A smile makeover is rarely one treatment. It’s usually a combination, such as whitening, straightening, veneers or crowns, and sometimes an implant to replace a missing tooth. Each can work well on its own, but the order you have them in can make a real difference to the result, the cost and how much of your natural tooth is kept.
Get the sequence wrong and you can end up with veneers that no longer match your teeth, or treatment that has to be redone. Here’s the order most dentists work in, and why.
1. Get your teeth and gums healthy first
Cosmetic work needs a healthy base. Before anything else, your dentist will check for decay, gum disease, cracked teeth and old fillings that are failing.
Gum health matters more than most people expect. Inflamed or receding gums can change where the gum line sits, and a veneer or crown fitted to unhealthy gums may not look right once they settle. Untreated decay under new cosmetic work can also mean that work has to be removed later.
This stage isn’t glamorous, but it protects everything that comes after it.
2. Straighten before you restore
If your teeth are crowded, crooked or spaced, it’s worth asking whether straightening them first, often with clear aligners, would help.
Veneers can disguise mild crookedness, but to make crooked teeth look straight the dentist may need to remove more of the tooth’s surface. Moving the teeth into a better position first can mean less tooth is removed later, or that you need fewer veneers. For some people, straightening and whitening alone give the result they wanted, with no veneers at all.
The trade-off is time. Straightening can take months, so it suits people who aren’t working to a tight deadline, like a wedding next month.
3. Whiten before veneers, crowns or bonding
This is the step that’s easiest to get wrong. As the NHS explains, whitening can only lighten the colour of natural teeth, so it won’t change crowns, dentures or implants. The same applies to porcelain veneers and composite bonding.
That means if you have veneers or a crown matched to your current shade and then whiten your other teeth, the new work can end up looking darker than the teeth around it. The fix is often to replace it, which is expensive.
The better approach is to whiten first, wait a couple of weeks for the colour to settle, then have any veneers, crowns or bonding matched to your new shade. If you only want a few veneers on your front teeth, this also helps them blend in with the teeth either side.
4. Veneers, crowns and implants come last
Once your teeth are healthy, in position and at the shade you want, it’s time for the work that’s hardest to change later.
- Veneers are thin shells bonded to the front of the teeth. Porcelain veneers usually involve removing a thin layer of enamel, so they’re a long-term commitment.
- Crowns cover the whole tooth and are often used for teeth that are heavily filled, cracked or weakened.
- Implants replace missing teeth. The implant itself is placed in the jaw and needs time to heal before the final crown is fitted, so it often starts earlier in the plan, with the visible crown matched to your final shade at the end.
Because these treatments are made to match the teeth around them, doing them last means they’re designed for your finished smile, not the one you started with.
See the result before you commit
Because much of this work is permanent, it helps to know what you’re aiming for before treatment starts. Many dentists now use photos, digital scans and digital smile design software to show how your smile could look. Some can also make a temporary “trial smile” so you can see and feel the proposed shape in your own mouth.
Before you agree to a plan, it’s worth asking your dentist:
- What order will the treatments happen in, and why?
- Do I need to whiten before any veneers, crowns or bonding?
- Would straightening first reduce how much tooth needs to be removed?
- How long will the whole plan take, and what will it cost at each stage?
- How long are the results likely to last, and what upkeep is involved?
A good dentist will be happy to explain their reasoning. If the plan jumps straight to veneers without discussing your gums, alignment or shade, ask why.
About the author
Dr Steven Rostkier is a cosmetic dentist in Melbourne, Australia, with more than 25 years of experience. A University of Melbourne graduate, he has run his own practice in Balwyn since 1999, providing cosmetic, restorative and general dentistry.