Most patients calling from West Palm Beach about cosmetic dentistry have one of three things going on. They’ve been thinking about a specific procedure for a long time and want to understand what it actually involves before booking anything. Or they had cosmetic work done somewhere else and something about the result never sat right with them. Or a tooth broke, or a crown from years ago finally needs to come out, and they’ve decided to address the appearance at the same time.
We see patients from West Palm Beach and throughout Palm Beach County at our Delray Beach office. Dr. Nicholas Goetz is a maxillofacial prosthodontist with fellowship training from UCLA — a specialty that takes three additional years after dental school focused specifically on restoration. That foundation informs every cosmetic case, from how the tooth gets prepped to how the shade is matched to the teeth beside it.
The Whitening Question
When a patient asks about whitening, the first question we ask is what caused the discoloration. Surface staining from coffee, wine, or tobacco responds well to in-office whitening. The gel concentration we use is higher than pharmacy products, and the application is controlled, which means a more even result. But staining that came from antibiotics taken as a child, or from a tooth that darkened after a root canal, is a different situation — whitening has limits, and veneers usually give a better outcome for those cases.
What Patients Usually Ask About Veneers
The most common misconception we clear up at veneer consultations is how much tooth structure gets removed. It varies based on what’s being corrected. For some cases the prep is minimal. For others, where the tooth’s existing shape or position requires more adjustment, the preparation is more involved. What we’re trying to build is a ceramic facing that looks like a tooth — same light response as the enamel next to it, same proportion. A veneer that reads as placed is a failure. A good one disappears.
Patients who’ve come in having already done research usually have a picture in their head of what they want. The consultation is about whether that outcome is achievable given their specific teeth, and what the path to get there looks like.
When Bonding Makes More Sense
For a small chip on a front tooth, or a gap a patient wants closed, composite resin bonding is often the better call. No tooth structure comes off. We build the resin directly onto the tooth and shape it to blend with what’s around it. Most of the time it’s a single appointment. When the correction needed is more significant — or a patient wants something that holds up for fifteen years — we talk through veneers instead.
Crowns and the Aesthetic Side
Not every crown case starts as a cosmetic one. But when a visible tooth needs full coverage, the result has to look right. We use porcelain on visible teeth and match the shade and shape to what’s around it as precisely as the case allows. For patients replacing a missing tooth with an implant, the crown over the implant involves the same decisions — how it looks affects how the patient lives with it for years.
Gum Tissue Matters Too
Some patients come in wanting cosmetic work on their teeth and don’t realize the gum line is part of what’s affecting the result. A gum line that’s uneven, a tooth where the gum sits too high or too low relative to its neighbors, or recession that’s pulled the tissue back and exposed root surface — any of that changes how the smile reads. Gum therapy is part of the picture when the soft tissue is contributing to the appearance.
What the Consultation Looks Like
We start by looking at the full picture — the tooth the patient is focused on, how it relates to what’s beside it, how it fits into the bite. We take photos, look at shade and proportion, and talk through what we find. If there’s a treatment plan, we walk through it step by step before any work starts.
Dr. Katie Gavalas sees patients alongside Dr. Goetz with the same thorough approach. We see one patient at a time, so the appointment isn’t shared with anyone else’s schedule.
If you’re in West Palm Beach and have been thinking about cosmetic work, contact us to schedule a consultation at our Delray Beach office.
