What are porcelain veneers?
Porcelain veneers are thin custom made shells or jackets designed to cover the front tooth surface 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:
- Close spaces caused by gum disease, “black triangles” between teeth
- Correcting the length and width
- Restore tooth decay, erosion, attrition, fixing heavy wear
- To cover the screw hole on an dental implant crown or root canal
- Tooth straightening without braces
- Changing occlusion
- Repair broken teeth, chips or cracks
- Brighten your smile
- Replace bonding with upgraded restorations
- Improve oral health by closing spaces and preventing food impaction
- Create even tooth shapes
- Consistant color
- Fix a chipped tooth, gapped teeth, diastemas
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 preserve 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 “believably natural”.
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 x-rays 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.
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.
Quality level of Ceramist influences Cost
Most ceramists are not certified dental technicians (CDTs). There are even fewer Master Ceramists (MDTs) who have years of training and developed talent. 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 veneer 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. When the vast majority of enamel has been removed, a crown a better treatment choice.
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.
Long term care for your new smile
A smile makeover is properly cared for in the same way as natural teeth. Brushing and flossing your teeth and gums is just as important.
Dr Fondriest is a highly sought after cosmetic dentist. He serves clients from throughout the United States.