Have you ever wondered how so many celebrities have such perfect-looking, straight and white teeth? In the past the only option, other than good genes and braces, was to have crowns or caps placed on all the front teeth. While this option achieved fairly good esthetic results, it was invasive and required cutting the front teeth down to small nubs. Over time the gum tissue often receded, exposing unsightly dark-looking metal crown margins that could only be corrected by making new crowns.
A much less invasive and esthetically superior option is now available with the placement of porcelain veneers. This veneer is a thin layer of porcelain custom fit to an individual's tooth. The porcelain reflects light much like the enamel of the tooth, so once in place it looks very natural. In comparison, crowns or caps are made by applying layers of porcelain over a metal substructure. The metal provides strength for the crown but results in a more opaque or nonvital-looking appearance of the porcelain.
When choosing porcelain veneers, it is important to consider the desired result. Is it straighter teeth? While veneers can achieve the illusion of straighter teeth by varying the shape and thickness of the porcelain, very crooked teeth must first be corrected orthodontically. Lighter and whiter teeth? Veneers are an effective method for covering dark-looking teeth, but it might be recommended to first bleach the teeth that will not be receiving veneers so that a more natural color match can be made.
Whatever the goal for placing porcelain veneers, both dentist and patient need to understand and agree upon what is realistic given the patient's oral condition. Many dentists now have cosmetic digital imaging systems that give an approximation of what the veneers will look like. As with any esthetic dental procedure, the overall health of the teeth and gums must first be considered. If teeth have large areas of decay or existing large fillings, veneers may not be a good option. If the gum tissue is unhealthy, it is extremely important to first treat any disease and create a solid foundation.
Let's assume you have completed a thorough consultation with your dentist, and you both decide that porcelain veneers are a good option. What is involved in the process? You can expect at least two appointments. During the first, you are given a local anesthetic and the front part of the teeth is shaped by removing a very thin layer of enamel, usually about 1/2 mm. After the teeth are shaped, an impression or a mold is made. This mold is sent to a dental lab along with the desired shade of porcelain. You may or may not have temporary veneers made during the first appointment. The temporaries are often not needed as the teeth are so minimally altered in appearance.
At the second visit, the veneers are tried onto the teeth. If they fit well and the desired esthetic is achieved, then the veneers are "bonded" onto the tooth structure. The bonding material can slightly alter the final shade of the veneers, so your dentist may try several shades before the final bonding is completed. While the veneers are being tried in the mouth they are very fragile. However, once bonded they are quite strong and durable.
It is important to take good care of your new veneers. You must brush and floss thoroughly and maintain good oral health. When cared for, veneers can easily last for 10 years. They can break, however, so avoid any activity that could traumatize your own teeth.
Cost of veneers varies, but you can expect to pay about $1,000 per tooth. Dental insurance may or may not cover part of the cost. The cost may increase if you choose to bleach your other teeth or replace dark metal fillings with white ones. The entire esthetic process may involve several different treatments, so have a clear understanding of the entire plan and associated costs.
Overall, porcelain veneers are a relatively noninvasive and cost-effective way to lighten, brighten and make your smile more youthful.
Molly P. Newlon, DDS, MA, graduated from UOP Dental School in 1982 and completed a GPR residency at the Veteran’s Administration Hospital in San Antonio, Texas. She was director of the Faculty Dental Practice for nine years, and 11 years ago became director of health and safety for the UCSF School of Dentistry. Molly provides training in infection control and health and safety to faculty, students and staff, and is an active member on numerous campuswide committees on health and safety and terrorism preparedness. Send questions to AskMolly@smartnow.com.
