A veneer is a thin shield of porcelain that is used to cover the front surface of the tooth. They are designed as a permanent way to change or enhance the look of stained, chipped, broken, or undesired teeth. A minimum of two appointments is often necessary to complete the procedure.
Here is what you can expect during a typical veneer preparation procedure.
The First of Many ImpressionsSimilar to most restorative dental procedures, impressions are taken before, during, and in some cases after the final placement of the veneers. The impressions taken before your veneer appointment are used to make a stone replica of your teeth. The stone cast may be sent to the dental laboratory to assist the lab tech when fabricating the final veneers, or to create a wax-up - a replica of what the final veneers will look like. The wax-up may be used to create a temporary set of veneers that is worn during the time when the veneers are being made.
Choosing a ShadeChoosing the shade of the veneers is an exciting step for most people. The final shade is determined by your request for a certain result, along with the dentist's recommendations. Customized to your skin tone and overall desire for whiter teeth, your dentist will recommend a shade that he feels will best appear as natural as possible, while still giving you the look of attractive, flawless teeth. It may be necessary for you to visit the dental laboratory that is making your veneers, as they are able to do a very customized shade analysis. Not only are they looking for the best shade for your individual skin tone, they may be trying to match the veneer to the shade of the surrounding teeth. This task is especially important to ensure the natural look of the veneer remains consistent.
Preparing the TeethVeneers require very little removal of the enamel surface of the tooth. It will generally depend on the type of veneer used, position of the teeth, or the dentist's preferred method of preparing the tooth.
You may or may not require local anesthetic for the appointment. Teeth that have been root canalled or teeth that require very little preparation, may allow you to avoid the need for anesthetic. Your dentist will use the high speed hand piece to contour the front surface of the tooth. Impressions of the prepared teeth are taken inside your mouth using a very precise impression material that starts out as a thick paste. The impression material is filled into a tray and placed on the teeth. The dental assistant will likely hold the impression tray in your mouth until the material sets, usually after 3 to 5 minutes. An impression of how your teeth bite together is also taken. Impression material is applied to the biting surface of the bottom and top teeth. You will be asked to bite down into the material for 1 to 2 minutes until the material is set; depending on the brand used. If the dentist is satisfied with all of the impressions, they are delivered to the dental laboratory.
Temporary VeneersThe dentist or dental assistant will construct a set of temporary veneers made from an acrylic material, that will be cemented onto your teeth with a temporary cement. They will resemble your natural tooth, but may not appear as white as the final set of veneers and may feel rougher than your naturally smooth enamel. These temporary coverings will help protect the teeth from sensitivity, but keep in mind they are just as their name indicates; temporary. You should avoid the following with your temporary veneers:
- Biting into or chewing hard and food
- Gum and sticky candy should be avoided
- Using the prepared teeth to open or tear non-food items
- Biting your nails
- Food or beverage that contains deep pigments that will stain the acrylic.
Your New SmileThe veneers will return after 7 to 10 business days for final cementation. They will be placed on your teeth without any cement so the dentist can inspect them for any obvious flaws. Your final approval will give the go ahead for the dentist to permanently cemented the veneer to the tooth's surface with a dental resin.
If you had local anesthetic for the first appointment, it may be necessary for this appointment as the teeth need to be cleaned with water and prepared with a solution called acid etch, that microscopically roughens the surface of the tooth. This is necessary to achieve the best adhesion of cement to your teeth. As mentioned your teeth will be prone to sensitivity and since the correct placement of the veneers is paramount, freezing may be a benefit to both you and the dentist.
The cement is placed on the back of the veneer and then placed onto your tooth. A bright light known as a curing light, may be used to harden the cement. Any excess hardened cement is removed from the teeth.
The dentist will check how your teeth bite together to ensure you re not biting incorrectly onto the veneers. Small reductions of the opposing teeth may be necessary if the bite is not correct.
Caring for Your VeneersAlthough veneers are designed to allow you to function normally, you may want to consider trying not to bite into hard food with your front teeth, or use your teeth to open difficult items, because they may chip or break. Occasional you may have foods and beverages like red wine, tomato sauce, grape juice, and tea or coffee. But keep in mind that the porcelain material can pick up stain from deeper pigmented foods and beverages. And unlike our natural teeth, they cannot be whitened with tooth whitening gels.
Your dentist may recommend the use of a night guard, or splint while sleeping. This will protect your lower teeth from the effects of the porcelain grinding on the enamel. Even if you do not knowingly grind your teeth, porcelain is damaging to enamel during even slight grinding of the teeth. Veneers are designed to last between 10 to 15 years. Regular cleanings from your dental hygienist are still recommended, along with regular dental checkups.
Sources:The American Dental Association. Oral Health Topics "Veneers".
The Canadian Dental Association "Bonding and Veneers".
Wiley, M.G.: "Effects of Porcelain on Occluding Surfaces of Restored Teeth", J Prosthet Dent 1989;61:133-7.