By Dr. Marina Ambridge, DDS, FAGD
The Good
Veneers are a great way to improve your smile and confidence, especially if your teeth are chipped, malformed, discolored, small, or cannot be sufficiently whitened. Veneers can be done in as few as two visits, are highly stain resistant, durable, and customizable in terms of shape and color to make them look ideal. There are two types of veneers: porcelain and composite. Porcelain veneers are stronger but may require the removal of about 0.3mm from the tooth. Composite veneers are handcrafted on top of existing teeth from several layers of specialized resin to mimic natural teeth. So, because composite veneers are placed on top of natural teeth, they can even be used to repair a defect on kids with underdeveloped permanent teeth. Finally, you can easily go with as few as one veneer if you need to correct the shape of a single tooth.
The Bad
There are certain issues associated with dental veneers, of which you need to be aware. Veneers are expensive due to the amount of planning and surgical time required from the dentist, as well as the time required from a skilled ceramist to handcraft each individual tooth. Porcelain veneers may require you to stay in a dental chair from three to six hours at a time if multiple teeth are treated, although mild sedation can help with that. Although some tooth enamel removal may be required, in many cases, none or very minimal enamel may need to be removed. Such cases include small teeth, existing dental work, use of short-term orthodontics before veneers, or when composite veneers are used. Finally, veneers, especially composite veneers, are extremely technique sensitive. Unfortunately, too many veneers end up unsuccessful due to a lack of adequate specialized training by the dentist-ceramist team.
The Ugly
Many factors come into play when determining if you are a good candidate for veneers. Veneers may not be for you if you have weakened teeth (e.g., large fillings, cracks), unhealthy teeth (e.g., cavities or active periodontal disease), do not have enough tooth structure tooth to hold a veneer, or suffer from bruxism (teeth clenching). Nevertheless, you may still be a candidate for the smile of your dreams with specialized crowns that are made with the same care that we would take for handcrafted veneers.
In addition, veneers may fail due to an incorrect bite. Your dentist should have specialized advanced training in occlusion (bite) analysis to evaluate and correct your bite before placing the veneers. Veneers should also be carefully customized to fit your facial symmetry and style. There are twelve styles of veneers, which range from youthful (softened oval style) to aggressive (square shaped veneers) for people, who want to project a strong personality.
Keep in mind that if the style, color, and translucency of your veneers do not match your face, lips, and the whites of your eyes correctly, your veneers will look out of place. Thus, it is important that your dentist has special aesthetic training and a natural feel for beauty/symmetry to help guide you towards the best types of veneers for you. Unfortunately, too many patients end up with veneers that look too white, large, opaque, or have a poor fit of the porcelain to the teeth, predisposing the teeth to future decay. So, make sure to ask your dentist what specialized cosmetic dental courses they have taken and whether they are a member of the American Academy of Cosmetic Dentists.
