Dental veneers are custom-designed shells of tooth-like ceramic material that, when applied over the surface of a tooth, can cover worn tooth enamel, uneven tooth alignment or spacing and chips or cracks. Dental veneers are becoming increasingly popular despite the average cost nationwide of dental veneers at around $900-$1200 per tooth.
Veneers have been popularized in the media after many total makeover shows have shown dramatic improvements into appearance and confidence after a new set of veneers. However, there are significant problems with traditional porcelain veneers, and many patients have reported very poor post operative outcomes. In order to fit the veneers, your cosmetic dentist needs to grind or shave the existing teeth to fit the porcelain veneers. This means that the tooth structure will be compromised, and the enamel that is protecting your tooth from decay will be exposed. This is non-reversable!
When are Veneers Appropriate?
Veneers can mask a variety of unsightly issues from dullness, wear, discoloration, mild chipping, cracking, spacing, to uneven teeth. They have become very popular at solving a wide range of cosmetic issues. However, applying veneers is the equivalent of painting a discoloured wall quickly with a new colour of paint. It will look great for the first few months, but soon after the original issues - mould, damp, etc. - that caused the problem in the first place will come back and ruin it. If you are using the veneer as cover-up, its vital to look at what you can do to fix the original problem in the first place.
* "Worn" Enamel: Over time, the thin, hard white substance covering your teeth (the tooth enamel) may become de-mineralized, dulled, and discolored. The degree of de-mineralization is due to your dietary and lifestyle habits (drinking soda, refined sugars, black tea, or coffee consumption, smoking, medication use, etc.). Tooth enamel cannot re-grow but it can be re-mineralized naturally to reverse this de-mineralization process. Tooth enamel is not 'worn' down. It can be re-mineralized through diet and avoiding acidic foods that leech the mineral content away from the teeth. Once the enamel re-mineralizes less of the secondary tooth structure is seen through the enamal layer, making your teeth whiter and brighter. Although enamel can stain, your teeth turn yellow and dull because the white enamel layer is being gradually lost. See this article on how to re-mineralize your teeth.
* General Wear and tear: Teeth naturally wear down as people age. Aged teeth are more likely to have chips, cracks or a generally uneven appearance. Working on re-mineralizing your teeth through diet will help to improve the apperance of your teeth naturally.
* Genetics: Certain people may be born with abnormal spacing between the teeth that grows wider as they age. Instead of using veneers to "paper over" the cracks, many people are choosing orthodontic treatment to correct spacing issues later in life. Speed braces are the latest technology that can be used over the course of 6 months to make dramatic improvements to your smile, while maintaining your natural tooth in their natural state. If you wear the retainer correcly, orthodontic treatment will fix your spacing issues for life. There are issues with braces as well for adults. For example, root damage is more prone to occur later in life when teeth are moved, but in general orthodontic treatment is much safer and has much better outcomes than veneers. Many people don't want to wear braces for cosmetic reasons. There are now plenty of options for you. For example lingual braces are fitted on the inside of your teeth and are practicaly invisible. You can even get speed brace versions of lingual braces, as well as ceramic braces, invisalign etc.
* Uneven teeth: Uneven teeth can result from tooth grinding or general wear and tear. If you grind your teeth, you are not a good candidate for veneers! See this article on post-operative issues with veneers.
* As an option to a Crown: In addition to being esthetically pleasing, dental veneers can also serve a functional purpose by protecting the surface of a damaged tooth. In some cases, veneers may replace the need for a dental crown, eliminating the need for more invasive tooth preparation. In general most dentists will want to fit a proper crown that can support your bite and chewing, rather than rely on the thin porcelain which will need to be replaced in any event.
How are Veneers attached to your Teeth?
Teeth are prepared for veneers by lightly buffing to allow for the small added thickness of the veneer. A mold is taken of the teeth, from which the veneers are modeled after. Temporary veneers will be placed and worn until your permanent veneers are ready. While wearing the temporary veneers, advise your cosmetic dentist of any adjustments or changes you would like made, such as in shape or size. These changes will be translated into your permanent veneers, so good communication between you and your dentist is important in achieving your new smile. Your dentist places the veneers with water or glycerin on the teeth to verify their perfect fit and the shade or color. The color cannot be changed after the veneers are adhered to your teeth. The tooth is then cleansed with chemicals to achieve a durable bond. Once the glue is between the veneer and your tooth, a light beam is used to harden the glue/cement.
How Long Do Dental Veneers Last?
* Veneers generally last between 10 and 15 years. After this time, the veneers would need to be replaced.
Do Dental Veneers Require Special Care?
* No. Good oral hygiene practices are still encouraged including brushing and flossing as you normally would.
* Even though porcelain veneers resist stains, it is recommended that you still avoid stain-causing foods and beverages (for example, coffee, tea or red wine).
What should be considered and what can go wrong?
Critical is the veneer sizing and colouration. Veneers cannot be altered in shade once fixed in place, so you will stuck with them or have to undergo an expensive replacement. Poor fitting venners can result in a bad bite, or exacerbate an existing bite issue. Another common problem is badly bonded veneers.
What are common problems caused by veneers?
When preparing teeth for veneers dentists will need to remove part of the orginal tooth structure. Although your dentist will do everything to try and minimise damage to the tooth, the tooth enamel is often ground down and sometimes the tooth can be more easily prone to tooth decay and pulp irritation. Many patients have reported having to have root canals after veneers - sometimes as many as one for each tooth that has been veneered. Veneers are bonded using a phosphoric acid etching technique, and some patients have sensitivity problems, caused by a combination of the original removal of the tooth structure with a reaction to the etching materials. Please see this article on post operative veneer issues after treatment.
When does SmartaHealth Recommend Traditional Veneers?
Although many people do have traditional veneers and a very happy with the results, we don't recommend anything that damages the original tooth structure. Unless the veneer can be fitted without damaging the tooth, we would not recommend them. The more grinding of the teeth the veneers require, the more long-tem irreparable damage is caused.
In the case of a bad discoloration issues, e.g.a severe tetracycline stain consider lumineers - which are very, very thin veneers which won't need grinding down the tooth.
If you need your teeth straightened wear braces. If you have discoloured teeth, have a professional tooth whitening treatment. If you still need further cosmetic help after that, lumineers will be a good choice, because they may well need no shaving of the tooth to achieve a great result.
Who is a good Candidate for Veneers?
If you grind your teeth or have gum disease you are not a good candidate for veneers. Veneers can be extremely expensive for you, but potentially very lucrative for your cosmetic dentist. Since this is an 'elective procedure' i.e you choose to have it done for cosmetic reasons and not medical need, you have much less recourse should things go wrong with the procedure later on. If you grind your teeth or have gum disease, you need to re-consider veneers. They are not a good option for you. There are still options open for you if you grind your teeth. You can get a night guard, that will protect your new veneers, for example. However, many people also grind their teeth during the day, under stress etc. Porcelain does not respond well to this pressure.
