cosmetic dentistry
What Is It?
How Does It Work?
What You Can Expect
Health Benefits
How To Choose a Practitioner
Evidence Based Rating Scale

What Is It?

Cosmetic dentistry is the art and science of creating an attractive smile. It differs from regular dentistry, which is concerned mainly with curing or eliminating problems in the mouth and replacing or restoring teeth using a variety of dental materials. Cosmetic dentistry focuses on form, whereas regular dentistry focuses on function.


Most patients choose cosmetic dentistry to make them look younger, to fix what they consider to be unattractive smiles, or simply to feel better about the way they look. Because cosmetic dentistry deals with esthetics more than function, most insurance companies do not cover the cost of the various procedures that enhance the smile.


Cosmetic dentistry includes five main approaches to creating a nicer smile: (1) tooth whitening; (2) bonding; (3) enamel shaping; (4) veneers; and (5) braces. These are discussed in more detail below.

How Does It Work?

Cosmetic dentistry employs various means to make the teeth whiter, straighter, smoother, and more shapely. Here are some of the most common methods



Tooth whitening uses chemicals to bleach teeth that are discolored or stained. Bleaching in the dentist’s office uses hydrogen peroxide gel, often along with bright light, to whiten the teeth 4 to 6 shades in a single 1-hour sitting. This is the most expensive approach, costing $1000 or more. At-home whitening uses carbamine peroxide gels in molds that remain in the mouth several hours a day (usually during sleep). This approach can whiten the teeth as much as 8 or 10 shades over a period of a few weeks, though difficult cases often require longer. At-home whitening costs less than office whitening, but it can still set you back $500 or more. Many cosmetic dentists recommend a combination of office and at-home approaches for the best results. Bleaching systems (or “whitening” toothpastes) you buy in the store are not as effective as dentist-managed systems.


Bonding uses tooth-colored materials to improve the appearance of teeth that have become chipped, broken, cracked, or stained. These materials—which may be resin or composite materials—are applied to the tooth’s surface, sculpted into the desired contour, hardened, and then polished. Resins allow for a quick repair (about an hour), but they tend to discolor with time. They’re not as durable as porcelain veneers (see below), but they are economical—generally less than $500 per tooth.


Enamel shaping can quickly improve the appearance of teeth by removing or contouring the enamel. This technique can be used to shorten long teeth, round off pointed teeth, and make the contour of the teeth follow the shape of the lower lip. Tooth shaping can be completed in under half an hour, and it’s inexpensive, often costing only $25 to $75 per tooth.


Veneers are custom-made, porcelain shells that the cosmetic dentist attaches directly to the fronts of the teeth after removing a thin layer of the enamel. Veneers can be used to close gaps between the teeth, to treat discoloed teeth that did not respond to whitening procedures, and to correct teeth that are chipped or worn or slightly crooked. This approach requires at least two trips to the dentist—one to remove the enamel, take impressions for the veneers, and put temporary veneers in place and another to attach the permanent veneers. The first visit takes a couple of hours, the second somewhat less time. Besides enhancing the appearance of the smile, veneers also increase the strength of the teeth. But veneers don’t come cheap: depending on your dentist, they could cost $500 to $1000 or more per tooth.


Braces aren’t just for children anymore. For teeth that are too crooked to disguise by using veneers and when the gaps are too wide to cover, orthodontics may be the best approach. Braces often have to be worn for years to achieve the best outcomes, and the entire course of treatment can easily run into the thousands of dollars. Some problems that can be corrected in children cannot be corrected in adults, because adult bones have already stopped growing. And braces usually take longer to correct crooked teeth in adults than in children. There may be one advantage, though: orthodontic treatment is often covered at least partly by dental insurance. 

What You Can Expect  

Tooth whitening can usually be completed during a 1-hour office visit (plus any at-home treatment your dentist recommends). You might experience some increased tooth sensitivity during the whitening procedures, but this will pass if you have healthy gums.


Depending upon the extent of the work, bonding can also be finished in about an hour. The only discomfort is that associated with preparing the area that will hold the bond or filling. As noted earlier, these bonds can discolor over time, and they tend to require repair or replacement every few years.


Enamel shaping is quick and painless, and the procedure (although permanent) does not cause any lasting damage to the tooth itself. Some patients experience slight tooth sensitivity after shaping.


As we already described, it will take you at least two visits to the cosmetic dentist to have your veneers designed and attached to your teeth. During the first visit, the teeth will be prepared for the veneers and temporary veneers will be placed on your teeth. During the second visit, the temporary veneers will be removed and the permanent veneers attached.


If you opt for braces, plan on 2 years or more. You’ll need to visit the orthodontist every month or so for assessments and adjustments. Wearing braces can be uncomfortable.

Health Benefits

While cosmetic dentistry is not usually undertaken for health reasons, many patients feel better about themselves when they have a new smile. They might feel more confident in social and business settings. They might feel more comfortable in social settings where they previously avoided smiling. And all these factors can contribute to a higher quality of life.

How To Choose a Practitioner  

Look for dentists who are members of the American Society of Dental Aesthetics (ASDA),, or of the American Academy of Cosmetic Dentistry (AACD), Both organizations offer a referral service so that you can find a member cosmetic dentist near you.


In addition, you should ask your prospective cosmetic dentist for the following items before undergoing treatment:

  • Before and after pictures
  • References from other patients
  • Assurance that the dentist has taken continuing education courses to keep up-to-date with the latest clinical cosmetic dentistry techniques


As with any dental procedure, be sure to consult your dentist before undertaking any cosmetic dental treatment. Make sure you understand the benefits, possible risks, and complications associated with the treatment you want.

There is very little clinical research about the long-term outcomes of most cosmetic dental treatments.


Remember that most cosmetic dental treatment will not be covered by your dental insurance, which views cosmetic dentistry as an elective, esthetic therapy, rather than “necessary” dental care.


If you have significant head and neck health problems, such as migraines, jaw pain (TMJ), or chronic sinusitis, WholeHealthMD consultants recommend that these be addressed before or in conjunction with any permanent cosmetic changes to your teeth or bite. For example, an evaluation and treatment for structure alignment problems by a DO, MD, or dentist certified by the Osteopathic Cranial Academy ( would be advisable since such treatment might promote your eventual healthy bite position.

Evidence Based Rating Scale

The Evidence Based Rating Scale is a tool that helps consumers translate the findings of medical research studies with what our clinical advisors have found to be efficacious in their personal practice. This tool is meant to simplify which supplements and therapies demonstrate promise in the treatment of certain conditions. This scale does not take into account any possible interactions with any medication/ condition/ or therapy which you may be currently undertaking. It is therefore advisable to ask your doctor before starting any new treatment regimen.









tooth discoloration









The American Dental Association (ADA) recognizes the safety and efficacy of tooth whitening.





tooth malalignment




Date Published: 01/13/2007

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