You’ve decided, after some deep reflection, that veneers are exactly what your teeth need for that Hollywood smile. Now you’re wondering, “What’s in store for me?”
Well, I’ll tell you.
Cases usually start with a full set of study models of your teeth that are then modified with wax to show you the desired final shape of the veneers. These study models can, in some cases, be used to make temporary acrylic veneers that can be tried in to allow you to OK the shape and design of the final restorations. Once the shape is agreed upon, a color is then chosen and an appointment is set to prepare the teeth.
Here we run smack dab into one of the greatest myths about veneers. Ads proliferate saying that they can provide veneers that require no removal of tooth structure and no anesthetic (that dreaded needle). This is false 95 percent of the time. The answer why is simple: If your teeth are all small, evenly spaced, and about a millimeter inset from where they should be ideally, then you can hope to have veneers made that are simply bonded to the existing enamel of your teeth and you will probably not need anesthetic.
The majority of patients seeking veneers do not fit this simple set of requirements and so their teeth require the removal of existing tooth structure to make room for the veneers.
The teeth are prepared with a dental handpiece (what all patients know as a dental drill). Essentially the preparation is the removal of any tooth structure that is in space that will be occupied by the porcelain veneers. In most cases this is a millimeter or so from the front of the tooth, and many cases require the height of the tooth to be reduced by as much as two millimeters. Once the teeth are prepared, there is no turning back. Now a very high-quality impression is taken and temporary veneers are made out of acrylic to wear until the delivery. The impression is then sent to a lab to custom make the porcelain veneers. This usually takes a minimum of two weeks; longer for more complex cases.
We can take a moment here to acknowledge that there are different types of porcelain veneers. Discussing the pros and cons of each is a topic for entire textbooks and a bit out of scope for our format here. A simple rule of thumb is that the stronger the porcelain material is the less natural its appearance. Your dentist should review your individual case with you and if they feel that certain compromises need to be made in the esthetics due to a need for greater strength, they can discuss those reasons with you.
When your veneers are back at the office an appointment will be made to bond them to your teeth. The teeth are cleaned, dried, and any final adjustments are made to the veneers. The veneers are finally bonded to the tooth with a very thin layer of adhesive. The final result is a beautiful new smile made of strong restorations that will last a long time.
Now, it would be a disservice to end the article with that last sentence. We’ve come this far; let’s delve a little deeper into that last thought and ask the following. How strong are they? How long lasting is “a long” time?
As to their strength, veneers, for all intents and purposes, will function just like your natural teeth. Before dental bonding progressed to the level it is today, veneers were weakened by the fact that the bond from porcelain to tooth was not as strong as either material, and the veneers would sometimes fail by flaking off the tooth.
Bond strengths today are almost as high as the strength of a natural tooth, so the answer to the original question is this: If your teeth were weakened by prior areas of decay and fillings, the final veneer restoration will most likely be stronger than what you started with. If you started with natural (unfractured and unrestored) teeth, the teeth with veneers will be slightly weaker, with a higher risk of fracturing off some porcelain, if traumatized.
How long will they last? This is a tough question to answer. As with any dental restoration, not taking proper care of your teeth can result in premature failure. Keep your teeth clean; brush, floss and use a fluoride rinse (and opening bottles with your teeth is still a practice best left to Australian rugby players).
The length of time I see quoted most often for veneers is conservatively 12 to 15 years. There are records of cases lasting much longer (I’ve seen cases that were placed over 20 years ago and still going strong) so there is no way to predict accurately exactly how long your veneers will last. The knowledge you need to take home is that if you are planning on getting veneers, and you are also planning on living longer than 15 to 20 years from now, you need to realize that at some point in your life you will be replacing the veneers.
So there it is, all out in the open: the good, the bad and the advertising. Whether or not to have veneers is a tough decision, and one not to be entered into lightly. With that being said, veneers are wonderful restorations, when done on the right patient. Hopefully with the above information I’ve helped you make a more informed decision as to whether or not that patient is you!
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.
