As a Dentist, I have the privilege of designing not only new, healthy smiles but helping transform the lives of my patients on many levels. Over my 30 years in dentistry, there is nothing more fulfilling than to see the confidence and self-esteem my patients gain from having a well-invested cosmetic treatment. Every area of their lives is enhanced; from the quality of their relationships to the success of their careers; to the person they wake up to each morning as they glance at themselves in the mirror filled with pride and gratitude.

Karol has been a loyal patient in our practice for over 24 years. Several years after I recommended cosmetic treatment, Karol was ready to start her smile makeover. Now the fact that she had a high school reunion coming up certainly gave her even more incentive to make a decision!

Here’s what we did for Karol:

We performed a gum lift to enhance her smile and then added a combination of porcelain crowns and porcelain veneers. As you can see, there is a dramatic difference in her teeth before vs. after – but can you “feel” her newly found confidence? Just gorgeous! By the way, she had a blast at her reunion and came home smiling ear to ear.

What are porcelain veneers? Porcelain veneers are ultra-thin shells of ceramic material, which are bonded to the front of teeth.  This procedure requires little or no anesthesia, and can be the ideal choice for improving the appearance of the front teeth.  Porcelain veneers are placed to mask discolorations, to brighten teeth, and to improve a smile. Highly resistant to permanent staining from coffee, tea, or even cigarette smoking, the wafer-thin porcelain veneers can achieve a tenacious bond to the tooth, resulting in an esthetically pleasing naturalness that is unsurpassed by other restorative options. 

Why a porcelain veneer?  Porcelain veneers are an excellent alternative to crowns in many situations. Because very little of the natural tooth structure is removed in the process, they provide a much more conservative approach (as compared to a full crown) to changing a tooth’s color, size, or shape.  Porcelain veneers can mask undesirable defects such as teeth stained by tetracycline, by an injury, or as a result of a root-canal procedure, and are ideal for masking discolored fillings in front teeth.  Patients with gaps between their front teeth or teeth that are chipped or worn may consider porcelain veneers.  

Generally veneers will last for many years, and the technique has shown remarkable longevity when properly performed.  Veneers may not be appropriate for patients who have strong chewing forces or for those who brux and grind their teeth. Full porcelain crowns will be stronger and have less of a tendency to fracture in this situation.  They may also not be suitable if closing the spaces between the teeth would mean creating larger than normal teeth, creating a “horse-like” result. Orthodontic movement of the teeth may reduce the spaces and give a more natural appearance.  If the teeth have large existing fillings, decay or large areas that have been fractured, porcelain crowns may be the treatment of choice.

What happens during the procedure?  Patients need at least three appointments for the entire procedure: diagnosis and treatment planning, preparation, and placement.

Diagnosis and treatment planning  It is critical that you take an active role in the smile design.  Spend time in the decision-making and planning of the smile. Understand the corrective limitations of the procedure.  Have more than one consultation, if necessary, to feel comfortable that we understand your objectives.  Often we will perform an additional diagnostic procedure where the veneers are created in wax so you can see exactly what they will look like before we get started. There is an additional charge for the “wax up” procedure that is normally done by the laboratory.

Preparation of teeth.  This appointment will take from one to two hours.  To prepare the teeth for the porcelain veneers, the teeth are lightly buffed or reduced to allow for the small added thickness of the veneer.  Usually about a half a millimeter of the tooth is removed, which may require a local anesthetic.  At this appointment a mold is taken of the teeth. This is then sent to the laboratory for the fabrications of the veneers.  This can take approximately  2 to 3 weeks.  If the teeth are too unsightly, or a bit sensitive,   temporary veneers will be fabricated and temporarily cemented to the newly prepared teeth.

Placement of veneers. This appointment will take about one or two hours. First, we will place the veneers in water or glycerine on the teeth to check their fit and get a sense of the shade or color.  While the veneers are resting on your teeth view the esthetic results, and pay particular attention to the color. At this point the color of the veneers can still be adjusted with the shade of the adhesive to be used. The color cannot be altered after veneers are placed. To apply the veneer, the tooth is cleansed with specific chemicals to achieve a bond. Once a special cement is sandwiched between the veneer and tooth, a visible light beam initiates the release of a catalyst to harden the adhesive.

How about maintenance?  For about a week or two, you may go through a period of adjustment as you get used to your “new” teeth that have been changed in size and shape.  Brush and floss daily.  After one or two weeks, you will return for a follow-up appointment for minor adjustments, if needed.

Have realistic expectations.  Porcelain veneers are reasonable facsimiles of natural teeth, not perfect replacements.  It is not uncommon to see slight variations in the color of porcelain veneers upon close inspections, as this occurs even in natural teeth, Nevertheless, this procedure can greatly enhance your smile, and can heighten inner satisfaction and self-esteem.

**This information was compiled by the Academy of General Dentistry (AGD)