What cosmetic dentistry is, and what it is not

Cosmetic dentistry describes an intention rather than a category of license. In California a dentist may announce as a specialist only in a recognized specialty, and cosmetic dentistry is not one of them. Everything here is general dentistry.

It is not a substitute for what else a mouth needs. Crowding is an orthodontic problem, and moving teeth with Invisalign keeps far more enamel than cutting them down for porcelain. A cracked tooth needs holding together before anyone discusses its color.

The aim is work nobody can identify as work. Where you land depends on your starting shade, how much enamel you have left and where your gum line sits, so two people asking for the same thing get different plans.

The treatments, and what each one is for

Most cosmetic problems can be solved more than one way. These five are listed roughly by how much tooth structure each one costs you.

Teeth whitening
Whitening lightens natural tooth structure with peroxide gel. Nothing is drilled and nothing removed, so it is the easiest thing to try and to stop. It has no effect on porcelain or composite.
Tooth-colored fillings
Bonded composite repairs decay, rebuilds a chipped corner and reshapes a worn edge. It removes less tooth than any other repair, and it can usually be repaired rather than replaced.
Porcelain veneers
Veneers are thin porcelain facings bonded to the front of a tooth, handling color, shape, worn edges and small gaps together. Preparing a tooth for one removes enamel and cannot be undone.
Porcelain crowns
A crown covers the whole tooth. The reason is usually structural, a fractured cusp or a tooth that is more filling than tooth, with appearance solved at the same time.
Porcelain bridges
A fixed bridge replaces a missing tooth using the teeth either side. The real price is what it takes from those two, which is why it is weighed against a dental implant first.

Shade, shape, proportion and the lip line

A natural tooth is not one flat color. It is more saturated near the gum and more translucent at the edge, so a single flat shade reads as false even when the number is right. Shade is recorded early and in daylight, because teeth dehydrate and lighten within minutes of the mouth being open.

Shape and proportion do more work than color. The two central incisors set the tone, their width against their length is what people read as normal without knowing why, and the edges usually follow the curve of the lower lip. An uneven gum line is not fixed by changing the teeth alone.

How a cosmetic plan is put together

Nothing irreversible happens at a first appointment. The order exists so decisions are made while they are cheap to change.

  1. An examination, photographs and records

    Decay, gum health, the bite, existing fillings and x-rays, then before photographs, a shade record and impressions. Those records plan the case and let you compare before and after honestly.

  2. A conversation about what actually bothers you

    Color, a chipped edge, a gap, a dark filling and the amount of gum on show are five different problems with five different answers.

  3. Whitening first, if it is part of the plan

    Porcelain and composite do not lighten. Whiten first, let the shade settle for a couple of weeks, then match restorations to where you landed.

  4. A wax-up and a trial smile

    The proposed shape is built in wax and copied into your mouth over unprepared teeth, so you see it before a bur touches anything. Changing your mind here costs nothing.

  5. Treatment in sequence, then a review

    Each step is checked before the next commits you. Afterwards the gums and bite are reviewed, and a night guard is made if you clench.

Conservative options come first

Enamel does not grow back, and any treatment that removes it commits the tooth to being restored from then on.

  • Whitening before veneers. Much of what people want from veneers is color, and whitening delivers color without touching the tooth.
  • Bonding for chips, gaps and worn edges. Composite added directly in one appointment, usually with little or no drilling, and removable later. It stains sooner than porcelain, a fair trade for keeping the tooth intact.
  • Recontouring. Small amounts of enamel polished from an edge to even up a chip. Quick, no anesthetic, and limited by the enamel thickness that protects the tooth.
  • Orthodontics for crowding. Moving a crowded tooth into line with Invisalign keeps the enamel. Veneering crowded teeth means cutting them to a common line.
  • Replacing a failing old restoration. A large discolored filling in a front tooth, redone in fresh composite, sometimes settles the complaint entirely.

Sometimes the conservative option is not enough and veneers or crowns are the right call. The point is the order, so removing enamel is a decision rather than a default.

What cosmetic dentistry costs, and how people pay for it

Cost depends on how many teeth are involved, the material, the laboratory work and whether the foundation needs repair first. No honest figure can be quoted before anyone has looked in your mouth. You get a written estimate before treatment starts.

Dental plans exist to treat disease rather than to change appearance, so purely cosmetic treatment is usually excluded. Where the same treatment is needed for a structural reason, a plan may look at it differently. Policies vary, so the reliable answer is a pre-treatment estimate. See insurance, financing and the patient information pages.

Questions we get asked about cosmetic dentistry

Is Dr. Brosi a cosmetic specialist?

No. He is a general dentist. California recognizes a limited list of dental specialties and cosmetic dentistry is not among them, so no dentist in the state may present themselves as a cosmetic specialist. There is more about him here.

Where do I start if I do not know what I want?

With an examination, photographs and a conversation about which specific thing bothers you. From there you get the realistic options with the trade-offs attached, including doing nothing, which is sometimes the right answer.

Will people be able to tell?

That depends on the choices made rather than the treatment. Work gives itself away through a shade brighter than anything natural, teeth that are all identical, and a gum line nobody addressed.

Can I see what it will look like beforehand?

For anything significant, yes, through a wax-up and a trial smile over your own teeth. Treat it as a guide rather than a photograph of the outcome: it shows length, shape and proportion, not how finished porcelain handles light.

What are your hours, and how do I book?

Monday to Wednesday 8:30 am to 5:00 pm, Thursday 7:30 am to 4:00 pm, closed Friday through Sunday. Call (559) 683-4694, use the contact page, or request an appointment.

In this area of treatment

Each of these has its own page with the detail that does not fit here.

  • Porcelain Veneers

    Thin porcelain facings bonded to the front of the teeth to correct shape, color, spacing and wear.

  • Teeth Whitening

    Custom-tray whitening supervised by a dentist, with the sensitivity managed rather than endured.

  • Porcelain Crowns and Caps

    A full-coverage porcelain restoration that rebuilds and protects a tooth too damaged for a filling.

  • Porcelain Fixed Bridges

    A fixed replacement for a missing tooth, anchored to the natural teeth on either side of the gap.

  • Tooth-Colored Composite Fillings

    Bonded, tooth-colored restorations that repair decay while removing less healthy tooth structure.