Cosmetic dentistry is supposed to make you look and feel good. But appearance is really only half the equation. Your teeth need to function properly and the gum tissue has to be healthy around your teeth. That’s why when it comes to veneers, proper design and placement is so important. And it is also critical that patients with veneers follow some basic rules.
The Bad and the Ugly
Signs of poor quality porcelain veneers
- Veneers are bulky and thick-looking
- Porcelain is too opaque or unnatural looking
- Teeth are tilted, the wrong length, or protruding
- Poor bonding, causing decay (cavities under the veneers)
- Excess bonding – adhesive was not removed, causing red, swollen, infected gums
- Porcelain is monochromatic and poorly finished (no shine)
- Veneers chip, break, or come off.
Several factors can affect how long your veneers will last, or how good they look. How many people like the look of teeth that are too fat, too opaque, and overall just unnatural looking? For porcelain to look natural and last a long time, the dentist and the patient must respect a few basic principles.
For the Dentist:
- Modeling for normal tooth anatomy (thickness, length and shape). To achieve a natural looking, beautiful smile, we have to design the smile so that the teeth are in ideal proportion to the face and that the veneers fit on the teeth as if the patient was born with them.If we simply add porcelain on top of a normal sized tooth, it will be too thick. If a tooth is very small and thin, it may be possible to place porcelain veneers without reducing the tooth at all. Properly designed veneers are conservative, often only about half a millimeter thick. That is very thin, about the thickness of your finger nail. If porcelain veneers are made properly, they will not feel thick. If they do, then either the dentist did not reduce the tooth enough to allow room for the porcelain, or the dental lab made them too thick. When this happens, it is usually because there was poor planning and the tooth was not reduced enough. Working with a good lab and doing a diagnostic wax-up of the proposed veneers will help achieve a more ideal outcome.
- Respecting the bite. This is one of the most challenging principles for the dentist, and where experience and training make a difference. Ideally, a diagnostic wax-up can help the dentist and the lab avoid problems. Patients who have worn teeth down may need the bite built up to allow room for the veneers to avoid breakage. The bite can be built up by adding bonding material to the biting surface or placing crowns on the back teeth.
- Maintaining effective bonding technique. With the advances made in dental adhesives, very strong bonding of porcelain veneers to teeth has become much more predictable. Bonding porcelain to teeth is a technically sensitive procedure. If the surfaces are not properly treated and free of contaminants such as oil, water and saliva, there will be a bond failure.
For the Patient:
- Teeth are not tools. Using your teeth for the wrong purposes, such as to open plastic bags or tear packing tape, can cause chipping or complete fracture of veneers, porcelain crowns or even your natural teeth.
- Wearing a night guard. Not everyone needs to wear a night guard, but we have found it is the best insurance to prevent porcelain chipping and breakage.
- Proper Home Care (brushing, flossing, Waterpik, etc). Bacteria can cause cavities or red, swollen, infected gums even around the finest porcelain veneers.
Well designed veneers can last a long time. I have patients with veneers that are still in good condition since 1984. But as strong as the dental adhesives are, they cannot be strong enough to prevent porcelain from breaking or failing if the dentist violates basic principles or the patient doesn’t do his or her part regarding the bite and home care. Veneers should last about ten years, and I personally feel that if they are done properly, they can last much longer. The result should be a natural looking smile that looks great, feels great, and lasts a very long time.