benefit to Invisalign as well. The clear aligners which are used to straighten your teeth can also double as teeth whitening trays. This means that you can straighten and whiten your teeth at the same time, giving you the equivalent of a mini smile makeover. You just have your dentist provide you with some whitening gel and you can wear in the aligners at a time most convenient for you.

This blog is brought to you by Kalamzoo Dentist Dr. Susan Dennis.

Should I Get Invisalign or Porcelain Veneers?

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I have wanted to improve my smile for years. I have one tooth that is a little crooked and my teeth are discolored. I was hoping to get porcelain veneers but my dentist said because of the crooked tooth, I would need to get braces first and then the porcelain veneers. I’m not too keen on the extra time and money that would require. If that is the case, is there a way to get my teeth white with Invisalign as well? I know that porcelain veneers can change the color but I’m guessing Invisalign just straightens them.

Tammy

Dear Tammy,

Invisalign Aligner

I am a bit concerned that your dentist is suggesting you would need braces before doing your porcelain veneers. Bear in mind as you read this that I have not examined you. However, if all you have is a slightly crooked tooth, then porcelain veneers can be placed and make the tooth look straight. It can also change the color, as you mentioned, but also the shape and size of the tooth. This is why they are used for complete smile makeovers.

If all that is wrong with your teeth is the crooked tooth and discoloration, then you could save yourself a lot of money by using Invisalign paired with teeth whitening. The Invisalign aligners can double as teeth whitening trays. All your dentist would need to provide you with is the professional strength teeth whitening gel. In most cases, Invisalign works in a fraction of the time it takes traditional braces to straighten your teeth. Unless there were other things about your teeth that you want to change, or you are in a super hurry, this is the route I would go.

On the other hand, if there are other things about your teeth that you want to change, then porcelain veneers will be the correct choice. That being said, I would not recommend you pressure your current dentist into doing them. The fact that he was pushing your toward braces tells me he is not very comfortable with his skill level using porcelain veneers. This means you will not get the beautiful result you are likely hoping for. You will need to find a different dentist with significant post-doctoral training creating porcelain veneers. Also, make sure he or she is willing to use a temporary try in paste and allow you to get a good look at the veneers in several different types of lighting. Only if you are absolutely in love with them, should the dentist do the permanent bonding. If you’re not thrilled, they should go back to the lab in order to make the changes needed.

This blog is brought to you by Kalamazoo Dentist Dr. Susan Dennis.

Smile Direct Club’s Collapse

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Last month, SmileDirectClub made an announcement that they’re closing their business. Not only have they voided their lifetime guarantee, but they’ll no longer be servicing their customers. Here’s the kicker, though. Even though they won’t be helping patients, if YOU are on a payment plan, they expect you to keep paying. Good luck if you want a refund, because they filed for bankruptcy.

An image advertising SmileDirectClub with an x over it.

What Went Wrong With SmileDirectClub?

You may be wondering what happened. After all, they were cheaper than Invisalign and had good press. Their demise started in June of 2023. Previous to that, SmileDirectClub would squelch negative reviews by only offering a refund if patients would remove their negative reviews as well as sign a non-disclosure agreement. In June, a court ordered them to cease that practice. This court decision also released about 17,000 customers from the non-disclosure agreement and they were free to let people know about their negative experiences. By September they filed for bankruptcy. Unable to find someone to buy the business they had no choice left but to close.

So, what are those abandoned customers supposed to do? SmileDirect is telling them to see a dentist, which might be the first sensible thing they’ve done in a while. My concern is that patients, already having spent their money, will be tempted to go with another online service. The problem with that is they will have the same problems because patient treatment is not overseen by a dentist.

The human body is fascinating. However, it is also unpredictable. Sometimes, though the software plans out the perfect treatment plan for a patient, their body decides not to follow along with the plan and adjustments need to be made. If you are not under the care of a dentist, not only will you have no one to help you with the needed adjustments, but you may not even recognize there needs to be a change until it is very obvious, which is often too late to make simple changes.

If you’re stuck and don’t know what to do about the rest of your treatment, don’t feel embarrassed about seeing a dentist. They are more likely to feel compassion for your situation than anything else.

This blog is brought to you by Kalamazoo Dentist Dr. Susan Dennis.