Among the lesser known tips offered in Dale Carnegie’s How to Win Friends and Influence People is the seemingly simple advice to smile more often. In the 1930’s, when Carnegie wrote his seminal guide, if the hue of your smile leaned more parchment than pearly and your incisors overlapped or sported a chip, chances are no one blinked an eye. Neither orthodontia nor veneers, which were invented in 1928 by a dentist in Hollywood, were widely available.
Flash forward to today, however, and beautiful teeth, much like toned arms and razor-sharp jawlines, have become one of society’s signifiers of status and privilege. Those in possession of an attractive smile are perceived as more intelligent and successful, not to mention healthy, research shows. In other words, yes, there is such a thing as smile privilege.
Not to worry, Town & Country’s Know-It-All’s Guide is here to help. We surveyed the leading experts about the latest technology and techniques in cosmetic dentistry to bring out your most brilliant and uber-natural looking smile. And while there’s a lot that a whitening treatment or braces can do to fix some staining or alignment issues, the quickest (albeit priciest) path to perfect teeth is paved in porcelain—veneers, that is. Keep reading for everything you need to know to secure the ultimate grin glow up.
What to Consider Before Getting a Smile Makeover
“First, you’ll need to get an exam of the facial contour,” says Dr. Gary Ruth, a top oral and maxillofacial surgeon in New York. One of the biggest recent shifts in dentistry is the emphasis on 3-D scans of the entire head and neck, not just the mouth, to determine if there are any skeletal issues at play, causing the smile or eyes to be canted or the jaw to be asymmetric. (A little is normal, say dentists.) Sometimes surgery is necessary to fix those issues.
How do I know if I am a good candidate for veneers?
“Veneers give teeth a new front” but major alignment fixes, such as bite and palate size corrections come first, explains Park Avenue Orthodontist Dr. David Seligman. Skipping these steps can lead to real health problems down the road. For example, a too-narrow palate that doesn’t leave enough room for proper tongue posture can cause sleep apnea, which can in turn contribute to reduced cognitive function “since we know that the brain cleans itself up at night,” explains Seligman.
Assuming your scans reveal that you don’t need any orthodontia or surgery, “veneers can be wonderful for patients who have worn, chipped, discolored, uneven, undersized, or naturally misshapen teeth. They’re also ideal for closing small spaces,” says Beverly Hills–based cosmetic dentist Dr. Arthur Glosman.
How do I find the right cosmetic dentist?
Like plastic surgeons, you can study before and afters of your cosmetic dentists’ work on Instagram or their website, but Dr. Michael Apa, the founder of Apa Aesthetic, whose patients include Jenifer Lopez and Uma Thurman, counsels against being dazzled by perfection. “What you’re looking for is consistency and, more importantly, variety,” he says. “Do the results suit each individual face, or does every patient walk out with the same smile? If every after photo looks identical, that’s not a portfolio, that’s a template.”
And while getting more than one opinion is a good idea, too many consultations can do more harm than good, says Dr. Nick Mavrostomos, a cosmetic dentist in the Apa Aesthetics New York office. “Ten chefs will give you ten different recipes. Choose a provider based on results. Collecting every opinion and comparing prices rarely gets you the best outcome—it gets you confused,” says Mavrostomos, who recently worked on fashion founder Kate Davidson Hudson’s porcelain veneers.
What should I ask during my consultation?
Start with your basic due diligence. “Look for certificates or continuing education credits in aesthetic dentistry. Most dentists should be at least seven years out of school before attempting highly aesthetic veneer cases,” counsels Dr. Dean Vafiadis, a Manhattan-based prosthodontist. Veneer redos and people who bite or clench their teeth are considered more difficult cases and need experts with more experience.
Other questions Vafiadis recommends asking include: “Can you show me a smile simulation? Do you use digital tech technologies to get more accurate results? Will you treat my gum line to follow my smile line? And If I want a more expanded smile, how would you do that?”
Apa also recommends asking who makes the veneers. Top dentists make theirs in-house using master ceramists who hand-paint teeth using a durable but life-like material called feldspathic porcelain.
I am afraid of looking like I got dentures. How do I ensure I get a natural result?
Today’s veneers are increasingly undetectable. They aren’t blindingly white and all one size, which is what can make teeth look fake. Real teeth have “more opacity at the core, warmth at the gumline, and translucency at the edges,” explains Apa. The ceramists in his offices paint each veneer, layer by layer, to mimic natural enamel’s nuances.
And whereas smiles used to be designed to be beautiful on their own, now doctors tailor each case to the individual. Apa says he studies each of his patients’ faces in thirds, forehead to brow, brow to the base of the nose, nose to chin. “When I assess someone, I’m looking at facial harmony first. And yes, face shape matters: a longer, narrower face generally doesn’t want long, narrow teeth stacked on top of it, while a wider face may need more lateral support so the smile doesn’t collapse inward or show dark spaces at the corners,” he said.
How long does the process take and does it hurt?
After the original planning sessions, which can include photos, x-rays, models of teeth, bite records and more, the next step is to place so-called temporaries on teeth and a small amount of the natural tooth is removed to make room for the veneer. (Doctors say this amount is far less than in the past, as there is a movement towards preserving as much of the original tooth as possible.) “The finals should simply be a more lifelike version of the temps: same tooth shape, same display, just brought to life in hand-layered porcelain.
What you see when you get the temporaries and then the finals should suit you immediately. “Nothing about the design should surprise you at the end,” says Apa.
The process will typically four appointments spaced out over three weeks. (Redos can be more involved as the first set of veneers has to be carefully removed first.) “Trust the process and don’t rush it,” says Dr. Guy Carnazza, a professor at New York University’s College of Dentistry, Esthetic Department, and a cosmetic dentist who has in the past told altar-bound brides that fast-tracking their smiles would be a mistake.
As for pain, Apa insists that patients’ anxiety is “worse than the experience” as people are numb during the prep and post-procedure discomfort is minimal and short-lived. Even with re-dos, which comprise as much as 60% of the work in Apa’s practices in Manhattan, Beverly Hills, Miami, and Dubai, patients experience little discomfort.
Do I need to stop getting Botox or filler before I get my veneers?
Botox, no; fillers, yes, says New York dermatologist Dr. David Kim. “When you get dental work our immune system gets revved up and can potentially look for foreign material, including filler. This can lead to nodule formation,” explains Kim, who says that patients should schedule dental work 30 days before or after getting any kind of hyaluronic or biostimulatory filler like Sculptra to avoid complications.
How do I maintain my new smile?
Caring for your veneers is the same as caring for your teeth and gums, says Glosman, who recommends brushing twice daily with a soft-bristled toothbrush, flossing every day, and seeing your dentist and hygienist regularly for professional maintenance. For patients who clench or grind, a custom night guard is essential to protect the veneers and teeth. “The good news is that porcelain itself doesn’t stain the way natural enamel can,” says Glosman.
How long will my veneers last?
Depending on how well you take care of your teeth, veneers can last anywhere from 10 to as long as 20 years.
What does everything cost?
Costs vary from doctor to doctor and depend largely on the material being used to craft the teeth. While there are less-expensive veneers that are painted directly on the tooth and made from a “composite” material, these often have to be replaced in five years due to staining. Porcelain veneers can cost anywhere between $2,000 to $5,000 per tooth. If an entire smile makeover is out of your budget, many dentists will suggest doing the most visible teeth instead of using a less expensive material on your whole smile.
