Questions and Answers about Porcelain Veneer Dentistry
Porcelain Veneer Repair in Wisconsin
1. Do Veneers Last a Lifetime?
Veneer life time is based on several factors. First is the veneer bonded to enamel or the softer dentin underneath. The size of underlying fillings or the color of the tooth can require a deeper preparation to block out these undesirable colors. The deeper the preparation, the weaker the connection between the porcelain and the tooth. This is because greater tooth removal exposes a softer layer of the tooth which has pores and fluid flow which decreases the ability of the cement to "bond" the veneer tightly to the tooth. Secondly, the type of cement and presence of moisture or contamination can effect the strength of the veneer sticking to the tooth. Lastly, biting forces, tooth grinding at night and using your teeth as tools to open bags, bite fingernails, etc. are all factors that can shorten the life of a veneer. Typically we tell patients they will last between 8 and 15 years.
2. My veneers have become dark over the years. How can I get them whiter?
Usually you have to remove the veneers and replace them. Though it never hurts to try and whiten a tooth from the backside, it may not create the color desired because teeth are thick and whitening through the entire tooth is unlikely.
3. My veneers feel thick and look too bulky. It doesn’t look natural.
A dentist needs to evaluate the entire smile, the position of the lips and the way teeth fit together to determine the best way to make and keep veneers looking natural. If a dentist tries to add to a tooth with too much porcelain, the result can feel "big and bulky" like "horse teeth". The dentist with a keen eye on beauty will discuss very thin veneers or a lumineer type product to prevent this. If however, the desired outcome can't be done with a minimal or no preparation veneer, then the dentist should educate the patient about options and a porcelain crown may be required that will allow the proper amount of tooth reduction, while giving the laboratory ceramist enough thickness of porcelain to work their magic. Just as an artist needs layers of paint to create beauty and 3 dimensions on a canvas, so does a ceramist need room to build in layers of color, translucence and characterization to create a natual result.
4. Is it difficult to have veneers re-done?
Removing veneers is tedious for a dentist as they have to work slowly to remove porcelain(which looks like tooth) without removing valuable tooth structure underneath. It is difficult to predict the amount of tooth left after taking off the veneer. So when the veneer is off, if little enamel is left and redoing a veneer has a poor prognosis, crowns may be the only option left. If, however, alot of enamel is preserved, redoing the veneer may only require taking a new impression- which will greatly shorten the appointment!
5. I have veneers but why do I see my old tooth color close to the gums?
If a veneer is placed before gums are healthy or in the presence of gum disease, then when the gums heal and shrink the root will be exposed. That is why veneers should only be done on healthy mouths with stable gums. In fact, in my office if the gum tissues are irritated at all on the day we prepare the teeth for veneers, we wait for a few weeks to take the final impression, to prevent this recession issue.
6. Do veneers mean the same thing as "instant orthodontics"?
Veneer placement to change crooked teeth or close gaps is often referred to as instant orthdontics. This is of course wrong! We only make it "look" as though you had orthodontics. A lot of orthodontists are upset over this phrase and the dentists using it to "sell" veneers. The problem is that veneers are an irreversible procedure once teeth are cut down.
Lumineers or no preparation veneers are reversible so they can be removed and the original teeth are in their original position and untouched. So if large gaps exist, the dentist has to cut away a large amount of tooth so a crown or veneer can be added that will extend the length of the tooth into the gap and appear as though the tooth was moved.
It is much healthier for a person to move their teeth and then do the veneers so precious tooth structure is not lost. I think Invisalign, orthodontic clear aligners or Essix Appliance Therapy (a less expensive method for moving teeth with clear aligners made in the office) before cosmetic dentistry can preserve enamel, make minimal preparation veneers easier and more predictable and allow us to put the foundation in an optimal place before the restorations are completed.
Certainly, if a person doesn't have the time or finances to go this route, crowns or veneers are much faster than going through these steps, but the important note is that OPTIONS should be given and discussed before performing these procedures.
6. Can Veneers match crowns?
In combination cases, where crowns are needed, ie: old ugly crowns are present next to virgin teeth, then veneers and crowns can match. The reason this is an issue is that a crown can be 2 millimeters thick and a veneer only .3-1.0 millimeters thick. It's hard to give teeth the same look with different thicknesses of glass. So the skill of the laboratory technician and the type of porcelain as well as the type of crown are crucial to achieve the success we require. Even the color of the veneer cement needs to be evaluated so that all the pieces of the puzzle can come together.
7. Veneers made out of composite resin or porcelain - which is better?
There is no correct answer to this question. If someone has beautiful teeth with minor spacing or chips, a composite veneer can be an excellent almost perfect option. It will be less expensive than a laboratory fabricated veneer and can be done in one visit as opposed to porcelain veneers which must be made in a dental facility and cemented at a second appointment.
The most popular veneer products are porcelain pieces that are bonded or cemented on to your teeth. They are made in a dental laboratory and can be expected to provide 10-15 years of service if maintained properly.
Usually veneers are made to fit on to teeth that have been reduced .5 to .75 millimeters. So they are more conservative than traditional crowns that often require 1.5 to 2.0 mm of reduction. In fact we now offer Lumineers or non-prepped veneers to preserve tooth structure when it is feasible.
Composite veneers are tooth colored resins, (tooth colored filling material), that is also bonded to your teeth. They have a life expectancy of 5-7 years, which can be longer or shorter depending on diet, maintenance and force factors of chewing.
Porcelain veneers are fabricated in different ways, depending on the lab, with powerful magnification by a porcelain ceramist. Specialized technologies are used to control nuances of color, opalescence, translucency, surface characterizations, age cracks, light reflection, etc.
The veneer temporaries that are typically made for premium veneer dentistry and worn by the patient become the templates for establishing the color, size, shape and feel of the veneers before they are even finished. Lab ceramists make models of the temporaries to create the final form and function for these veneers.
Pros and Cons
Have more questions about veneers or bonding dentistry in general? Contact Dr. Winter with your questions to obtain the answers you are looking for.
Wisconsin Reconstructive Implant Dentistry
Richard Winter, DDS FAGD
Hampton Dental Associates
5323 W. Hampton Avenue
Milwaukee Wisconsin WI 53218
(414) 464-9021
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