The word veneer means a material “that hides something unpleasant or unwanted” (1). In dentistry veneers are used to hide the original teeth with a more “cosmetically appealing” appearance, made from another material, usually porcelain.
Porcelain veneers are thin pieces of ceramic glass-like material that are placed on the front of a natural tooth surface in order to improve it’s cosmetic appearance. Veneers are very thin (about 0.5mm) and they’re usually used to cover only the front teeth, and not molars.
The American Academy of Cosmetic Dentistry (AACD) defines a dental porcelain veneer as a “thin piece of porcelain used to re-create the natural look of teeth, while also providing strength and resilience comparable to natural tooth enamel” (2).
Dental veneers were actually invented all the way back in 1928, when a dentist in California was requested to change the appearance of an actor’s teeth for a role (3). Perhaps this is another reason why the phrase “Hollywood Smile” has become so associated with dental veneers.
What do veneers do?
Veneers replace a bit of the natural tooth structure in order to improve the overall function and appearance of a smile.
Contemporary dentistry is moving towards the belief that the less invasive a dental procedure is, the more aesthetic the results, and this is especially true of porcelain veneers. Therefore only the minimum amount of tooth structure will be removed (4).
One of the most important requirements for getting dental veneers is that your teeth must be cavity-free and healthy.
Below are the cases where getting veneers could be an option:
1. Gaps between teeth
Having gaps between teeth is one of the most indicated cases for dental veneers.
Because a foreign object (the porcelain veneer) is going to be placed on the external surface of a tooth (the enamel), some space will need to be made for this veneer to fit comfortably.
If not enough space is accommodated for, then the veneers will look and feel extremely bulky, and will affect the normal bite causing a huge number of problems.
Veneers are usually 0.5mm thick, and this is the amount of thickness that is removed from the outer layer of the tooth so that the veneer can attach to it.
If there is spacing already present in a smile, then this is a perfect case for veneers, as only the minimum amount of tooth surface is required to be removed to fit the porcelain veneers.
2. Yellow or discoloured teeth
Teeth whitening (either home whitening kits or in-office whitening) is usually the dental solution for getting brighter and whiter smiles. But the problem with teeth whitening is that it doesn’t brighten smiles as much as some people like, and it doesn’t last very long (especially if you drink a lot of coffee or tea).
Once veneers have been placed they can instantly whiten a smile to the exact shade that you like.
Some tooth discoloration is due to caries or previous dental restorations. Dental veneers can replace or mask these older and less cosmetic appearances.
3. Teeth that are broken or chipped
A small chip on the corner of a tooth may be repaired by composite (resin) white fillings. However these don’t last as long as ceramic veneers and are not as aesthetic.
4. Overlapping teeth and crowded smiles
Opposite to people complaining of gaps between their teeth, you may instead have limited space in your mouth to accommodate all your teeth, which has resulted in your teeth overlapping each other.
Orthodontics and braces are usually the first line of treatment for a crowded smile, but some people may prefer to have veneers instead.
What are veneers made of?
Dental veneers are usually made of two materials: porcelain and composite (resin). Below is a quick comparison between the two:
1. Porcelain veneers
Advantages of porcelain veneers:
- More durable (Stronger)
- Last longer – 93% of veneers last longer than 10 years (5). On average veneers last between 10 and 15 years.
- More aesthetic and natural looking – Unlike composite veneers, porcelain veneers are translucent and can appear like natural teeth.
- Porcelain veneers don’t stain as easily as composite veneers
Disadvantages of porcelain veneers:
- More technique-sensitive – Porcelain veneers are quite complex to do and the outcome depends heavily on the skill of the dentist. Experience and skill are essential, and will impact how cosmetic and natural the veneers will look, as well as how long the veneers will last.
- Take longer to do. According to the AACD, getting dental veneers (from start to finish) may take anytime between 1 to 8 weeks, but usually it takes around 2 weeks. This is because impressions need to be taken and sent to the laboratory, where the veneers will have to be made. In addition to this there are several more steps involved in getting porcelain veneers as opposed to composite veneers such as; mock-up of the veneers, wearing temporaries, and bite-registration.
- Are more expensive
2. Composite (resin) veneers
Advantages of composite veneers:
- Much cheaper than porcelain veneers
- Quicker! Composite veneers are usually done in one session
- Relatively less invasive than porcelain veneers
Disadvantages of composite veneers:
- Considerably much less durable than porcelain veneers – Composite veneers are not as strong as porcelain veneers, and many can fracture under heavy loads.
- Composite veneers can shrink and cause leakage of saliva and bacteria into the natural tooth structure below.
- Composite veneers only last around 2-4 years.
- More prone to staining, and they change colour much quicker than porcelain veneers.
- In comparison to porcelain veneers, composite veneers are not as aesthetic.
How are veneers put on?
1. Veneers Consultation and Diagnosis:
Your dentist will talk to you about your complaints and result goals. During this session it’s important to be as accurate as possible about the type of smile you hope to achieve by getting the veneers.
After, your dentist will examine your teeth clinically, and if everything is fine the veneer preparation procedure can begin. If you have inflamed gums, or have cavities that need fillings first, then your dentist may delay your veneers treatment until after you’ve completed those instead.
It’s important that your gums are perfectly healthy before you can get veneers. This means that many people require thorough periodontal work such as scaling and root surface debridement before they can get veneers.
During this session your dentist may also take preliminary records such as x-rays or an impression of your mouth.
2. Veneers Tooth Preparation:
As mentioned above, in order to get veneers your teeth need to reshaped slightly so that they can fit the porcelain veneers. This drilling and reshaping of the outer layer of the tooth is called tooth preparation.
Your dentist will remove a very thin (0.5mm) part of the outer layer of your tooth. The thickness that is removed is the same amount to accommodate the thickness of the veneer.
An impression or a gauge may be used by your dentist to make sure they are drilling enough tooth structure, and this improves the accuracy and the overall results of the treatment (5).
After the tooth preparation is complete, an impression is taken of teeth after they have been reshaped, and this is then sent to the lab so that they can create your custom veneers.
Depending on when your next session will be, or how your teeth look after being reshaped, temporary veneers may be done by your dentist immediately in the clinic. These aren’t made from porcelain and don’t last long, but may have a similar shape to how your final veneers will look. They’re intended only as temporary coverage until your next session where you can try your porcelain veneers.
3. Veneers Try-in and Bonding
In this session your porcelain veneers will have arrived from the lab to the clinic, and will be bonded permanently against your teeth.
The veneers are first placed without any cement against your teeth to check their fit, colour, and overall look. You can check your new smile with a mirror and let your dentist know if you have any complaints such as how they look, if they feel uncomfortable, or if you don’t like their colour.
Most veneers will require minimal modifying during this try-in, your dentist may reduce some of it’s size, or trim away slightly in the fitting surface until you feel comfortable. Once everything is fine and you like the new veneers, then they can be permanently cemented onto your teeth through bonding.
Bonding is the dental term for using resin and composite materials to stick the veneers to your teeth (to cement the veneers). The material that is used is extremely strong and resilient, making sure that the veneer is stuck completely to the natural tooth surface with no gaps between them. This prevents any pores of leakage of bacteria or saliva under the veneers on to the tooth, and allows the veneers to stay for as long as possible.
Your teeth are first cleaned, and then an acid etch is placed on them for around 20 seconds. This is done in order to further remove any foreign debris and to harden the surface so that it can accommodate the cement.
A similar process happens to the porcelain veneers to clean them, and then the cement (bonding agent) is placed on both your teeth and the inside of the veneer.
With the cement inside them, the veneers are then placed against your teeth and a special light is used to activate this cement and make sure it hardens completely and quickly. During the bonding, your dentist may use a brush to remove the excess cement, especially around your gum line.
During bonding it’s important that no saliva comes in contact with either the tooth surface that will accommodate the porcelain veneer, or the veneer itself. This is called moisture control and your dentist may need to use a rubber dam to achieve this.
This was the last step in getting your veneers, once the veneers have been bonded and cemented permanently you’ve then completed your dental veneer treatment and can enjoy your new and beautiful smile!
What are Lumineers?
Lumineers are a brand of porcelain dental veneers that can be placed on teeth with little to almost no preparation and reshaping of natural tooth structure. For this reason Lumineers are also referred to as ‘minimally invasive veneers’ or ‘non-prep veneers’.
Their website claims that they can be applied almost “seamlessly over your existing teeth” (6), this is because lumineers are extremely thin (about 0.2mm!)
Keeping this in mind, lumineers only work for a very select and specific type of patients (5). So who can benefit from lumineers?
- People who gaps between their teeth
- People with a midline diastema (a gap between their 2 front teeth)
- People with a cracked teeth
- People who only want to whiten teeth
Porcelain veneers aftercare
After getting your porcelain veneers, it’s really important to treat them as if they’re your natural teeth.
Maintaining your oral hygiene by brushing your teeth twice a day with fluoride toothpaste and flossing once a day is still extremely important – even for your veneers. Even though the porcelain veneer material itself cannot develop a cavity, if you don’t clean your teeth regularly then bacteria can still affect your natural tooth and affect it underneath the veneer (7).
Flossing is very important for veneers as bacteria is usually located between adjacent teeth. Normal tooth brushing alone would not be sufficient to remove this bacteria and so make sure you floss once a day between your teeth (and veneers).
Even though Veneers are extremely durable and strong, they can still unfortunately break under heavy loads. You should be fine biting down on an apple for example, but harder foods such as accidentally biting down on a bone, or cracking open a pistachio shell, may cause it to break.
Don’t chew and bite down on hard objects regularly with your veneers if not necessary. For example, chewing on a pen or biting your fingernails may make your veneers more likely to fracture.
It’s very important to get regular checkups and dental cleanings for your overall oral health but also to evaluate your veneers. You should be going to the dentist at least every 6 months unless told otherwise directly by your dentist or dental hygienist.
Porcelain Veneers FAQ
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Can teeth rot under veneers over time?
If you follow the above tips, then ideally you should be brushing your teeth twice a day, flossing once a day, and going for a dental checkup every 6 months. If you follow these rules then the tooth surface underneath your veneers should be strong, healthy, and reinforced by the veneers.
If you’re not paying attention to your oral health then a cavity could potentially develop and affect the tooth beneath the veneer. If this does happen, then unfortunately your veneer would have to be broken to be removed, so that your dentist can remove the bacteria and do a dental filling.
This would be a true waste of money, time, and expose you to damage and potential pain – so make sure to take care of your teeth and veneers by cleaning your teeth properly!
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What do veneers cost?
The average cost of a dental veneer is around $900 – $2500 (8). Of course this depends greatly on where you’re thinking of getting your veneers and how experienced or specialised your dentist is.
Getting multiple veneers may also drop the price of each individual veneer slightly.
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How to take care of your veneers?
As mentioned above, make sure to brush twice a day and floss once a day. Additionally, don’t bite down and chew regularly on foreign objects, like using your teeth to open packages or bags.
If your grind or clench your teeth due to stress or during sleep, make sure to notify your dentist immediately as grinding can break your veneers. Your dentist will manufacture a “night guard” splint that you can wear in your mouth during your sleep to protect your veneers, teeth, and TMJ.
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Will you need anaesthetic when getting veneers?
Whether or not you will require local anesthetic during your veneers procedure will depend on you. The only time were you may require anaesthetic is during the tooth preparation stage, where a very thin layer of your teeth is removed.
This tooth material being removed is in the enamel which contains no nerves but may cause some sensitivity, especially for people who are apprehensive, anxious, or people who complain of teeth sensitivity.
There’s nothing wrong with getting anaesthetic and it won’t affect the procedure or the outcome in any way, so if you think you may require some or feel uncomfortable about having your teeth slightly reshaped without any dental anaesthetic then make sure to notify your dentist so that they can administer some.
