Veneers are a form of cosmetic dentistry in which a shell or layer of tooth-colored porcelain or composite is placed over the facial surfaces of your teeth to correct worn tooth enamel, uneven tooth alignment or spacing, discoloration and chips or cracks.
Although dental veneers fall into the category of cosmetic dentistry because they create bright, white smiles with beautifully aligned, shapely teeth, they also protect the surface of damaged teeth and may eliminate the need for more extensive treatments. Other benefits of veneers include durability, an improved smile appearance, and the need for little-to-no removal of tooth structure compared to crowns.
Regardless of what causes unattractive teeth, dental veneers may solve most or even all of your cosmetic dental issues, including:
Worn enamel: Over time, the thin, hard translucent substance covering your teeth (enamel) may become worn, dulled and discolored. Such wear and discoloration may be natural or result from a genetic predisposition. However, it often results from consuming soft drinks, tea or coffee; smoking; using certain medications, etc.
Wear and tear: Teeth naturally wear down as people age. Aged teeth are more likely to have chips, cracks or a generally uneven appearance.
Genetics: Certain people are born with abnormal spacing between their teeth that widens with age.
Uneven teeth: Uneven teeth can result from tooth grinding or general wear and tear.
Porcelain Veneers and Composite Resin Veneers
The two most common materials used to fabricate or create dental veneers are composite resin and porcelain. Indirect (created outside of your mouth) porcelain veneers and composite veneers are made by a dental technician in a dental laboratory; direct (created directly on your teeth) composite veneers are made by your dentist during your appointment at the dental office.
Porcelain dental veneers are more appropriate solutions for severe cases involving dullness, wear, discoloration, extensive chipping, cracking, spacing or uneven teeth.
Composite bonding or just bonding — which refers to direct composite veneers — is an inexpensive, effective and minimally invasive way to restore and correct small chips, cracks and discoloration in the teeth.
When are Veneers Appropriate?
The removal of any natural tooth structure is permanent, so cosmetic dentists today prefer to offer patients the most minimally invasive options first. If your natural teeth are functionally and esthetically adequate, dental veneers may not be an appropriate treatment for you.
However, if you have severely dull or discolored teeth, your treatment options may include porcelain dental veneers or composite veneers. Veneers do have the added benefits of longevity and a proven ability to enhance the appearance of the mouth, smile and other facial features that are better supported by properly shaped teeth.
Veneers or Whitening?
Porcelain dental veneers or direct composite veneers may require the “shaping” or “prepping” of all teeth being treated. Therefore, some cosmetic dentists first recommend teeth whitening to people with mildly discolored teeth who want a whiter and brighter smile because it is the least invasive cosmetic dentistry option. If crooked teeth or alignment issues are involved, whitening also may be combined with orthodontic treatments, including Invisalign.
Care of Dental Veneers
Care must be taken not to abuse veneers because the thin porcelain shells or composite layers can be damaged or break.
Your dentist may advise you against certain uses or dietary tendencies (such as eating carrots) and may recommend you wear a protective appliance while sleeping, especially if you are a bruxer.
Veneers Cost Factors
The cost of dental veneers depends on many factors, including:
- The fees of the cosmetic dentist performing the procedure.
- The artistic and technical skill of the ceramist making the veneers and the cosmetic dentist who places the veneers.
- The location where dental veneers treatment is performed. Costs for dental veneers and all cosmetic dentistry procedures vary widely by region of the country, specifically from large metropolitan areas to smaller towns.
- The type of dental insurance you have. Dental insurance typically does not cover cosmetic procedures.
- The material used. Porcelain veneers are more expensive than indirect or direct composite resin veneers.
- The number of teeth requiring veneers.
Many dentists offer payment plans for cosmetic and restorative dental procedures. Ask your dentist about financing options. If your dentist doesn’t offer financing, you may qualify for third-party financing through companies like CareCredit. Qualified candidates can work with a financing company to develop a monthly payment plan to fit their budget.
Veneers Consultation and Treatment Planning
To determine if you are a candidate for dental veneers, your dentist will schedule a preliminary consultation during which your oral health will be evaluated and all available treatment options discussed. Veneer treatment involving tooth preparation is irreversible, so it is important that your dentist discuss any alternatives that provide the same results but with minimal to no removal of tooth structure. If you and your dentist decide that veneers are the best option, the next step involves a thorough review of treatment details, including preparing your teeth for your specific veneer procedure and what will be necessary for them to look and fit correctly.
During your veneers consultation, you will actively participate in the “smile design process.” By sharing your preferences for the shape, length, width and color of the veneers and the change in the appearance of your smile that you want them to create, you help ensure that your veneer treatment will meet your expectations. It is important that your dentist understands your objectives when undergoing a veneer procedure.
The Dental Veneer Procedure
The dental veneer procedure can often be completed in two dental visits over the course of six weeks. The visits are comprehensive and may require several hours of examination and tooth preparation. Dental offices typically boast amenities that may include sedation dentistry and audio/visual distractions, and dental spas even offer massages and other services to help you relax and stay comfortable.
The diagnostic and examination phase of dental veneer treatment is essential and identifies any oral health concerns that must first be addressed before veneer placement. Your dentist also will work with you to select the best tooth color for you from a special shade chart. Imaging technologies can provide you with a preview of your expected results, and before and after images can allow you to view other successful cases. Treatment begins when the examination is completed and the customized plan designed.
There are several steps in the dental veneer procedure. First, your dentist will likely administer a local anesthetic so you will be comfortable during tooth preparation and placement of the veneer. Your natural tooth is then prepared by minimally reshaping it with a small handheld rotational cutting device called a bur to provide the best fit. Burs come in various shapes and sizes and allow precise and minimal shaping of a tooth prior to veneer placement.
If your treatment involves direct composite resin veneers, your dentist then will apply the appropriately shaded composite to your teeth, shape the material and harden it using a high intensity light. Additional layers of composite may be applied to build the veneer to the correct shape, length and form for your smile. When all composite is placed, the veneers will be finished and polished using burs and polishers to create a vital and lifelike smile.
If your treatment requires porcelain veneers, your dentist will make an impression of your teeth from which a mold of your mouth will be made. This impression may be sent to an outside dental laboratory where the veneers will be professionally fabricated. Some dentists have an in-house dental laboratory and technicians to provide restorative and esthetic treatments such as porcelain veneers in less time. Other dentists have chairside CAD/CAM technology and may fabricate the veneer in one visit.
Dental Labs, CAD/CAM and Temporaries
Dentists typically work with outside dental laboratories for the fabrication of the restorations they need. Some dental laboratories use CAD/CAM technology to fabricate veneers. If your veneers will be made in a dental laboratory, you may receive temporary veneers at your preparation appointment.
Temporary veneers provide a preview of the expected outcome. Temporary veneers may not always be placed. If your dental veneer treatment involves one or a couple of teeth and enough enamel remains on the surface, your dentist may forgo the temporary process.
However, after your teeth are shaped, they may be more sensitive to hot and cold due to the loss of enamel during tooth preparation. Increased sensitivity may also occur if you have temporaries placed and for a brief time following placement of the final veneers.
During your initial consultation and examination, discuss temporaries with your dentist. Temporaries offer a preview of the expected look, feel and fit of the veneer. Temporaries also help cosmetic dentists identify adjustments that may be needed during fabrication of your permanent veneer.
During the veneer placement appointment, your dentist will remove the temporaries and place your final veneers. Your dentist also will evaluate and adjust the newly placed veneers to ensure the optimal fit and color.
When dentists use CAD/CAM technology in their office to produce veneers, your restorations will be made, bonded and adjusted onto your teeth in one visit. This type of treatment is often marketed by dentists as “same day dentistry” and does not require temporaries.
Veneers Recovery and Post-Procedure Care
Veneers are durable and have been shown to last for many years before requiring replacement. Seeing your dentist and hygienist for regular examinations and dental cleanings is important for maintaining the health of your mouth and longevity of your veneers.
However, like other porcelain restorations, chipping and fractures may occur. Chipped or fractured porcelain veneers cannot be repaired, so your dentist will advise you of the costs and added time associated with replacing a damaged restoration.
To reduce the risk of damage to your veneers, do not bite or chew on hard objects such as nut shells or bones, and do not use your teeth to open or tear packages. Your dentist also may advise you to avoid certain foods that could damage the porcelain or composite used.
Brush and floss your teeth as you normally would, and be sure to use a non-abrasive toothpaste. Because veneers are highly polishable, the risk of staining the veneers with food or drink after the procedure is complete is greatly reduced. However, brushing after drinking red wine, coffee, tea or soda is advisable.
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