Porcelain Veneers

Porcelain veneers have offered the most exciting and revolutionary advancement in aesthetic dentistry. They have become a popular cosmetic solution because of their natural appearance and durability.

Porcelain veneers can match our natural tooth colour offering a uniform and authentic appearance.

The procedure requires little or no anesthesia, and can be performed by general and cosmetic dentists. Dental veneers can be used to treat smile imperfections such as a slightly crooked, discolored, chipped or cracked teeth or even to cover spaces in between the teeth.

Porcelain veneers is the dental cosmetic treatment that has helped most of the TV and movie stars to get that dazzling smile we all see on the screen.

Regardless of what is the cause of dental imperfections, porcelain veneers may solve most of the cosmetic dental problems of unattractive teeth, such as:

• Stained or Discolored Teeth - Porcelain veneers are used to whiten teeth with discolorations because of root canal treatment; use of tetracycline or other drugs; excessive fluoride use; tooth trauma; smoking; old resin fillings that have discolored or other causes.
• Chipped or broken teeth – besides the cosmetic effect of covering chips and cracks, veneers can actually strengthen teeth with minor structural damage.
• Irregularly shaped teeth - teeth that are too small, too big, have uneven surfaces or they are oddly shaped teeth (for example, have craters, small holes or bulges in them)
• Crowded or crooked teeth – in many cases veneers can correct their appearance without the need for braces
• Diastema – unaesthetic gaps between front teeth can be closed with veneers on one or more teeth.
• Uneven teeth - dental veneers can restore teeth that are lower than their adjacent teeth either by nature or due to physical wear from tooth grinding.

This first step towards a bright new smile with porcelain veneers requires good communication between the patient and the dentist. During your first appointment you should discuss clearly and in detail your smile expectations with your dentist. Your dentist will examine your teeth to make sure porcelain veneers are appropriate for you and determine any oral health concerns that must be addressed before starting the veneers process .

• any tooth decay problems must be treated before the application of dental veneers
• if you need a tooth whitening for the rest of your teeth, that should be done prior to choosing the tooth color for your porcelain veneers
• untreated gingivitis and receding gums may seriously affect the aesthetic result of veneers)

Ask your dentist to explain the advantages and disadvantages of porcelain veneers over other possible alternatives such as enamel shaping, bonding, crowns, tooth bleaching, braces etc. The dentist will describe what the procedure will involve and help you understand the corrective limitations of the procedure. Before and after images of other successful cases are usually available in cosmetic dentist offices

The cosmetic dentist may also take x-rays to determine the depth of the enamel and other technical characteristics of the teeth to be treated. Also, your dentist will work with you to select the best matching tooth color for you from a special shade chart. Some dental offices have imaging technologies that can provide you with a preview of your expected results.

Your active participation in decision-making and planning of the smile design can save you from frustration, disappointment or additional cost. Ask if temporary veneers are provided and if they are included in the price or they are offered with additional cost. Ask how much time will be needed for completing the treatment and if any last minute adjustments are allowed.

Porcelain Veneers Treatment - Preparation of teeth

Preparation is the next phase after the treatment plan design which is dedicated to preparing and taking an impression of the teeth. The procedure usually takes between 1.5 - 2 hours.

Although porcelain veneers are very thin, in most of the cases the depth of the tooth has to be adjusted to allow for the small added thickness of the veneer. The procedure involves removing only a thin amount of the enamel which is the outer layer of the tooth. The tooth surfaces that have to be reduced are the front face and the top of the tooth. The amount of enamel that has to be removed is usually nearly equal to the thickness of the veneer to be added to the tooth surface between 0.5mm to 1.0mm, but it can be up to 2.0mm. It depends on how drastic is the change on the shape or size of the tooth. This procedure of tooth reduction is called ‘prepping’. Some brands of porcelain veneers require more prepping than others. In some cases, no enamel has to be removed (small sized or worn down teeth).

The tooth is reshaped using a small handheld rotational cutting device called a burr. Burrs come in various shapes and sizes and allow for the precise and minimal shaping of a tooth prior to veneer placement.

The prepping procedure is generally not painful, but it may be uncomfortable for some people, especially if over 0.5mm of enamel has to be removed or the tooth has already very thin enamel layer. If needed, your dentist will use a local anesthetic to numb the area before trimming off the enamel, so that you will be comfortable during the preparation of the tooth for the application of porcelain veneers.

Porcelain Veneers Treatment - Fabrication of dental veneers

Next, after the tooth or teeth are prepared, your dentist will take an impression of the teeth and make a mold. This model is sent to a dental laboratory, which will fabricate the porcelain shells (veneers). It might take a week or two for the lab to return the veneers to the dentist.

Some cosmetic dentists offer an in-house dental lab and technicians, through which restorative and aesthetic materials such as porcelain veneers may be fabricated in a shorter period of time. If the veneers are going to be made in a dental lab, it may be needed that you are fitted with temporary veneers for some days while your permanent ones are fabricated.

Temporary veneers may be necessary if teeth have undergone extensive preparation and they have become unsightly or sensitive to hot and cold due to enamel loss. Even if not needed for these reasons, temporary veneers may be beneficial for the final result of the treatment, as they can give you a preview of the expected outcome. Based on how the temporary veneers look in your mouth you can ask your cosmetic dentist to make any adjustments or changes in shape or size you would like to the final model before the development of the permanent tooth veneer.

Temporary dental veneers have an additional cost, so the dentist will not always use them. During your initial consultation, you should discuss the subject with your dentist and make clear if they will be provided and if their cost is included in the price.

Porcelain Veneers Treatment - Bonding of veneers on teeth

When the lab has finished your porcelain veneers, it is time for the last phase of the process, the bonding of the veneers on teeth. But before they are permanently cemented to your tooth, your dentist will apply them temporarily on your teeth to examine their fit and color. If they do not fit properly, your dentist will remove them and trim them to the right shape. The process will be repeated until you and your dentist feel comfortable with how they look like and fit.

The color of the porcelain veneers may also be adjusted lightly, by adjusting the color of the cement that will be used for bonding. If major adjustments in shape or color are needed, it may be necessary the veneers to be returned to the dental lab for the modifications.

When the proper fit and the right color are achieved, the veneers are ready for permanent bonding. While minor adjustments on the shape of the veneers can be done even after bonding, the color cannot be altered after veneers are cemented. Next, the teeth are prepared for the bonding process, they are cleaned, polished and their surface is roughened (etched).

Then a special bonding agent (cement) is applied to the veneer and it is placed on the prepared tooth. When the veneer is properly positioned on the tooth, the dentist will apply a special curing light beam to the dental veneer, which acts as a catalyst activating the chemicals in the cement causing it to harden very quickly.

Finally any excess cement is removed, and the dentist makes any final adjustments in the veneer if necessary.

The whole process for porcelain veneers usually requires 2 to 3 appointments. Some dentists will need one full appointment for each phase of the process (as described above). Others usually combine the first two phases of design and preparation into one appointment and will take the second one for the final bonding of the porcelein veneers.

The time between the preparation and bonding appointments is about 1-2 weeks depending on the time needed for the external dental lab to prepare the veneers.

In a small number of specialized cosmetic dental offices the procedure could be completed in just one single appointment. These dental offices have CAD/CAM technology available in the office and an in house dental technician, allowing for the manufacture and placement of your porcelain veneers in the same day. The benefit is that you are not required to wear temporary veneers and you can complete the procedure in a single visit, rather than waiting 1-2 weeks.

TYour dentist will arrange a follow-up appointment after one or two weeks to examine the final placement and appearance of the veneer after the gums have adjust around it. Veneers do not need additional maintenance, other than proper brushing and flossing on a daily basis, as normal. You should brush and floss your porcelin veneers the same way you care for your natural teeth.

Your dentist will also explain some precautions you have to take to maximize the longevity of your veneers. You should be careful not to bite your nails, chew on pencils or other hard objects, or by any other way put unnecessary pressure on your treated teeth, because the veneers can chip or come off. If you have any history of bruxism your dentist may also recommend that you wear a night guard to avoid damaging your teeth veneers while asleep.

Although porcelain veneers are stain resistant, you should still avoid foods like coffee, tea and red wine as much as possible to prevent future staining. If the porcelain veneers are applied by an experienced dentist, with proper daily care, they can last from ten to fifteen years.

If you want to improve your smile’s appearance you should first visit a cosmetic dentist for consultation. Cosmetic dentists have the expertise to analyze your cosmetic needs, and propose a complete plan of cosmetic dental procedures that will best fit your expectations and finances.