Porcelain Veneers or Crowns? Which Would Be Better for Me?

The health of our smile and oral health is a very important part of all of our lives. It allows us to evoke numerous expressions of emotion, speak with confidence, and eat comfortably. If you’re considering ways to restore your teeth and enhance your smile, then you have many options. When teeth have stains, chips, or old fillings, a common recommendation is to revitalize the teeth with either crowns or veneers. Both alternatives are popular and can achieve life-changing results in the health and beauty of your smile.

Although both treatments will improve the appearance of your smile, there are some key similarities and differences between veneers and crowns that you should be familiar with depending on your situation. This article will give you some background on veneers and crowns to help you be informed when discussing your treatment options with your dentist.

What are Veneers or Crowns?

When teeth are chipped, misshapen, or discolored in ways that are more than what a composite filling can restore, your dentist may recommend restoring the teeth with either veneers or crowns. Both crowns and veneers are forms of dental restorations. The veneer and crowns are similar as they both add a covering, usually a ceramic material, to an existing tooth to improve the appearance or structural integrity of a tooth. A veneer generally covers primarily only the front surface of the tooth while a crown covers the front and back of the tooth essentially securely holding the tooth together. So, therefore, a veneer is chosen over a crown when the back surface of the tooth is structurally sound, but the front of the tooth has cosmetic defects. Both crowns and veneers are equally effective in improving the aesthetic appearance of teeth. The choice usually comes down to how badly broken the underlying tooth is. 

A veneer is a custom made to fit the teeth out of thin porcelain. The porcelain veneer is bonded to the front of a tooth, essentially becoming one with the tooth. To you and any observers, the tooth will look natural and will not have any visible seams. The porcelain is color-matched to your natural teeth. In terms of strength, dental veneers are strong but often brittle. In most cases, veneers generally can last 10-20 years but you will need to be somewhat cautious as excessively sharp or repeated impacts can dislodge or crack them.

A crown is also custom made, but instead of only bonding to the front of the tooth, a dental crown encapsulates the entire tooth. It can be made of metal, porcelain or a combination of both. In our practice at Aesthetic Smile Reconstruction, the majority of crowns are made from either a ceramic or a white metal called– zirconia. Both ceramic and zirconia materials, provide natural aesthetics without any dark metal shading at the gumline. The zirconia crowns are a great option for a patient that has a strong bite and is prone to breaking or cracking teeth. 

The Preparation–How Veneers and Crowns Affect the Underlying Tooth

Veneers preserve your natural tooth structure. Due to the design of how veneers adhere to teeth, less of the tooth needs to be adjusted and removed in order to fit a porcelain veneer. They do not require tooth adjustment of the back of your tooth known as the lingual surface. Because of this, veneers are considered a more conservative treatment compared to crowns.  To prepare a tooth for a veneer, your dentist will adjust any weak or worn areas on the front of your tooth. He or she will adjust the shape of the front of your tooth to allow the veneer to position ideally over the front of the teeth. Most of this adjustment is done to the front and sides of the teeth where the veneer will restore the tooth. The remaining underlying surface of the tooth will be your natural tooth structure. 

Crowns are generally indicated when there is a larger portion of the tooth that is broken or weakened. The dentist will adjust the weakened area and which typically requires the tooth to be adjusted about 1-2mm on both sides. This typically means there are about 2-3 times as much tooth removed when a crown is placed compared to a veneer, and the removed portion is fully replaced with the crown which successfully restores and secures the tooth again.

Both veneers and crowns can enhance things like shape, size, color, and alignment of the teeth. Since treatment is fully customized to a patient’s needs, there are in between options where a veneer may cover more of the tooth than a traditional veneer, but less tooth than a crown. For example, in times where a patient needs veneers to correct significantly crooked teeth, additional tooth adjustment may be done to compensate for parts of the tooth that are significantly out of alignment. In this situation, more of the tooth would be covered by the ceramic of the veneer to deliver the desired result. 

When Should I Choose Veneers?

Veneers are an excellent option if your teeth are generally structurally sound but you have aesthetic concerns such as badly stained teeth, cracks in teeth, chipped teeth, gaps, or crowded crooked teeth. For patients with these concerns, veneers can dramatically improve the beauty of your smile. Veneers can also improve the health of your teeth compared to crowded or broken teeth. Veneers place the teeth in proper alignment which reduced food impaction and aid the ability for the patient to floss and maintain healthy gums. The improved color, shape, and size of the teeth also have significant emotional benefits and has been shown to boost confidence and happiness for patients. 

It is important to note that there is a commitment required to veneers to maintain them with proper hygiene so that they do not decay. When properly cared for veneers generally last a long time and are considered permanent enhancements to the teeth. Over time, typically about 10-20 years, just like natural teeth the veneer may begin to age and require replacement. Veneers are just as permanent as a crown and should be considered generally as durable when the patient refrains from unnecessarily tearing things like bags or wrappers with their teeth. 

When Should I Choose Crowns?

Crowns are typically needed instead of a veneer when the underlying teeth have significantly more defects. This often happens when the teeth have large existing fillings, have large existing fractures, or have a history of root canals. By treating badly broken teeth with a crown, the crown serves to protect the underlying tooth from further damage and in a sense hold it together so that it maintains strength. It is important to note that, just like veneers, crowns allow for all the same aesthetic improvements such as color, size, shape, and crooked teeth. When a crown is cemented securely over the underlying tooth, it forms the new outside surface for the tooth with the desired aesthetics. The natural tooth is safely protected underneath and is not seen. 

In patients with TMJ and that have a history of grinding, it is often recommended to consider crowns over veneers to add strength to the restoration and additional protection to the underlying tooth. Since veneers only cover the front side of the tooth, the dentist will carefully evaluate if the patient is likely to grind and put stress on the veneer which could potentially cause the veneer to fracture. Therefore, patients with significantly worn teeth from grinding are often recommended crowns over veneers. 

Crowns are both functional and aesthetic improvements to teeth. The average lifetime of a crown is similar to a veneer at about 10-20 years. After a crown has been placed it is considered permanent, and the tooth will always require a crown to cover it. 

Differences in Cost and Insurance Coverage

Crowns and veneers are similar in cost. However, veneers are usually considered a purely cosmetic treatment. Because veneers are considered cosmetic by insurance, they are very unlikely to have insurance benefits available. Because crowns are often used to treat both functional and cosmetic concerns, crowns are often covered by insurance benefits typically at around 50% of the cost shared between the insurance and the patient up to the yearly maximum. 

Maintaining Your Perfect Smile

The goal of both crowns and veneers is to restore the teeth beautifully for many years to come. Your dentist will discuss recommendations with you to aid the success of your veneers and crowns. Brushing twice a day and flossing once per day is the basic requirement. Your dentist may recommend a fluoride mouth rinse or a prescription toothpaste to help you further prevent decay. Although very durable, you generally don’t want to place any unnecessary stress on your veneers or crowns. You should refrain from tearing wrappers with your teeth or crunching excessively hard things over your veneers or crowns such as ice or hard toast. Veneers and crowns are generally more resistant to stains than natural teeth, but they can still gather some stain over time. With proper care, your veneers or crowns should last for approximately 10-20 years allowing you to enjoy your beautiful smile for many years to come. 

Aesthetic Smile Reconstruction is the leader in porcelain dental veneers in Waltham, MA as well as the neighboring towns of Newton, Wellesley, and Lexington. Dr. Sutera has successfully treated thousands of patients, each with a variety of goals and aspirations. Dr. Sutera is considered a leader in the Boston Metro area in veneers due to his blended expertise in facial aesthetics, TMJ, and sedation dentistry. He is one of the few cosmetic dentists in the Waltham area trained directly in facial aesthetics by renowned cosmetic dentists, Dr. Larry Rosenthal, and Dr. Michael Apa, at the Rosenthal Institute at NYU. Dr. Sutera and his team are skilled professionals who will closely get to know your goals and desires. Aesthetic Smile Reconstruction strives to provide beautiful, life-changing dental health care. Contact us today, we’d love to share a smile.