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Todd Gandy
Q&A Expert
Dentistry
Veneers, Part 1

Q: I’ve seen a lot of ads in magazines and on television about how porcelain veneers can give you a perfect smile. I have spaces and crooked teeth; my smile is far from perfect. What would I have to do to have a smile like the ones they show in the ads? – Jennifer

A:  Great question!  Veneers are everywhere these days in advertising.  They are probably the single biggest product in dentistry that is being marketed directly to patients.  Ads run the gamut from simple pictures of people with beautiful smiles (usually models that do not have veneers, a fact that I find funny) to dangerously close to outright lies (promising “no shots” is the one that immediately comes to mind). The truth about veneers is that they are different in every case.  Custom made by a laboratory out of porcelain and bonded to the tooth, the results on the right patient can be amazing.  Simple cases are one or two teeth with fractures or decay that can be restored to health with a veneer replacing the missing parts of the teeth.  Tough cases are the ones (like yours) where the patient is concerned about all of the teeth in their smile because of how they look.

The key (and the focus of this, Part One of the answer to your question) is determining: Are you the right patient for veneers?  To do this you first must turn a critical eye on your teeth and identify exactly what you don’t like about them.

Are the teeth a color you find displeasing?  If teeth are dark they can be lightened with whitening products.  Often patients are asked to try whitening prior to committing to veneers to see if they can reach a pleasing result with this conservative and reversible treatment.  Very dark stains that do not respond to bleaching can be an indication for veneers.

Do you dislike the shape of your teeth?  Teeth can be slightly reshaped by a dentist who removes small amounts of enamel or adds small amounts of tooth colored filling material.  These tricks are good for minor shape changes only.  Too much tooth structure removed and you have now removed the protective outer enamel layer of the tooth.  Too much white filling material added to a tooth can be very difficult to obtain a natural coloring and often does not last for much longer than five years or so.

Do you have spaces and rotated or crooked teeth?  Teeth position can be corrected with orthodontic appliances (traditional brackets or possibly with some of the newer progressive removable clear retainers).  Orthodontics is the way to go if the shape of the teeth is acceptable.  The drawback for most patients is the time involved (one year minimum).  I always push for orthodontic correction when patients only dislike the placement of their teeth because when treatment is complete you still have only your natural, unrestored, teeth (natural teeth last indefinitely if taken care of, all veneers fail eventually but I’ll get to that in Part Two).

Teeth that are way out of line will need to be moved in line with orthodontics even if the patient wants veneers to correct other problems.  Porcelain can only be laid down to a certain limit of thickness.  As an example, a tooth that is half a centimeter back from the other teeth cannot be properly restored by adding a half centimeter of porcelain to the front surface.  The tooth would have to be moved to within a millimeter or so of the desired final position and then restored with a veneer.

So Jennifer, you can now consider all your options.  Whether or not veneers are the right treatment for you is a personal choice and one not to be entered into lightly. For the sake of our discussion let’s pretend that considering all the issues above, you are set on veneers.  In Part Two, I’ll give you an idea of what occurs in a normal veneer case, how veneers work, and what their limitations are.  Stay tuned . . .

Todd Gandy is a Redding dentist whose journey to dentistry was circuitous. He first attended UC Davis and worked as a mechanical engineer in his then-chosen field before he realized dentistry was his true calling. He returned to school, this time in San Francisco, to become a dentist. He graduated from UOP School of Dentistry and returned to Redding with his wife and two daughters to start a practice. Todd T. Gandy DDS Comprehensive Dental Care is located at 2950 Eureka Way, Suite B, Redding, CA 96001. His office phone number is 243-1855.

Todd Gandy

is a sixth-generation Shasta County resident who attended UC Davis and worked as a mechanical engineer before he realized dentistry was his true calling. He graduated from UOP School of Dentistry and settled down in Redding with his wife and two daughters to start his practice, Todd T. Gandy Comprehensive Dental Care. His office is at 2950 Eureka Way, Suite B, in Redding. He can be reached at 243-1855.

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