A dental veneer is a thin layer of tooth-like laminate that is placed over a tooth, either to improve its shape, size or colour or to protect a tooth’s surface from further damage.
Benefits of dental veneers.
Dental veneers are often used to attain the perfect smile. Some of us have small teeth, resulting in spaces that cannot be easily closed using braces or discoloured teeth that resist whitening. Others may have worn away the edges of their teeth or suffer from conditions that cause erosion of the enamel of their teeth, resulting in a prematurely aged appearance.
Multiple veneers can mask these spaces, restore teeth height that have been shortened by wear, protect teeth from further erosion, fill small black triangles between teeth caused by gum recession, improve color, shape, and symmetry, and make the teeth appear straight.
What will the dentist do?
Communication with your dentist about your concerns and exploring alternate solutions is essential for a successful outcome. Each smile is different and veneers need to be carefully prescribed. Your dentist will start with a smile analysis to determine the steps that are necessary to achieve the smile that you desire. Thereafter, he may carry out a diagnostic mock-up or show you a simulation of your new smile.
Porcelain veneers consist of a thin ceramic shell (which replace tooth enamel), and an adhesive layer that bonds it to natural tooth. A small amount of the original tooth enamel must be removed, usually less than a millimetre, to create room for the porcelain veneer. An impression of the preparation is taken and sent to the dental laboratory for veneer fabrication. Once ready, the veneer is fitted in place using light-sensitive resin based adhesives.
The procedure for composite veneers is slightly different as the veneer material is applied directly onto the prepared tooth surface, sculpted to its desired shape and hardened using a curing light.
How long will it take?
The procedure can often be completed within two visits. The time taken for teeth preparation and fitting is dependent on the number of teeth being treated.
What will the experience be like?
Teeth preparation is usually done under local anaesthetic to minimize discomfort. You should expect transient sensitivity to hot and cold temperature in between visits and immediately after the fitting appointment. This is due to the removal of that thin layer of enamel and typically resolves within a few days.
Dental veneers are strong enough to withstand normal chewing forces and you can expect to use them like your own teeth. Like glass, they are also brittle and you will do well to avoid the same excessive stresses you would avoid with natural teeth (e.g. don’t bite your fingernails, chew ice, or use them to open beer bottles!)
How do I decide on the type of dental veneers?
Dental veneers can be made from composite, ceramic or porcelain. A composite veneer can be built-up in the mouth or indirectly fabricated in a dental laboratory. In contrast, a ceramic or porcelain veneer may only be indirectly fabricated.
Porcelain veneers are more durable, have excellent aesthetics and stain resistance compared to composites. It has a glass like property and can be sculpted, making it very difficult to tell the difference between a porcelain veneer and a natural tooth.
Composite veneers can be fabricated in a single visit and are generally more affordable. It is however more prone to staining and leakage compared to porcelain veneers.
‘Prepless’ or ‘Minimal prep’ ceramic veneers
Some dental laboratories/manufacturers are able to fabricate very thin ceramic veneers that reduce the amount of tooth structure removal. These types of veneers are more conservative and reduce the incidence of teeth sensitivity, albeit more expensive. They have their own disadvantages and may not be suitable for everyone.
Are there any risks?
You should always weigh the advantages and disadvantages of dental veneers carefully as your dentist may need to remove between 0.3mm and 0.8 mm of enamel to accommodate the thickness of the dental veneers.
Dental veneers need to be diligently maintained with good personal oral hygiene and professional oral care. Failure to do so may lead to premature failure due to decay or gum disease affecting the margins of the veneers. Another common problem is veneer fracture due to normal function, grinding habits or mishaps. This can be mitigated to a certain extent with the use of a night guard when sleeping.
Today, with improved resin based adhesives, dental veneers can last an average of between 5 and 10 years. Some studies suggest that approximately 50% of dental veneers will have to be replaced at the tenth year anniversary due to porcelain fracture, leakage, discolouration, decay or shrinkage of the gum line.
The use of dental veneers to simulate straight teeth, commonly referred to as ‘instant orthodontics’, in young patients with healthy teeth is not recommended. The long term maintenance needed and potential need for irreversible teeth preparation is simply not worth the time saved from undergoing routine braces treatment.