| A general dentist protects the health and function of your teeth through exams, cleanings, fillings and crowns. A cosmetic dentist improves how your teeth look through veneers, whitening and bonding. Most patients need the general dentist first. |
Same degree, different focus. Both hold a DDS or DMD. Cosmetic dentistry is not a specialty recognised by the American Dental Association – it is a focus built through post-graduate training in esthetics.
Health comes before appearance. Active decay or gum disease must be treated before any cosmetic work. Veneers placed over an untreated problem fail early.
Insurance splits along the same line. Treatment that restores function is often partly covered. Purely esthetic treatment usually is not. See our dental insurance page for how this works in practice.
One practice can do both. At Dental Line in Encino, Dr. Irena Starchenko provides general, restorative and cosmetic care, so the sequencing is handled in one treatment plan.
If you are deciding who to book, the practical question is not which type of dentist is better. It is which problem you are solving first. A cracked molar and a discoloured front tooth are different jobs, and starting with the wrong one wastes money. This guide covers the training difference, what each provider actually does, how to sequence treatment, what insurance covers, and how to choose for your situation.
What training separates a general dentist from a cosmetic dentist?
Both complete the same four-year dental degree. The difference is what they study afterwards. Cosmetic dentistry is not an ADA-recognised specialty, so any licensed dentist may offer cosmetic treatment. What separates practitioners is post-graduate training, case volume and documented results.
What a DDS or DMD covers
A general dentist earns a Doctor of Dental Surgery (DDS) or Doctor of Dental Medicine (DMD). The two degrees are equivalent – the letters reflect the awarding school, not a difference in training. The curriculum covers diagnosis, prevention, restorative dentistry, periodontal care, endodontics, oral surgery and pediatric care. State licensure requires passing written and clinical board examinations, plus continuing education to renew.
What cosmetic training adds
Dentists who focus on esthetics pursue additional coursework in areas the core curriculum treats only briefly:
- Smile design. Proportion, midline, incisal edge position and how tooth display relates to lip movement.
- Shade matching. Reading value, hue and translucency so a single restoration is invisible beside natural teeth – the hardest part of a single front crown.
- Material selection. When porcelain veneers are appropriate versus composite bonding, and how each ages.
- Occlusion. How a rebuilt bite distributes force. Esthetic work that ignores occlusion chips or debonds.
- Credentials. Bodies such as the American Academy of Cosmetic Dentistry (AACD) and the Academy of General Dentistry offer accreditation requiring submitted case documentation.
What to ask: “How many of these have you done in the last year, and can I see before-and-after photos of your own cases?” Case volume and the practitioner’s own photography tell you more than a logo on a website.
Which services does each one provide?
General dentistry keeps teeth healthy and functional. Cosmetic dentistry changes how they look. A large middle group – crowns, bridges, bonding, inlays – does both, which is why the categories are easier to read as a spectrum than a wall.
Table 1. Where each treatment sits on the health-to-esthetics spectrum
| Treatment | Primary Purpose | Category | Typically Insured? |
|---|---|---|---|
| Exams and Cleanings | Prevent decay and gum disease | General | Yes, typically in full |
| Tooth-Coloured Fillings | Repair decay and restore function | General, esthetic benefit | Usually partly |
| Root Canal Therapy | Save an infected tooth | General | Usually partly |
| Deep Gum Cleaning | Treat periodontal disease | General | Usually partly |
| Crowns | Rebuild a broken tooth | Both | Often partly |
| Bridges | Replace missing teeth | Both | Often partly |
| Implants | Replace a tooth root and crown | Both | Varies widely |
| Inlays and Onlays | Conservative mid-size repair | Both | Often partly |
| Composite Bonding | Reshape or close small gaps | Mostly cosmetic | Rarely |
| Porcelain Veneers | Reshape and brighten front teeth | Cosmetic | Rarely |
| Professional Whitening | Lighten tooth shade | Cosmetic | No |
| Laser Gum Contouring | Reshape the gum line | Cosmetic | Rarely |
Read the third column carefully. The treatments marked Both are where most real patients live. A cracked molar needs a crown for structural reasons – but if it is a visible tooth, shade and contour matter just as much, and that is a cosmetic skill applied to a restorative problem. The same is true of inlays and onlays and of bridge work.
The general dentistry core
Preventive care is the highest-return dental spending there is, because it stops problems while they are still cheap to fix – the case we make in detail in how preventive dental care saves money. The core is: routine exams, professional cleanings, tooth-coloured fillings, deep gum cleaning where periodontal disease is present, and emergency care for trauma or acute pain.
[H3] The cosmetic core
Cosmetic treatment addresses shade, shape, alignment and proportion. The main options are professional whitening, porcelain veneers, composite bonding, laser gum contouring, and orthodontic movement with clear aligners or braces. Choosing between the overlapping ones is its own decision – we compare them directly in veneers vs teeth whitening and bonding vs veneers.
One correction worth making: whitening does not work on every kind of discolouration. Surface staining from coffee or wine responds well. Discolouration from inside the tooth – trauma, tetracycline, ageing dentine – does not, and needs veneers or bonding instead. The difference is explained in intrinsic vs extrinsic tooth stains. Patients who whiten repeatedly with no result usually have the intrinsic kind.
Which one do you need first?
Health first, appearance second – and this order is not negotiable. Cosmetic work bonded to a tooth with active decay, or placed in a mouth with untreated gum disease, fails early. You pay twice.
Table 2. Start here, based on what you have noticed
| What You Have Noticed | See First | Why | Then Consider |
|---|---|---|---|
| Pain, swelling, or a bad taste | General – urgently | Likely infection. Delay risks the tooth. | Nothing until resolved |
| Bleeding gums when brushing | General | Gum disease must be stable before any bonding. | Whitening, then esthetics |
| A visible chip, no pain | Either | Bonding often fixes it in one visit. | Bonding or a veneer |
| Teeth look yellow overall | General for an exam | Rule out decay, then confirm stain type. | Whitening if extrinsic |
| Old grey or mismatched fillings | General | Replacement is restorative work. | Tooth-coloured replacements |
| A missing tooth | General | Bone and bite must be assessed. | Implant or bridge |
| Crowded or crooked teeth | General for records | Alignment precedes veneers. | Aligners or braces |
| Nothing wrong, want a brighter smile | Either | A current exam is still the safe start. | Whitening or a makeover plan |
Why the sequence saves money
Consider a patient who wants veneers on the upper front six but has moderate gum inflammation. Veneers placed at that gum line will look correct for a few months. As inflammation resolves – or worsens – the gum margin moves, and the veneer margin becomes visible as a dark line. The restorations were made accurately for a gum position that no longer exists. Treating the gums first costs less than replacing six veneers. The same logic governs smile makeover planning, where sequencing is most of the work.
How to judge a practitioner
- Ask for their own case photos. Not stock images, not the manufacturer’s brochure – their patients, their camera.
- Ask for the number, not the adjective. “Experienced with veneers” means little. “Roughly 40 veneer cases a year” is checkable.
- Ask what happens if it fails. A practitioner confident in their work states a remake policy plainly.
- Ask to see the technology. Intraoral scanners and digital imaging affect fit accuracy. Our equipment and technology page lists what we use.
- Check the whole-family fit. If you want one practice for everyone, weigh what matters in choosing a family dentist in Encino.
What does each cost, and what will insurance pay?
Insurance follows medical necessity, not the label on the treatment. If a treatment restores function or prevents disease, a dental plan will usually contribute. If its only purpose is appearance, it usually will not – regardless of which dentist performs it.
That single rule explains most coverage surprises. A crown on a fractured molar is typically a covered restorative procedure. A crown placed on a sound tooth purely to change its shape is typically not, even though the laboratory work is identical. Preventive visits are the exception in your favour: most PPO plans cover exams and cleanings in full or close to it, which is why choosing a PPO family dentist changes the arithmetic of routine care.
On price: cost depends on material, tooth position, laboratory and how much preparation is needed, so a published range is often misleading for an individual case. Rather than quote figures that may not apply to you, we give a written treatment plan with per-item costs after examination. For orientation on how fees are structured, see average family dentist fees in Encino, professional whitening costs and tooth-coloured filling options. Payment options are on our financing page, and plan questions are covered on our insurance page.
Table 3. How long treatments typically last
| Treatment | Typical Service Life | What Shortens It |
|---|---|---|
| Professional Whitening | Months to about 2 years | Coffee, tea, red wine, tobacco |
| Composite Bonding | About 4 to 8 years | Staining at margins, edge chipping |
| Porcelain Veneers | About 10 to 15 years | Grinding, no nightguard, gum recession |
| Crowns | About 10 to 15 years or more | Decay at the margin, fracture |
| Bridges | About 10 to 15 years | Decay in supporting teeth, gum disease |
| Implants | Often decades for the fixture | Peri-implantitis, smoking, poor hygiene |
| Tooth-Coloured Fillings | About 7 to 10 years | Grinding, large cavity size |
These are general clinical ranges, not a guarantee for your case. Two factors move them more than material choice: whether you grind your teeth, and whether you keep up routine cleanings. On veneers specifically, we go deeper in how long porcelain veneers last; on crown materials, in CEREC vs traditional crowns.
Why one practice for both is usually simpler
When the same dentist handles health and appearance, sequencing and shade decisions are made once, by one person, with the whole plan in view. Split the work between two practices and the coordination becomes the patient’s job.
A worked example. A patient needs a crown on an upper first premolar and also wants the front teeth whitened. Order matters: whitening must come first, because a crown cannot be lightened afterwards – its shade is fixed at manufacture. Whiten first, let the shade stabilise for about two weeks, then match the crown to the new shade. Reverse the order and the patient ends up with a correctly made crown that is visibly darker than the teeth beside it, and the only fix is remaking it. A single practice catches this at the planning stage. Two separate practices frequently do not.
The same coordination applies to replacing a missing tooth, where the choice between an implant and a bridge or between implants and dentures depends on bone volume, bite forces and the condition of neighbouring teeth – restorative judgements with permanent esthetic consequences. It applies to repairing a chipped tooth, where the fastest fix and the longest-lasting fix are not always the same. And it applies to alignment, where aligners versus braces changes what esthetic work is possible afterwards.
At Dental Line in Encino, Dr. Irena Starchenko provides general, restorative and cosmetic dentistry under one treatment plan. If you are new, what to expect at your first visit and our new patient guide explain how the first appointment works.
Frequently asked questions
Is a cosmetic dentist a real specialty?
No. The American Dental Association recognises specialties such as orthodontics, periodontics and endodontics, but cosmetic dentistry is not among them. Any licensed dentist may describe themselves as a cosmetic dentist. This is exactly why post-graduate training, case volume and before-and-after photography matter more than the title. See what a cosmetic dentist is and who performs cosmetic dental work.
Can my general dentist do cosmetic work?
Often yes, and for many treatments they are the right choice. Whitening, composite bonding and single-tooth esthetic crowns are routine general-practice procedures. Larger cases – a full upper arch of veneers, or a rebuild that changes the bite – warrant asking specifically about comparable cases they have completed.
Which procedures count as cosmetic?
Whitening, veneers, composite bonding and gum contouring are the clearest cases. Crowns, bridges and implants are usually classified as restorative because their primary purpose is function, even when the esthetic result is the reason the patient sought treatment. Table 1 above shows where each one sits.
Will insurance cover cosmetic dentistry?
Purely esthetic treatment is usually not covered; treatment that restores function often is, at least partly. Whitening and veneers on healthy teeth are typically excluded. A crown on a fractured tooth is typically a covered restorative benefit. Confirm the specific procedure code with your plan before treatment – our insurance page explains how we help with this.
What happens at a first cosmetic consultation?
An examination first, then a conversation about what you want to change. Expect photographs, X-rays and often a digital scan, plus a check of gum health and bite. You should leave with a written plan listing the sequence, the number of visits and the cost per item. If you are asked to commit to treatment without that document, ask for it.
Are there risks to cosmetic treatment?
Yes, and they are worth knowing before you consent. Whitening commonly causes temporary sensitivity. Veneers usually require removing a thin layer of enamel, which does not grow back – that decision is permanent. Poorly contoured restorations can trap plaque and inflame the gum. Grinding shortens the life of any esthetic restoration, which is why a nightguard is often part of the plan. Discuss your medical history and any grinding habit at the consultation.
How do I protect the result?
Routine hygiene and routine visits, plus a nightguard if you grind. Brush and floss daily, use a non-abrasive toothpaste – whitening pastes can dull polished porcelain – and limit staining drinks in the first 48 hours after whitening or bonding. Keep regular cleanings: most restoration failures start as decay or gum disease at the margin, both of which are visible at a check-up long before they are visible to you.
Can general and cosmetic treatment happen together?
Yes, and combining them in one plan is usually the better approach – provided health comes first. The normal order is: stabilise disease, complete restorative work, then place esthetic treatment onto a healthy foundation. One exception runs the other way – whitening is done before any adjacent crown or veneer is made, so the new restoration can be matched to the final shade.
