Veneers

What are Dental Veneers?

Dental veneers are extremely thin, translucent, tooth-colored shells that are bonded to the surfaces of teeth to change their appearance and improve esthetics. Porcelain veneers are veneers made out of ceramic or porcelain material. Their great advantage is that they look extremely natural and match the appearance of real teeth, and can completely change the look of your teeth by changing their shape, size, length and color. Many people want porcelain veneers simply for changing their smile altogether and these are an excellent option.

Why you may need dental veeneers

Porcelain veneers are indicated for the following reasons:

  • Gapped teeth/ diastemas
  • Broken or chipped teeth
  • Stained teeth
  • Discolored teeth caused by cracks or improperly done endodontic treatment
  • Pitted teeth due to dental fluorosis
  • Uneven / irregularly shaped teeth

How the dental veneers are placed

Having cosmetic treatment with porcelain veneers usually involves two or three visits to the dentist. In the first visit, the dentist assesses your teeth and you discuss what look you would like to achieve after getting veneers.

The dentist shows you options and you can select the tooth shade and finer details of your liking. The dentist then prepares your teeth for the fabrication and placement of the dental veneers which typically involves removing a 0.5mm layer of your enamel and then, taking an impression of the prepared teeth.

The impression is sent to the dental lab for fabrication of the veneers, which takes about a week to ten days. He may place temporary veneers on your teeth to prevent sensitivity and to ease any discomfort while you wait for the veneers to be made at the dental lab.

On your next visit, your dental veneers are ready and are placed on your teeth for trial basis before bonding. It is during this visit that minor adjustments and finishing touches to the veneers are made by the dentist until the final dimensions are set and the veneers are ready to be bonded onto your teeth. The surfaces of the teeth to be treated are ‘etched’ or topically treated with a mild acid to produce a roughened surface for better bonding of the veneers to the teeth.

A bonding agent, such as composite, which matches the selected shade of veneers is used and the veneers are then permanently bonded onto the teeth. The final result is a beautiful, completely changed natural white smile.

Advantages of porcelain veneers

Porcelain veneer treatment offers many advantages over dental crowns:

  • They are stain resistant and very long lasting
  • They do not irritate the gums
  • They are a much less invasive substitute for crowns, which require massive removal of natural tooth substance and shaping of the tooth
  • They give a completely natural appearance as they are semi-transparent like natural teeth
  • Sensitive teeth can be made less sensitive due to the protective effect veneers provide
  • The procedure is painless
  • Only takes up to 2-3 visits for a permanent result

Dental veneers are therefore an excellent option for getting the perfect white smile that you desire.

Do Dental Veneers Require Special Aftercare?

Although the tooth is covered with a dental veneer, keep in mind that the covering is limited only to the front surface.  Decay can still form on the posterior or back façade of the tooth or under the veneer.  Therefore good oral hygiene is crucial.

Flossing and brushing twice each day is important to remove food debris and particulate matter.  Using a non-abrasive toothpaste containing fluoride is recommended.

Because the porcelain veneer borders the gum line, it is crucial that thorough cleansing with plaque removal is performed to make certain that the gum line surrounding the teeth does not recede.  (This occurs in response to gingivitis or periodontitis- an inflammation of the gum and oral tissues secondary to tartar and plaque.

Don’t tempt staining

While the surface of porcelain veneers are markedly resistant to stains, the cement used to adhere the veneer to the tooth surface can absorb and reflect the stain as time progresses.  Thus, staining visible around the edges or periphery where the veneer meets the actual tooth can mar the aesthetic appearance of the tooth.

Eliminate foods and beverages that stain teeth due to the tannins and chromogens (richly pigmented molecules) which are contained within:

  • Wine
  • Coffee
  • Tea
  • Tomatoes
  • Berries (black currant, blueberries, pomegranates, cherries) as well as the juice made from them
  • Richly-colored sauces (e.g. soy, curry, tomato sauce)
  • Soda and carbonated beverages

Also eliminate use of tobacco products.  If this is not possible, consider brushing teeth or using a mouthwash after use of the above.

Bruxism

Bruxism is a term for grinding and clenching teeth. This behavior exerts undue, heavy force on the veneers and teeth in general, which places them at a higher risk for chipping or breakage.  Although this clenching behavior while awake can be done by habit, it is often secondary to a response to stress.  This tension should be addressed and treated.  For prevention of dental harm at night secondary to grinding, a plastic night guard (made by the dentist to fit your dentition) should be worn.

Don’t be forceful

In order to protect the durability and length of porcelain veneers, heavy force and sudden impact should be avoided as it is not designed to withstand such pressure.    Often the dentist will design the dental alignment so that biting certain hard objects are unlikely such as:

  • Hair pins
  • Fingernails
  • Ice
  • Bottles
  • Nut shells (e.g. pistachios)

Biting on these objects can result in displacing the veneers or breaking them.

If one participates in body contact sports or activities where getting hit in the mouth are a possibility, wearing a dental guard would be a prudent practice.

Following these precautions will ensure that your veneers last a long time and that your great smile represents you!

 

Benefits of Dental Veneers

Part of that impression that someone is a “natural” beauty is the glow that someone radiates- and part of that glow is the smile (and teeth).

Natural teeth have a translucent quality- they have a glowing appearance as if light were coming through.  This is actually not far from the truth.

Normal tooth enamel is translucent- light shining on the surface of a tooth, gets absorbed into the enamel layer.  As the light penetrates through the complete enamel thickness, it bounces off the opaque dentin layer that is located just beneath the enamel and then emits back out of the tooth.

This behavior of light passage and reflection off the tooth layers is responsible for the lustrous attribute that teeth possess.

Our technology in the past did not enable us to synthesize a material that duplicated this lustrous appearance.  Prior fabrications were only semi-translucent so that shining ight hitting a repaired tooth would bounce off the exterior as opposed to being absorbed into the bonding.  So, despite the improvement to the tooth shape and appearance, there was no luster.  Instead it was dull and very distinguishable.

Life-Like…Real or Not?

Because porcelain veneers are ceramic or possessing a glass-like composition, they are not only functional but also translucent which is a great advancement.  After a porcelain veneer is made adherent to the dental surface, it will very accurately act like normal dental enamel in its light handling characteristics.

Just like a normal healthy tooth, when light hits the exterior façade of a tooth with a porcelain veneer, it penetrates into the veneer in the same manner that it would absorb through normal dental enamel.

Having crossed through the full thickness of the porcelain, the light will bounce off the opaque cement and dentin which lies underneath and then out the tooth again. This mimics the same lustrous effect and translucency trait that makes it seem like a natural, healthy tooth.  It is so natural, it is hard to distinguish between the two.

Stain-Free

Because porcelain is a “glass-like” ceramic, the porcelain veneer is extremely stain resistant.  This advantage bypasses the dental bonding materials of the past which did not have the capacity to avoid discoloration.  This was a distinct problem in those people who smoked or who ingested foods with rich pigmentation containing tannins and chromogens such as those found in coffee, tea, wine and berries.

It is still a good idea to limit the exposure of the veneers to these staining foods and beverages since the cement used to adhere the veneers are not stain-resistant and could discolor as time progressed if consumed excessively.

So to “recap” having porcelain veneers allows you to “act natural”!

The Placement of Dental Veneers

We’ve come a long way from the time that the only option available to us when a front tooth chipped or broke was a cap.  The crude making of this was obvious and made the tooth larger than normal.  More importantly, the tooth was ground down to a small spike, never accessible to any other treatment options again.

Now that our technology has been finely honed, the making and placement of veneers gives the appearance of a normal tooth (sometimes far better than the normal tooth!)

First the teeth must be thoroughly examined for any cavities or surrounding gingival inflammation.  If either exists, immediate attention and treatment must be paid to this first.

Once the tooth is determined to be healthy, the dentist will prepare the tooth for the eventual veneer placement.  Veneers can be placed on one tooth or many.  If the purpose of the veneers is to whiten the smile, then it is advisable to have the veneers applied to all the teeth that are visible in the front.  Usually at least 8 teeth are done on both the upper and lower levels.

Tooth Preparation

Porcelain veneers are only placed on one side of the tooth- the front surface. This front surface needs to be prepared by being shaving the facade to around the same thickness as that of the veneer itself.  In doing so, the tooth size will not be noticeably changed.

Typically the tooth enamel is trimmed very thinly, approximately one half to .7 millimeters, which is very small, compared to other dental processes.  The use of a local anesthetic can be used, depending on the pain threshold of the patient.

Making an Impression

Once the tooth enamel has been trimmed, an impression will be made of the tooth by creating a mold with putty and then the patient bites into the soft material, which then hardens.  Alternately, an impression can be made with a camera that takes measurements optically. The camera is attached to a “milling” machine that then makes the veneer.  Creating the veneer this way allows for manufacture and placement during one office visit instead of two.

Most dentists, feeling that the appearance and shape is better, consider having a putty impression, which is sent to a lab whereupon the veneer is made, the superior technique.

It’s only Temporary

Once the teeth that will be receiving the veneers have been prepared, they will have a rough surface, which may be uncomfortable for contact with the tongue. In addition, the prepared teeth may exhibit sensitivity to temperature extremes (hot and cold).

To avoid both of these issues, a temporary veneer is placed over the teeth as a protective covering while waiting for the permanent veneer.

If the Tooth Fits

The permanent veneer will be examined and assessed by the dentist and trimmed repeatedly until the fit is deemed appropriate.  The veneer is cemented into the proper position and ground down to the exact measurements desired by the dentist. Bonding is then performed, followed by cleaning and polishing.

Your bite will be evaluated to ensure a good fit and then it’s ready for use giving you not only tooth strength and durability but also that dazzling smile!

Composite Resin vs Porcelain Veneers

Having veneers placed on one’s teeth is a popular request for cosmetic dentists today.  Your professional dentist will discuss whether or not you would be a good candidate after a thorough examination and evaluation.

Now that you’ve chosen veneers as the cosmetic dental procedure, the dentist must choose which one is the most appropriate for you.

The veneer material may be made from composite resin or porcelain; each one has its benefits and drawbacks.

Benefits of Composite Resin Veneers

  • One Office Visit

Composite resin veneers can be made and placed within a single sitting in the dental chair.  The tooth is prepared with an appropriate amount of enamel structure removed to permit veneer placement without making the tooth too bulky. The composite resin is formed into the shape desired. After a bonding agent is applied, the composite resin is then placed, followed by a curing technique

Once satisfactorily complete, the tooth is polished and ready for action.

  • Repair

If a composite resin breaks with wear, it can be repaired, unlike porcelain veneers, which must be completely replaced.

  • Cost

Because the dental chair as opposed to can make composite resin veneers porcelain veneers which must be fabricated in a dental laboratory, and takes more than one office visit with more preparation, porcelain veneers are more costly

Benefits of Porcelain Veneers

  • Stain Resistant

In comparison to other bonding agents, porcelain veneers are stain resistant due to its impermeable ceramic surface.  Therefore eating and drinking richly pigmented foods and beverages containing tannins or chromagens will not mar the veneer appearance (as in coffee, tea, red wine, berries).

  • Conservative

Only a small bit of enamel is removed to make way for the veneers which are quite thin ranging in size between one half millimeter to .7 mm. This leaves the integral structure of the tooth intact and therefore stronger.

  • Natural in appearance

The characteristic translucency of porcelain veneers makes the tooth appear quite natural and life-like so that it is difficult to discern any dental work to the tooth itself.  Light enters the veneer and enamel and then bounces or reflects back when it hits the dentin giving a pearly luster in the same manner as most teeth. The perception of depth that one gets with porcelain is not shared with composite resins or other bonding material.

  • Durable

Avoidance of chewing hard objects like nails, nutshells and ice along with practicing good oral hygiene, will afford individuals many years of enjoyment from the porcelain veneers (10-15 years or longer).  The veneer bonded to healthy teeth makes it very strong.

To “recap”, if time in the dental office is an issue or the cost of the procedure is a strong consideration, then a composite resin may be the more sensible choice.

However, if these are not issues, porcelain veneers may be the way to go.

Either way, the dentist will help you decide.  Enjoy your new teeth and new look!

 

 

Are Veneers Your Only Makeover Option?

Cosmetic dentistry is a way that people who are unhappy or self-conscious with their teeth and seldom smile can get a new lease on life.  Technology today offers several treatment options for those individuals looking for a more aesthetic smile.

Although veneer placement is a popular choice for cosmetic dentists today, there are times when porcelain crowns (also referred to as caps) are chosen instead. These are highly aesthetic as well.  The determination between the two depends on the function of the tooth post-procedure.

While customized porcelain veneers are generally used to improve the tooth’s color and shape, it is applied only to the front surface of the tooth. The procedure is usually not performed in teeth with a great loss of structure from dental decay or root canal treatments where a cap or crown will fit over the entire tooth.

There are several variables to consider.  Porcelain crowns might be a better choice if:

  • Patient suffers from severe bruxism (grinding and clenching of teeth)
  • Teeth have had root canals causing it to be brittle
  • There are missing teeth and device needs to be linked together for added strength
  • The dental bite is “edge to edge”
  • The occlusion (bite) must be changed
  • Tooth is markedly stained
  • Tooth is fractured

Since the crown envelops the complete tooth, they provide a good choice for a problematic tooth.  Veneers cover only one façade.  The tooth preparation because of the coverage between the two, differs with much more of the tooth structure needs to be removed with the crown so that there is enough space for the restoration to have the proper gum contour as well as aesthetics and desired strength.

While the cost can vary tremendously depending not only on locale but also between dental offices within the same geographic area, crowns tend to be more expensive than veneers.

Instead of depending on veneers to close gaps between teeth or crowns, there are occasions when dental implants will be suggested to replace the missing teeth and restore the natural appearance of the smile.

A titanium screw is inserted into the jaw and an artificial tooth is attached to this screw.  The implant is quite stable and does not damage surrounding teeth.

In addition to restoring the natural bite, dental implants provide an aesthetic purpose by reestablishing the normal appearance of teeth.

Rather than going to the dentist with a solitary purpose in mind, it is prudent to have a thorough examination and consultation.  The professional dentist will sit down with you and explain all the advantages and benefits as well as the contraindications so that the right choice is made for you.

 

Questions to Ask About Veneers

Before getting veneers to improve your smile, there are many questions that need to be considered and by compiling this list prior to the consultation with your dental specialist, you can go in prepared and with confidence.

By having all the questions answered and having a thorough consultation, there will be no surprises or confusion and the possible risks will be decreased as well.

  • What will my smile look like with veneers?  Do you have a computer that can do a rendition of my appearance for me?
  • How is the shade selected?  Is that done by me or the dentist?
  • How many of my teeth will need veneers?  Is there a minimum amount of the teeth that need to be done?
  • What happens to the rear teeth that are not involved in the veneers?  Will they show?
  • Will my teeth need to be completely shaved down even if the enamel is healthy?  How much of it is drilled or reduced?
  • How should my veneers be cleaned?  Is there any special toothbrush?  Is there any special toothpaste?
  • Are there foods that I must now avoid?
  • Are there beverages that I must now avoid?
  • How long will my veneers last?
  • Do veneers ever “pop off”?
  • If I want my veneers removed in the future, is that a possibility?  What would the teeth look like?
  • How are the veneers attached?  Is it possible to be allergic to the adhesive or is it possible to have a bad reaction to it?
  • How many office visits will I need to have the veneers placed?
  • Are the veneers made in the dental office or in an outside dental laboratory?
  • How experienced are you (the dentist) in making and attaching the veneers?
  • Are you certified in placement of veneers?
  • Are there special diagnostic tests that need to be performed prior to considering me a candidate?
  • Is consumption of alcoholic beverages still possible?
  • Can I bite into crunchy foods or are the teeth not strong enough to withstand pressures?
  • If I tend to grind my teeth at night, can I still get veneers or will it be too much undue pressure for them?

Knowing the answers to these questions, will allow you to have the procedure done with confidence so that you truly will be able to smile with those dazzling teeth.

Dental Veneers vs Crowns and Bonding

When determining whether application of veneers is the option for you or crowns and bonding is the better choice, there are benefits and disadvantages of both that should be kept in mind.

With latest technology, the choice to correct dental imperfections can be any of the three, unlike years ago when the only available option was to place a cap or crown over each problematic tooth.

Benefits of Veneers over Crowns and Bonds

  • Veneers last longer than bonding
  • Porcelain veneers resist staining
  • The exact color can be obtained with veneers
  • Veneers add strength and durability to the teeth
  • Only regular oral hygiene with brushing and flossing is required for maintenance.  No special routine is needed.
  • Less healthy tooth material is removed than with crowns
  • Teeth shape alteration is more moderate with veneers
  • Gives a more natural look and feel to the teeth
  • If brushed and taken care of properly, veneers can last up to 15 years.

The disadvantage of dental veneers is that it is not as strong as crowns.  They cannot withstand undue pressure so that people suffering from bruxism or grinding and clenching teeth at night can cause undue harm to the veneers.  (This can be addressed with a mouth guard).  A tooth would not be eligible for veneers if it has had extensive structural work done as in extensive fillings from decay.

Because of the decrease in strength compared to crowns, veneers chip or crack more easily. They also are vulnerable to decay and if enough of the enamel is lost, will necessitate covering the tooth with a crown, anyway.

Teeth covered up with veneers have the risk of becoming sensitive to exposure to hot and cold as in hot and cold beverages, ice, cold air. Sour and sweet foods may also trigger the sensitivity sensation.  This is characterized by sharp, sudden and shooting pain deep into the nerve endings of the teeth. The cause of sensitivity is exposure of dentin (the underlying layer to enamel) which has thousands of channels leading to the pulp (nerve center) and may be opened from manipulation of the tooth enamel or receding gum lines.

If the veneer develops a fracture or crack, which is either undetected or untreated, bacteria from plaque may enter the pulp from tubules, thereby causing inflammation and additional sensitivity.

Once the decision to have veneers or crowns is made however, the process is not reversible.  In either case, you will have a beautiful set of teeth and a dazzling smile!

What Are Thineers

The new thineer is a wafer thin hybrid veneer. Thineers are quick, easy to apply, and non-invasive.

Thineers procedure

No enamel has to be removed from the tooth surface, therefore making it a comfortable experience. This means that local anesthetic may not necessary when placing the thineers, which is a big plus for patients weary of injections and pain.

Temporary coverings can be fitted until your thineers are ready to be fitted.

The permanent thineer will be fitted using a strong cement. This prevents any leakages from occurring under the veneer.

Why you might want thineers:

It is possible to have thineers if:

  • Reshape your existing teeth
  • Your teeth are crooked
  • Your teeth have staining on them
  • You have unsightly gaps between existing teeth
  • Your teeth are chipped

How long do they last?

Thineers can last up to 20 years, so long as the teeth are regularly maintained and cared for.