Porcelain veneers are a trusted cosmetic procedure which can achieve striking effects in one to two appointments. They are considered to be the most natural natural-looking option to conceal several types of imperfections.
Veneers and Light Reflection
Natural dental enamel is translucent. Light shines through this layer and bounces off the underlying dentin, giving smiles their healthy sheen. Dental porcelain is also semi-translucent, meaning that light reflects off of the restorations just as it does off of dental enamel. Thanks to the highly customized fabrication process described above and the way light interacts with the restorations, porcelain veneers are virtually indistinguishable from enamel. Patients can enjoy a thoroughly enhanced but completely natural smile.
Advantages over Other Procedures
In addition to the comprehensive nature of veneers, this treatment offers a number of advantages over similar alternatives:
- Veneers are stain resistant and last for years at a time. When patients choose teeth whitening treatment, they often receive less dramatic results and must undergo touchup treatments approximately twice a year.
- Veneers look more lifelike than similar enhancements. Cosmetic dental bonding can correct similar flaws, but the material is opaque, meaning it does not reflect light the way porcelain does.
- Veneers are stronger than composite resin.
- Although veneers typically cost more than bonding or teeth whitening, they usually have a smaller price tag than dental crowns.
Increased Confidence and Happiness
One of the biggest advantages of porcelain veneers is the effect they can have on a patient's self-assurance and emotional wellness. When patients feel good about the appearance of their teeth, they are more likely to smile. In turn, this can increase their mood, social life, and even professional success. Multiple studies have proven that smiling directly impacts emotion; a landmark study conducted by Dr. Robert Zajonc in 1989 found that even a forced smile could actually make people feel happier. Zajonc theorized that the when people activate the muscles needed for smiling, it actually raises the temperature of blood travelling to the brain. In turn, these higher temperatures stimulate the parts of the brain that control emotion.4 Not only are veneers a great investment in a patient's appearance, they could also be an investment in their overall wellbeing.
Patient Transformations: Before and After
Oral Health Benefits
The primary benefits of veneers are cosmetic; however, there are several ways that they can boost overall dental health. First, they can lend some strength to damaged teeth. Patients should note, however, that veneers cannot restore a severely damaged or weakened tooth. In these cases, a dental crown will provide better protection for a patient's oral health.
Encouraging Oral Hygiene
Veneers can also promote good dental hygiene. When patients have a beautifully enhanced, natural smile, they are more likely to practice outstanding care and maintenance. At their initial consultation or at any time during the placement process, patients should ask their dentist about the best way to care for their veneers and protect the underlying teeth.
Health Advantages over Other Dental Procedures
Although veneers typically require some enamel removal, this procedure leaves the majority of the tooth structure intact. In contrast, to place a crown, a dentist must reshape the entire tooth, removing a significant amount of dental material. For patients looking for a more conservative option with minimal tooth modification, veneers may be the ideal alternative.
Traditional Porcelain Veneers
Veneers are thin ceramic shells, roughly the thickness of an eggshell or contact lens.
For cases of minor misalignment and bite problems, porcelain veneers can serve as a sort of "instant" orthodontics, dramatically improving the appearance and function of the teeth without requiring the months or even years needed with traditional orthodontics.
Repairs for Gapped Teeth
Diastema, or gapped teeth, can occur for a number of reasons, including genetics, gum disease, an incorrect swallowing reflex and irregularly sized teeth. Many patients assume that the only way to correct gaps in their smile is to undergo several years of orthodontic treatment. While this may have been true in the past, today veneers offer an immediate solution. By creating veneers that are slightly larger than the underlying teeth, a cosmetic dentist can close in this space with porcelain restorations.
Enhancing Crooked Teeth
Patients with only slightly misaligned teeth or with a single severely crooked tooth are understandably reluctant to wear braces for several years. Fortunately, veneers are an effective and fast alternative. By placing a new façade, a cosmetic dentist can mask irregularly rotated or positioned teeth. At the same time, the restorations can mask other flaws for instant orthodontics with additional cosmetic benefits.
Veneers and Severe Orthodontic Issues
Patients who are considering veneers for instant orthodontics should note that this treatment is not considered an effective option for severely crooked teeth or malocclusion. Because veneers do not actually correct the underlying tooth structure, patients with serious orthodontic issues should address these problems to prevent complications such as dental erosion or TMJ. Additionally, when patients who have malocclusion receive veneers, the restorations often have a very short lifetime; the porcelain faces constant pressure from the dental misalignment. In a relatively short time, this can lead to structural damage, or a veneer can come off entirely.
As with any medical treatment, there are some risks associated with the placement of porcelain veneers. For the most part, these risks are minor and quite rare.
Veneers are considered a very low-risk treatment. However, as with any medical or dental procedure, there is some chance of complications. Because this treatment often involves enamel removal, the biggest risk is that a patient will experience permanent tooth sensitivity, especially to hot or cold temperatures. Typically, if sensitivity lasts for more than 3 to 6 months after veneers placement, this indicates an underlying problem with the procedure. For example, the dental cement may be leaking or the nerve may have been exposed and infected during placement.
There is also a slight risk that the underlying dentin may become damaged during the enamel removal process. Alternatively, a poorly fitting veneer could change the alignment of a patient's bite, leading to dental sensitivity, discomfort while eating, or, in more extreme cases, bruxism and jaw pain.
Although veneers can last several decades, they must eventually be replaced, and the second placement process will involve another round of enamel removal. Those who already have some enamel erosion before their first treatment may not have enough material for a second placement. In these cases, they will require an alternative restoration such as cosmetic bonding or a dental crown. Patients should discuss their replacement options before receiving their first set of veneers. If they are not willing to consider alternative treatments in the future, they should not choose a procedure that will permanently alter their teeth.
Minimizing the Risks
As stated above, veneers are considered to be a very safe dental treatment, and there are several things that patients can do to further reduce their risks. First, they should be cautious when choosing their cosmetic dentist, following the guidelines listed above. By reading reviews from past patients, they can determine whether a particular dentist has a history of case complications. Second, if they are truly concerned about dental sensitivity or the permanent nature of veneers, patients may opt for no-prep veneers. Because they require little enamel removal, if any, the risk of sensitivity is lower. Patients should be aware, however, that some dentists believe no-prep veneers look less natural than traditional veneers.
In nearly every case, your dentist will need to remove a small amount of enamel from each treated tooth.
Temporary Side Effects
While permanent sensitivity following veneers placement is uncommon, many patients do experience some mild temporary discomfort. Typically this sensitivity is most apparent during the first 1 to 3 weeks after veneers placement. Patients can control sensitivity by avoiding very hot and cold foods, especially in close succession. Patients should also try using desensitizing toothpaste for up 6 months after treatment.
In 2007, D.M. Layton and T. Walton conducted a seminal study on the durability and complication rates of veneers. Tracing the lifespan of 304 veneers placed by the same dentist in 100 dental patients, Layton and Walton found that approximately 96% of the veneers lasted 5 to 6 years, 93% lasted 10 to 11 years, 91% survived 12 to 13 years, and 73% lasted 15 to 16 years. Only 16 of the veneers failed. These failures were attributed to unsatisfactory aesthetic results, structural damage, loss of retention, and dental decay.5 A more recent study, published in the International Journal of Prosthodontics in 2012, traced the lifespan of 318 veneers placed in 84 patients between 1987 and 2009. The study concluded that 94.4% of the veneers survived 5 years, 93.5% lasted 10 years, and 82.93% lasted 20 years. Participants included 42 patients with bruxism and 23 smokers, indicating that veneers are a long-lasting option, even for these high-risk groups. 6 Neither of the studies reported any significant complications for the participants' overall dental or physical health.
Alternatives to Porcelain Veneers
If you or your dentist decides that porcelain veneers are not the right treatment for you for any reason, there are several other options that can rejuvenate and restore radiance to your smile.
For patients with insufficient dental enamel or for those who are hesitant to permanently alter the structure of their teeth, dental bonding, often called composite veneers, may the optimal solution. A dentist applies dental composite to the front of a patient's teeth. This material is carefully selected to match the natural color of his or her smile. By carefully sculpting the material, the dentist can achieve many of the same results possible with veneers. Like veneers, bonding can correct severe stains, cracks, misaligned teeth, and gaps between teeth. Unlike veneers, however, composite resin is opaque and does not offer the natural sheen of porcelain.
Patients who are looking to enhance the color of their smile may opt for teeth whitening. By chemically breaking down the bonds that hold dental stains together, both in-office and at-home treatment can lighten teeth by up to eight shades. However, this treatment is only suitable for extrinsic stains, such as those caused by food or smoking. Whitening treatment will not affect tetracycline stains or the discoloration caused by decay or an old dental filling.
In some ways, dental crowns are very similar to veneers. Custom-made to match a patient's natural teeth, these tooth-shaped porcelain caps fit over a damaged tooth. However, unlike veneers, a crown extends all the way around a tooth, meaning the dentist must remove a significant amount of the dental structure. Crowns are an excellent option for patients who have considerable damage that affects the strength or structural integrity of a tooth. However, for patients who are simply seeking cosmetic enhancements, veneers are an effective, less invasive option.
As stated above, those with severely crooked teeth or malocclusion may not be good candidates for veneers. Rather, they may want to consider more comprehensive orthodontic treatment. Thanks to modern dental advances, patients are not limited to traditional metal braces; they can also choose tooth-colored brackets, clear aligner trays, and accelerated treatment options.
Frequently Asked Questions
Does the placement procedure hurt?
The placement of porcelain veneers is typically a pain-free procedure. Dentists usually numb the tooth and the surrounding area before removing the dental enamel. In many cases, this amount of enamel is so small that patients do not even require anesthesia. Once the enamel is removed, patients may experience some sensitivity, particularly before the veneers are attached; once the porcelain is in place, this discomfort should disappear within a few weeks. The attachment of veneers involves no discomfort, although patients may need a few weeks to adjust to the feel of the veneers in their mouths.
How long does the placement procedure take?
Traditional veneers placement takes place over two visits. The length of time required for each of these visits will depend on how many veneers a patient chooses to have placed. Following enamel removal and dental impressions, it typically takes between 1 and 2 weeks for patients to receive their new veneers. When dentists use CEREC technology to fabricate veneers in the office, patients could enjoy a dramatically enhanced smile in just a few hours.
How do I know if veneers are right for me?
The only way to know if porcelain veneers are a viable option is through a complete evaluation and exam. A cosmetic dentist will examine a patient's dental history, as well as his or her current dental health and the condition of the dental enamel. The dentist will also explain other cosmetic treatments, so that the patient can make a fully informed decision about his or her dental care.
Do veneers look natural?
Veneers are among the most realistic dental enhancements available. Because they are custom-made for each patient, they will match the shape and color of the surrounding teeth. Additionally, because they are translucent, veneers interact with light just like natural dental enamel.
How many veneers should I get?
Veneers are intended to enhance the teeth that show when a patient smiles, so the number of veneers a patient needs partially depends on how wide their smile is. Some people only show six teeth when they grin, while others may display up to twelve teeth. Of course, a patient's specific cosmetic goals will also determine how many veneers he or she should receive. For example, if someone wants to treat a single chipped tooth, he may only require one veneer. On the other hand, if another patient wants to conceal widespread tetracycline stains, she could require as many as ten or twelve veneers. Patients will also need to consider their budget; because veneers are individually priced, the number of veneers is the biggest factor in determining the overall cost of treatment.
What happens if I only get veneers on my upper teeth?
Because veneers are custom-created to match the surrounding teeth, veneers can be an effective way to treat only the upper (or lower) teeth. However, many patients choose to have teeth whitening performed on the other dental arch for more comprehensive, uniform enhancement.
What should I do if a veneer breaks or comes off?
In the unlikely event that this happens, patients should gather any pieces and store them in safe place before calling their dentist. They should never try to glue the porcelain back in place, although, if they feel extremely self-conscious without the restoration, they can temporarily apply it with drug store adhesive. Many times, a dentist can reapply a broken or loosened veneer. In other cases, a dentist may need to replace the veneer or restore the tooth with another treatment such as a dental crown.
Can I get veneers if I have gum disease or dental decay?
Before receiving veneers, patients should have good dental and periodontal health. Although cavities or gum disease do not permanently disqualify patients from veneers, a dentist must treat these conditions before a patient undergoes any cosmetic enhancements. Veneers can be an excellent option for restoring a patient's smile after it is compromised by decay or a similar condition.
Is one type of veneers better than another kind?
Each type of veneers has its own advantages, and certain dentists prefer to work exclusively with particular brands or types of porcelain. Ultimately, the type of veneers patients choose will be based on their specific needs and the recommendations of their dentist.
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