Which treatment should I choose?

In many circumstances you will have a choice of different treatment options to get to your desired end result. So which option do you choose? It can sometimes be difficult to decide which treatment option best meets your needs.

There are many factors to consider, and you first need to decide which factors are most important to you. These factors are listed below, put them in rank order if that helps. Once you have done this it will make it easier to decide which treatment option is right for you.

Biological Cost

Teeth do not have the ability to repair themselves, so any tooth structure that is removed can never be grown back.  Some procedures require more tooth structure to be removed than others, and these procedures have a higher 'Biological Cost', which potentially sets the tooth on a path leading to more time-consuming and expensive work in the future.  See The Restorative Cycle. If biological cost is important to you, you will want to choose treatments which retain as much of your natural tooth as possible. 

Maintenance

Different restorations may have higher maintenance needs than others.

Example: When comparing porcelain and composite veneers, composite veneers may need intermittent 'polishing' as they can lose their lustre over time.

If a restoration is placed in a tooth, no matter what type, it will need extra special cleaning at point where the restoration meets the tooth.

Repairability

If the restoration were to break, how easy is it to repair? If the restoration isn't repairable, how much is it to replace?

These are both very valid questions. Depending on why the restoration has failed in the first place, it may not be possible to repair or replace with a like-for-like  restoration. 

Generally, the further along your tooth is along The Restorative Cycle, the more complex and costly treatment becomes.

Example: Porcelain crown and veneers cannot be predictably repaired if they become chipped.  They can often be temporarily repaired but the nature of porcelain as a material means the long term solution often involves replacement of the entire restoration.

Longevity & Predictability

We all want any dental treatment we receive to give us many years of good service, however, it is important to remember that no restoration lasts forever.

Certain treatment options offer more predictability and generally last longer than others, however, there are so many variables that it can be difficult to answer the question How long will my restoration last?

Technical Difficulty

More technically difficult procedures require greater skill to achieve a good result. Technically difficult treatments need to be planned very well, with an  awareness of what can be done if things do not go exactly to plan.

Treatment Length

Some treatments can be completed same day in the chairside, others take a number of visits spread over many months.

If you have a fixed deadline to complete all treatment (e.g. wedding) there may be time constraints which mean your treatment options are limited.

Example: You may want straight white teeth, where the ideal solution for many would be orthodontic treatment to align the teeth followed by whitening, but this option takes time. Another option for some may be crowns or veneers, which an be completed far quicker, but comes with a much higher biological cost.

Functionality

The goal of all treatment is to enable you to eat and speak confidently whilst being pain-free. Different treatment options may achieve this in different ways.

Example: When replacing a missing tooth, the option of a denture, bridge or implant may be available. Some patients may rule out a denture as they do not want anything they have to remove from their mouth on a daily basis.

Aesthetic Result

How good the final result looks may be of paramount importance to you above all else. It is perfectly reasonable to want a beautiful smile, but it is also important that you have a healthy smile that you are able to maintain and have the means to repair and replace restorations if needs be.  

Financial Cost

Many dental procedures require an significant financial investment.  Although most dentists offer payment plans, there may be a limit on what you can afford, or are willing to spend on dental treatment, which may curtail your options.