dental veneer before after

Dental veneers (also known as porcelain veneers or sometimes as dental laminates or even dental porcelain laminates) are an important part of the repertoire of every cosmetic dentist. These veneers are very thin (about 0.5 to no more than 0.7 millimeters or about one-fiftieth of an inch) coverings bonded to the fronts of teeth.

In layman terms, think of Veneers as being similar to an artificial fingernail which is placed on top of a natural fingernail to change and improve the latter’s appearance. There are veneers that are even slimmer and are referred to as Lumineers.

Veneers are great

1. For worn down, chipped or broken teeth
2. For misaligned, crooked, uneven or irregularly shaped teeth.
3. For teeth with unsightly gaps between them.
4. For discolored teeth, for changing the color of them and for concealing stained fillings or other stains (such as those caused by excessive use of tetracycline or fluoride, by root canal treatments.

Figure above shows cases where veneers have markedly improved the appearance of teeth.

What to expect

You could explain what your expectations are and how you would like your teeth to look. The dentist will examine your teeth and possibly take x-rays and make impressions of your mouth and teeth. Afterwards, recommendations and options will be given enabling you to make an educated preference. The treatment is painless and the entire procedure could be completed in 2 sittings.


Cosmetic dentistry with veneers

How its done

Dental veneer is a cosmetic procedure and a relatively simple one, but involves a series of steps. Below , we have summarized them in a manner easily understood by the patient.

Step 1: Trimming

The tooth will be trimmed, most commonly by 0.5 millimeters (about one-fiftieth of an inch). Some authorities give a range of 0.6 millimeters and one reference said 0.7 millimeters. Regardless, the tooth will be trimmed for about the same thickness that the veneer placed upon it will have. This makes sense. If you place a mirror on a piece of furniture then the mirror will jut out by some distance. This may not be esthetically pleasing.

However, if you chisel the furniture by the same thickness of the mirror then the mirror will be flush or even with the furniture, making it more appealing. If it becomes apparent that a part or parts of the tooth show decay then those will be removed as well. Regardless, it will be a small amount of trimming, and no nerves will be affected so it will be rare that anesthesia (“Novocain”) will be used.

Step 2: Determining the shade

A shade guide will be used to determine a proper match of the veneer. It is possible that different portions will be of different hues.

Step 3: Taking the impression

If it has not already been done–or even if it has–a new impression of the tooth and its surrounding area will be made. It is from this impression that the veneer will be produced. There are two methods of making this impression:

  1. With impression clay or putty. This is a thick paste that is put into a tray and having your teeth immersed into it. It is then sent to a dental laboratory and one to two weeks later, a unique veneer will be returned for your use and wear.

  2. Using a dental milling machine. This is a machine that has a camera that can photograph and record the impression of the tooth. It will then create your veneer from a block of ceramic.

The latter sounds ideal and quick but it is more of a “one size fits all” type. The dental laboratory, however, can craft a veneer that will more closely match the color and hues of your tooth. With advances in technology, especially that of 3-D printing, this could change in the near future.

Step 4: Optional temporary Veneer

If the first method is done then it will, again, take 1-2 weeks before the final veneer is available. If the tooth is very unsightly then there may be a desire for a temporary veneer. However, it is usually not warranted. It is true that the trimmed tooth may look and feel “different” or “peculiar” and rough but there is little justification for having a temporary veneer (especially as a result of its additional cost).

However, if a greater portion of the tooth has been trimmed or if there is evidence that thermal sensitivity will increase (that the patient will not be able to eat or drink hot or cold items) then a temporary veneer may be properly recommended.

Step 5: Evaluation

Once it is time to place the permanent veneer, there will be some final determinations:

Checking the fit: It will be placed, looked at, removed and trimmed, and this sequence will continue until it is completely satisfactory.

Checking the shape: Especially regarding the edges. These may need to be rounded, shortened or squared off to more perfectly match the tooth.

Checking the color: If the color is not a good match then you may think that this would be a failure. However, because of the veneer’s translucency, other materials such as the bonding agent or cement can be used to modify the appearance. As with the second evaluation, this process can be repeated until the cement creating the specific and desired color is found. Once the veneer has actually been cemented or bonded to the tooth, however, it is too late to alter the color.

Step 6: Bonding

Slightly before this, though, will be cleaning. Both the tooth and the veneer will be thoroughly cleaned. Any debris or imperfections can result in decay or the buildup of plaque. Then, it is a matter of applying the dental adhesive or cement or bonding agent to the veneer, and placing it on the tooth. A curing light will be shone which activates the chemicals present in the cement, and causing it to harden very quickly (within a minute). The final steps are to remove any excess cement, trim the contours of the veneer, and verify that your bite has not been altered.

Step 7: Followup

A proper follow-up needs to be carried out; in this case, it is usually a week after the veneer has been placed. As with any dental procedure, there can be concerns about thermal sensitivity. If you do experience this then you may be relieved to know that it tends to go away on its own, although there can be options of hastening this. If you have any other concerns then you should raise them now.

When they are not recommended

  • For worn down, chipped or broken teeth caused by clenching of the jaw or grinding of the teeth. One medical study showed that if this habit is not stopped then the chances of the veneer failing increases by 800%

  • For teeth with little enamel. This is because enamel is stronger than the veneer and will absorb and diffuse any forces to the veneer. If there is little enamel then the veneer will be bonded to the dentin (the portion of the tooth encased by enamel) which is weaker than the veneer and will increase the chances of the latter’s breaking or chipping

  • For teeth that need strengthening. If your teeth need strengthening then they should be strengthened. If you have a bad skin condition then you could apply make-up to cover it, but it will not help correct the underlying problem. A dental veneer is much like the proper use of make-up; it will make a good thing even better, but it may not address or rectify any underlying conditions that surround it.

  • There does seem to be an over-use, over-dependence and over-reliance on cosmetic dental procedures, especially among young people who have generally healthy teeth. You should not let others convince you that you have a problem with your teeth. If you, yourself, feel a concern then do discuss it with a professional to learn what he or she thinks about it.