What Affects the Cost of a Smile Makeover

A plan, not a procedure

"Smile makeover" is not a single treatment. It describes a plan that may combine several: whitening, bonding, veneers, crowns, braces or aligners, gum reshaping, or replacing missing teeth. Because the mix differs for each person, so does the cost. This article gives no prices, as a figure printed in an article cannot account for your mouth. For the planning process, see the smile design page.

The general factors that affect all dental fees are covered in what affects the cost of dental treatment. This post looks at what is specific to cosmetic work.

1. Which treatments are combined

This is the largest factor. A plan of whitening and a little bonding is a smaller undertaking than one that includes orthodontic treatment, several veneers or crowns, and gum contouring. Each added treatment brings its own visits, materials and laboratory work. Ask for the plan to be broken into steps so you can see what each one adds.

2. The number of teeth involved

Most smile work is priced per tooth or per unit. A change to the two front teeth is different from a change to eight or ten teeth across the smile line. Treating more teeth also takes more appointments and more chair time.

3. Materials

Material choices affect cost, appearance and how long a restoration lasts:

• Composite resin (bonding) is built up directly on the tooth in the clinic. It can usually be repaired but may stain or wear sooner.
• Porcelain or ceramic veneers and crowns are made in a laboratory. They resist staining well, but they cost more and need more than one visit.
• Whitening may be done in the clinic or with custom trays at home, and needs to be repeated from time to time.

The ADA's guidance on veneers notes that veneers are a commitment, because some enamel is usually removed.

4. Laboratory work

Veneers, crowns and some aligners are made by dental technicians. The technician's time, the type of ceramic and the number of units all affect the fee. Shade matching and a trial, or mock-up, of the shape before the final work can add visits, though they help you see and approve the result.

5. Dental health work that comes first

Cosmetic treatment is built on healthy teeth and gums. Cavities, gum disease, worn teeth or an uneven bite usually need attention before anything cosmetic is placed. Treating them is part of the real cost of the plan, even if it is not the part you were thinking about. Whitening, for example, is normally done after cavities and gum problems have been dealt with.

6. Straightening teeth

If crowding or gaps are the main concern, braces or clear aligners may do more, with less removal of tooth structure, than covering the teeth with veneers. Orthodontic treatment usually runs for months, with regular visits, so it affects both time and cost. See braces vs clear aligners for how these compare.

7. Number of visits and staging

A larger plan can often be carried out in stages. Your dentist can separate what is needed for health from what is purely cosmetic and suggest an order, so that you can decide how far to go.

8. Upkeep

Cosmetic work needs care. Veneers and crowns can chip, bonding can stain, and whitening fades. A night guard may be advised if you grind your teeth. Ask what review visits, repairs or replacement over the years are likely to involve, since these form part of the long-term cost.

What to ask before you agree to a plan

1. Which treatments are in the plan, and what does each one involve?
2. Which of them are needed for health, and which are optional?
3. Which materials are proposed, and what are the alternatives?
4. Are the laboratory work, mock-up, follow-up visits and any temporary teeth included?
5. How long is each part expected to last, and what care does it need?
6. Can it be done in stages?

Remember that results vary between people and no dentist can promise a particular appearance. Take time to understand the plan, and ask for it in writing.