Veneers

The first step is to design and plan the veneer, similar to a construction blueprint to optimize its size, shape, your bite and access for cleaning.  During the second step, your tooth is carefully and meticulously shaped in preparation to support the eventual finished veneer. Sometimes during this same shaping and measuring appointment, a temporary acrylic (plastic) veneer is made if the tooth has significant sensitivity or compromised appearance.  Also during this second step, measurements or molds are made from which a precisely fitted and natural appearing veneer can be custom made in the dental laboratory. The laboratory process of making your veneer occurs between appointments and is completed by specially trained laboratory technicians. The final steps involve completion of any adjustments to your veneer and its attachment, after which your veneer is not removable.

A veneer is most commonly made using a thin shell or layer of ceramic which is custom colored to match your other teeth.  Ceramic material is very hard and quite durable once it is bonded to the tooth. A tooth which supports a veneer may first require a filling to eliminate defects created by decay or old deteriorated fillings.

High quality, natural looking veneers need to be more than just ‘white’, they must approximate the complex color scheme of your other teeth or they will stick out like a ‘sore thumb’.  Color is approximately matched using standardized color tabs which are selected with your approval and is included in basic veneer fees. If your veneer is prominently visible, some degree of additional customization will usually be required to more closely match your other teeth.  This customization process can proceed until the best possible match is obtained subject to the limitations of man-made materials and fees based on the length of time required for customization. When skillful clinical treatment is combined with artful laboratory technical work it is often difficult to detect the difference between a well made veneer and your natural teeth.  Natural teeth will tend to slowly darken with age. Teeth restored with a veneer will mostly remain the same color.

Shape is extremely critical and is one of the most frequently overlooked aspects of many veneers.  This has resulted in an otherwise attractive smile being ruined by veneers not matching the remaining teeth and appearing as if they stick out.  Proper shape is also required to prevent food jamming between teeth and to permit easy and thorough cleaning to avoid bad breath.

Red, blue or swollen gums and gum recession are ugly and can be caused by improperly made veneers.  Many veneers are now quickly made ‘on the spot’ in the dental office but far too often have a poor shape, poor fit and a rough surface causing gum problems.  The gum around the veneer made with gentle, accurate techniques should be pink, firm, not bleed during cleaning and not suffer significant recession.

A well made veneer should have a perfect bite and feel completely even with the other teeth on the very first day and does not require time to settle in.  An uneven bite will either be uncomfortable or allow your other teeth to shift and become crooked.

The shape of the tooth under a veneer is extremely critical.  If properly designed and shaped, veneers should not fall off and should look like they have an excellent alignment and appearance.  Expert treatment during the shaping of the tooth when the veneer is first made can essentially eliminate needless future costs of re-attaching or remaking a veneer that won’t stay on.  Mistakes in shaping the tooth for a veneer can cause harm to the gum resulting in the need for additional expensive treatment at best and at worst, can not be undone or reversed resulting in a permanent defect.

A veneer should feel comfortable, look natural and maintain or restore your ability to eat and speak.  Our patients routinely can’t feel much difference between a real tooth and a veneer.

Do not expect your general dentist to obtain the results routinely obtainable in our prosthodontic specialty office.  General dentists try to stay on top of all the general routine treatments patients need but can’t be expected to be capable of providing specialized treatment.  There are some capable dental specialists in Mexico and elsewhere but always beware of ‘discount dentistry’. An attempt to obtain specialty treatment from those without the appropriate training and experience is likely to create problems and regret.

Most veneers fail because of tooth decay or stain due to leakage under the edge of the veneer both of which are frequently caused by average or poor fitting veneers and inadequate cleaning.  An extremely well fitting veneer is less likely to allow decay or leakage with stain to get under the veneer potentially destroying the tooth underneath it. A veneer that can be properly cleaned will last much longer, increasing the likelihood that you will keep your teeth a lifetime and reduce future dental care and costs.

Cleaning teeth with veneers is not too different from cleaning natural teeth.  You must thoroughly brush your teeth and clean between the teeth using the appropriate cleaning aid every day.  You will be shown and coached on the techniques necessary to care for your veneer and supporting teeth. Veneers and their supporting teeth must be regularly cleaned and checked by your dentist to ensure the supporting teeth do not get cavities/decay or leakage/stain.  An extremely well fitting veneer, that can be properly cleaned will last much longer, and increase the likelihood you will keep your teeth a lifetime at less cost. A veneer with average or poor fit can’t be cleaned properly and is not likely to last long.

Veneers should be strong and not easily break.  Unfortunately, if veneers are not kept very thin, properly designed and attached to the tooth, they can fracture, fall off or have extensive leakage with stain typically at the edge near the gum.  Elsewhere, in an effort to decrease costs, veneers can be made cheaply but are typically excessively thick and bulky with very unfortunate results.

By using specialized knowledge, skill and experience in combination with careful planning and attention to detail, a veneer can be made with excellent fit, appearance and function and is likely to last for many years.