Porcelain Veneers

Feldspathic Veneers

This Winnetka patient had spaces or gaps in her smile. She wanted natural shading and surface textures so that no one could tell that she had her teeth done.  She had beautiful porcelain smile improvements.

What are porcelain veneers?

Porcelain veneers are thin custom made shells or jackets designed to cover the front of a tooth. These bonded covers or laminates offer a durable way of creating or restoring beauty to a smile. They also can be used to re-establish function and strength.

These thin sheets of ceramic are becoming a very popular treatment choice for cosmetic dentists.  They only cover the parts of the tooth that have been damaged or that require a change of shape or color. A porcelain veneer can be a far more conservative alternative to a dental crown.  The more skilled dentists tend to remove less tooth structure.

Uses of Veneers:

Characteristics of Porcelain Laminates

Laminates were originally developed as a way to save tooth structure while improving how the teeth look.  These teeth covers can be as thin as 0.2mm. Often only a small amount of tooth reduction is needed. They always save more enamel than crowns. More structure is retained each time a tooth is fixed. The tooth will be stronger and able to be fixed again in the future.

The porcelain margin blends very nicely with the tooth. This blended margin avoids the dreaded “black line” commonly found on poorly done or old porcelain-on-metal-crowns.  These restorations are bonded to place and are far less likely to leak or fail.  These thin ceramic restorations  can match the light transmitting properties of natural enamel. This allows our veneers to be invisible and as Dr. Fondriest says, “believably natural”.

The porcelain can be made thin enough to have a contact lens effect

Porcelain can be made so thin that it blends nicely with the natural tooth beneath it. This makes the margin invisible. A contact lens effect allows the margin to blend into the root.

Porcelain Veneers: Procedure and Process

There are three phases to a veneering procedure:

1) Evaluation and planning between doctor and patient:

First we ask you to share your goals and expectations with us. We will take photographs, models and possibly xrays to plan the steps to achieve the desired outcome.  Sometimes other specialists (e.g. orthodontists, periodontists) are brought in to help achieve perfect symmetry in your smile. A plan is settled and the exact length, shape, surface texture, shade, and position of every tooth is determined. The doctor and his lab technician partner will decide if any tooth structure needs to be removed.

2) Preparation of the mouth and impressions:

The dentist removes a small amount of enamel. Laminates can be created with little drilling of tooth enamel. If aggressive changes in shape or position are desired drilling will be needed. Significant drilling will require temporary veneers to give you a nice interim smile.

Impressions of the teeth and supporting structures are taken and sent to the laboratory. Photographs, measurements of the face, bite, and jaw movements are also sent. A detailed prescription is written by the doctor. A complete summary of what your dreams, desires, and expectations is sent to the dental laboratory. This informs the ceramist exactly what you want.

Veneering Teeth

This Indianapolis physician wanted a smile makeover. She really didn’t want us to drill on her real teeth. Her teeth had been dark due to using tetracycline as a teenager. Her local dentist said that he would have to do full crowns to cover the darkness. She did her research and came to us to be restored. We were able to be much more conservative with tooth reduction by doing low prep veneers. We chose a porcelain that was opaque enough to cover the stains but still beautiful.

3)  Delivery and bonding:

The dentist will confirm proper fit and appearance. Then the custom teeth covers are bonded to the front of your tooth. The bonding agents are made of the same materials (composite) that tooth colored fillings are made from.  Satisfaction with the result is universally positive.  You may need a short time to adapt phonetically if the tooth locations or lengths have been changed.  This adaptation period varies from a few hours to several weeks.

 What do porcelain veneers cost?

Prices can range greatly. Consider that you got quotes from 5 different dentists to do a smile makeover for you. The quote might be as little as $3500 and as high as $100,000! Patients don’t understand the variation in quality levels of different dentists. What quality niche is your dentist?There are also levels of perfection.  How perfect do you want your smile to look? a perfect smile is different for everyone.

A more conservative cosmetic dentist may be able to improve your smile with teeth whitening and a little reshaping of your teeth. While another dentist might do aggressive drilling down of 28 teeth. The best option is to fit the treatment to your personal goals. Get at least one other consultation other than your regular dentist.

Veneers before and after

Often night grinders have shortened or heavily worn teeth. There is an untrue belief (even by some dentists) that laminates can’t be done if you grind your teeth. Actually, porcelain veneers are an excellent choice for night grinders. Advances in ceramics have the newer porcelains matching the wear and fracture strength of natural enamel. If done properly, veneers are just as strong as Nature!

Quality level of Ceramist influences Cost

Most ceramists are not certified dental technicians (CDTs). Fewer still are Master Ceramists (MDTs). As with every profession, there is a bell shaped curve of talent and outcome quality. The higher end dentists use the finest ceramists. The training level of the ceramist determines the quality of the veneer restorations.

The ceramist will charge the dentist directly anywhere from $25 to $1,200 for a single veneer. The restorative dentist then adds this lab fee to the overall cost to the patient. The cost to the patient also ranges greatly from as low as $1200/veneer to $3100/veneer. It is common to have 6-12 veneers done at a time.

Are porcelain veneers strong?

All types of veneers can be strong, but like many things in life, it depends. If the dentist has a light touch with the drill then the veneer will be incredibly strong. In fact it will strengthen the tooth. If no enamel remains a veneer may not be a strong option. Perhaps a crown would be better.

Without enamel the bond is weaker. The strength and longevity will be suspect. This is especially true with people who grind their teeth.  Due to a low tensile strength of glass, it is possible for veneers  to chip at the edges when overloaded.  As stated earlier, porcelain is about 90% the strength of natural enamel.

Porcelain can be bonded to teeth just like composite resin but is much stronger than composite veneers. The bond is very strong if the dentist follows all of the steps. Unfortunately to lower cost, dentists will skip important steps if they take more time.

 

Dr Fondriest is a Nationally recognized and highly sought after cosmetic dentist. He serves clients from throughout the United States