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  • Q&A with Australian Health Practitioners

    What is the difference between crowns and veneers?

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    Dr Barbara Szylkarski has 18 years experience in private practice dentistry for adults and children. She has also worked alongside one of brisbanes renowned prosthodontists, … View Profile

    Treating a tooth with a veneer is like resurfacing the front of the tooth rather than fully capping over it.  Fully capping over a tooth is a crown.

    People often think of a veneer as being a little like false fingernails, glued onto the front of the real nail that reamins underneath so it looks better.  The tooth underneath does not change very much but it can now have a new shape, size and colour.  Very often it can achieve many of the benefits of a crown but with a more conservative procedure.

    Treating a tooth with a crown is like capping over a whole tooth.  It forms a full 360 degree coverage aroung the tooth, hence holding it together.  The procedure is a little more invasive than a veneer ie:more tooth structure is removed, but this is necessary as the material needs to be a little thicker than a veneer for strength.  But also the tooth may need to be held together as it is weak or a lot of tooth structure is missing.

    There are some variations between the two with regards to size.  Some veneers may wrap around the sides a little and some crowns may not give full coverage.  But the reasons for choosing one or the other are the same.

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    In 2000 I graduated from the University of Sydney with Honours. I have worked in Country, General Family, Cosmetic Dentistry, Orthodontic and Dental Implant practices, … View Profile

    Cosmetic Dentistry in the 21st Century

    Every dental advertisement you see mentions Cosmetic Dentistry. It is the new catch cry of the dental professional in the 21st century, but what does it really mean.

    Cosmetic Dentistry or Aesthetic dentistry is a rather broad description for dental procedures that improve or enhance a patients smile and so therefore their dental appearance. Remember though that not all cosmetic dentistry needs to be expensive, or it doesn’t mean complete ‘Dental makeovers’. A true cosmetic dentist is one that just carries out all of their treatment not only to a high functional level but also to a high cosmetic level. If you have a dentist who has cosmetic prowess then by the time you see them year in year out, and you replace fillings etc as they fail, then in the end you will have a beautiful long lasting cosmetically pleasing smile.

    It is important that your dentist or any ‘Cosmetic Dentist’ asks their patients “What do you not like about the appearance of your teeth?”. The reason for this is sometimes to improve or enhance a patients smile is merely a means of smoothing the chips off the front teeth and reshaping them a little whilst smoothing, this can make a dramatic effect to the appearance with out costing anything. It may be that the patient is happy with the colour and shape, but just doesn’t like one particular metal filling, once again an easy fix by just replacing the filling to a more cosmetic material, and therefore not expensive. What about if the patient doesn’t mind the shape and position but just wants whiter teeth, another easy fix, just whiten the teeth.

    Treatment plans for cosmetics should be based on what the patient has issues with not what the Dentist feels is the most ideal treatment plan, with maximum profits.

    If you are looking for the ‘Cosmetic Makeover,’ which includes reshaping the smile, maybe repositioning crooked teeth, or replacing lost teeth, be careful who you pick. Explore all your options with the dentist. Remember when picking a ‘Cosmetic Dentist’ to carry the work out, cosmetic treatment is like an art form, you should always be shown a model of your teeth as they could look like, so you have control from the start. Not all ‘Cosmetic Dentists’ are good at what they do, try and see some before and after photo’s of their work. Good ‘Cosmetic Dentists’ keep copies of their work because they are proud of it, they get a kick out of transforming smiles, just like a sculptor or a painter.

    When it comes to the ‘cosmetic makeover’ spending a little more on better quality materials and a better practitioner, ends up costing you less money in repairs and redoing the work later on. Be careful of dentists that want to replace all your old amalgams because they are ugly or leaking mercury into your system, its not really true, these dentists will often place ‘tooth coloured fillings’ which as just a plastic and don’t last as long as other materials available and no where near as long as the amalgams. Be guided by what you want, and what you dislike.



    If you are considering the ‘cosmetic makeover’ or just replacing a missing tooth, your options are as follows;

    • Teeth Whitening
    • Porcelain Veneers
    • Crowns
    • Bridges
    • Dental Implants
    Teeth Whitening

    Teeth whitening is a safe and non invasive procedure that may be used to improve the colour of your teeth. It is a proven and effective cosmetic dental procedure. The agents used to whiten teeth have been in use for more than 60 years.


    How Does it Work?

    The active ingredient used in teeth whitening is Hydrogen Peroxide (H2O2). The oxygen element penetrates the teeth and oxidises the stains and pigments within their structure. The basic chemical action is that the long chain colour molecules are broken down into shorter chains therefore changing the optical appearance of the molecules, which in turn makes the teeth appear lighter in colour. The shade of the teeth is improved, without altering the structure.

    What is a Crown?

    Dental Crowns (sometimes referred to as dental caps) are used to cover and encase teeth to rebuild and strengthen teeth that may be broken or decayed. They can also be used to cosmetically enhance the appearance of a tooth as they are able to cover colour irregularities.

    Crowns are made in a Dental Laboratory buy a Technician who uses moulds of your teeth taken by the Dentist.

    Many different materials can be recommended by your Dentist depending on the tooth involved, its position and sometimes on your preference. These materials include; Porcelain Crowns, Porcelain bonded to Metal Crowns, (this combines the strength of metal with the natural appearance of tooth coloured porcelain.) or Gold Alloy Crowns.

    When is a Crown required?

    A Crown may be recommended by your Dentist if a substantial amount of tooth structure has been lost, this may be as a result of decay or trauma. The materials used strengthen the remaining tooth and will prevent any further damage. If the tooth has previously been heavily filled, then to avoid cracks and breaking, a Crown might be suggested by means of prevention. A crown may also be used to improve appearance and perhaps most importantly restore function. Crowns are also used if trying to realign teeth where veneers will not achieve the required result.


    What is a Bridge?

    A Bridge is a permanently fixed unit that is used to replace missing teeth. It requires teeth either side of the space to support the structure, much like a bridge across a river where the bridge has two poles supporting the fake teeth.

    The bridge is made up of one or more crowns either side of the space with a false tooth or teeth attached in between.

    Alternatively, used mostly anteriorly, an enamel bonded bridge may be used. Here the false tooth is attached to a metal or porcelain framework which is then bonded to the supporting teeth.

    When might a Bridge be required?

    A bridge may be recommended by your Dentist to replace a missing tooth, particularly if the teeth either side of the space are heavily restored and therefore crowning would be a good option.


    What is a Veneer?

    A veneer is a very thin piece of tooth coloured porcelain made to bond and cover the front surface of a tooth.

    Porcelain is used because it is a hard wearing and non-porous material. A shade can be created to match the surrounding teeth or improve the overall colour of teeth.

    A very small amount of tooth structure is removed in preparation and then impressions are taken which are sent to a technician to make the veneer. At the second visit the veneer is tried in and if perfect in shade and fit it is bonded to the tooth surface.


    When are Veneers used?

    Veneers are excellent for improving the shade, shape, size or length of teeth. They can be used to treat discoloured, chipped, and slightly misaligned or misshaped teeth.
    If well maintained they will last for many years.


    What is a Dental Implant?

    Dental Implant is a titanium screw that is placed into the bone where there are missing teeth. The screw then bonds to the surrounding bone and so becomes like having a root replaced in the mouth. After a healing period, a crown is then screwed to the implant.

    When are Dental Implants used?

    Dental Implants are a better option than a Bridge if:

    • The gap is more than two teeth. If the gap is any wider than two teeth then there will be too much force put on the support poles if a bridge is used, causing damage to the support teeth;
    • If the gap does not have teeth either side to use as poles or support teeth for a bridge;
    • If the teeth either side of the gap have not been treated or minimally treated in the past. Teeth are there strongest long term if left untreated; or
    • If there are potentially any future issues that may arise from the other teeth. Bridges are a connected unit between three or four teeth, so if something goes wrong with one, everything then needs to be replaced. It is always a lot simpler and cheaper in the future if you are only dealing with one tooth instead of multiple teeth.

    Dr Adam Alford graduated form the University of Sydney, Australia, in 2000 with honors. Dr Alford has worked extensively in Cosmetic and Implant practices in Australia and the UK. He has a special interest in cosmetics and tooth whitening. Dr Alford is the author of the article and he maintains a General Dental, Cosmetic and Implant Dental Surgery in Sydney CBD http://www.mlccentredental.com.au Webmasters are free to reprint this article provided that it is not edited, the authors information is included, and the links are included as live links. To find out more about cosmetic dentistry please view http://www.mlccentredental.com.au/cosmetic-dentistry.php . To find out more about Dental Implants please view http://www.mlccentredental.com.au/dental-implants.php .

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