A veneer is a restoration that covers the visible front and usually biting portion of a tooth and is not removable. The most common reasons for placing a veneer on a tooth are to alter a tooth's size, shape or color for cosmetic reasons.
A veneer is most commonly made using a thin shell or layer of ceramic which is tooth colored. Ceramic material is very hard and quite durable once it is bonded to the tooth. A tooth may first require a filling to eliminate defects created by previous decay or fractures. Veneers are not usually placed on extensively broken down teeth, however a crown (cap) might be considered.
Several steps are involved in placing a veneer. The first step is to design and plan the veneer to optimize its size and shape, your bite and access for cleaning. Your tooth is then carefully and meticulously shaped so that a precisely fitted and natural appearing veneer can be made for you. A mold will be made of your tooth from which the veneer will subsequently be made. The laboratory phase of making your veneer occurs between appointments and is completed by specially trained laboratory technicians. The final steps involve completion of any adjustments to your veneer prior and subsequent to its attachment, after which your veneer is not removable. During the laboratory phase, while the veneer is being made, your tooth will have a slightly smaller and duller appearance and will likely be somewhat sensitive to hot and cold, which is temporary and will disappear when the veneer is attached to the tooth.
Natural looking veneers need to be more than just 'white', they must match the complex color scheme of your other teeth or they will stick out like a 'sore thumb'. When skillful clinical treatment is combined with artful laboratory technical work it is often difficult to detect the difference between a well made veneer and your natural tooth. Natural teeth will tend to slowly darken with age. Teeth restored with veneers will remain the same original color. Natural teeth, however can be somewhat lightened by dental bleaching.
Shape is extremely critical and is one of the most frequently overlooked aspects of many veneers. This can result in an otherwise attractive smile being ruined by veneers not matching the remaining teeth and appearing as if they stick out. Proper shape is also required to prevent food jamming between teeth and to permit fast and easy cleaning.
Red, blue or swollen gums and gum recession are ugly and can be caused by improperly made veneers. The gum around the veneer should be pink, firm and not bleed during cleaning. Well made veneers completed using gentle techniques should have minimal effect on natural looking pink gums.
A well made veneer should feel completely even with the other teeth on the very first day and does not require time to settle in. A veneer that is slightly 'high' can result in great pain and inability to chew properly, whereas a veneer that is slightly 'low' will result in tooth movement and bite instability which compromises the other teeth. A veneer should also be made to feel comfortable when you slide your teeth from side to side or back to front as in chewing. A well made veneer should actually help stabilize your bite and maximize that tooth's chewing ability.
If carefully planned and designed, veneers can be used to re-create an even bite and give the impression that crooked teeth are actually well aligned. This can ensure optimal chewing ability and help maintain bite stability over many years which is important if you are planning to keep your teeth for a lifetime.
A veneer should feel comfortable and look natural. A tooth with a veneer on it will maintain or restore your ability to eat and speak.
Most veneers fail because of tooth decay under the edge of the veneer or gum disease, both of which are frequently caused by a poor fitting veneer and inadequate cleaning. An extremely well fitting veneer is less likely to allow decay to get under the veneer destroying the tooth underneath it. A veneer that fits well is also easier and faster to clean saving you time everytime you clean your teeth and saving you money every time the dentist cleans your teeth. A veneer that can be properly cleaned will last much longer, further reducing the financial cost of dental care throughout your lifetime but even more importantly, a veneer that lasts longer will increase the likelihood that you will keep your teeth a lifetime.
The shape of the tooth under a veneer is extremely critical. The greater the expertise in completing this treatment, the more likely the tooth and gum will not require additional expensive corrective treatment. If properly designed and shaped, veneers should not fall off. Expert treatment during the shaping of the tooth when the veneer is first made can essentially eliminate the un-necesssary future costs of re-cementing or remaking a veneer that won't stay on.
It is important to have all of your teeth examined and cleaned regularly by your dentist especially when they have veneers on them. By using specialized knowledge, skill and experience in combination with careful planning and attention to detail, a veneer can usually be made to last for many years if appropriately cleaned. A well made veneer will minimize the need for future treatment and increase the likelihood you will keep your teeth for a lifetime. All these details will give you the best value for your time and financial investment.
Cleaning teeth with veneers on them is very similar to cleaning non-restored natural teeth. You must thoroughly brush your teeth and clean between the teeth using either floss, super floss or a prox-a-brush every day.
Mrs. K.G. was 40 years old in 1995 when she decided that she wanted to eliminate the large space between her two front teeth. Her sister had the same problem, but when her dentist had closed the space by bonding tooth colored filling material, the teeth then looked too wide and the color match was not very good. So Mrs. K.G. was interested in having crowns on her front teeth and was already thinking that she might need some orthodontic braces to move the teeth a little closer together prior to proceeding with the crowns. This is approximately what we recommended, except we suggested that veneers be used instead of crowns. Once her orthodontist completed the tooth movement, we completed the veneers to achieve the smile that Mrs. K.G. was looking for without spaces and without having disproportionately wide front teeth.