What are veneers?
A veneer is a thin layer of something. In the case of teeth it is a thin layer of porcelain that is placed over a tooth to alter its shape, position or colour. In many cases all of the above.
When are they carried out?
Sometimes a veneer is carried out on a single tooth as a result of that tooth suffering an accident that has caused it to break or become discoloured. In these cases the single veneer must replicate its neighbouring tooth exactly to create the illusion that the tooth has not been damaged. This is very challenging.
More commonly a greater number of veneers are carried out together to change the appearance of a smile. Typically either 2, 4 or 6 veneers are carried out at the same time to create symmetry in the smile.
What is involved?
In simple terms, a small amount of tooth tissue is removed from the front of a tooth, a record is taken of this new shape and a veneer is created to fit the front of the tooth.
Does this damage the tooth?
Yes. Any removal of tooth tissue is detrimental to the health of a tooth. It compromises the overall strength of the tooth and increases the chance of bacteria entering the nerve system of the tooth.
However, dentists always endeavour to keep the tooth preparation to a minimum to preserve as much tooth as possible and decrease these risks. In addition it must be noted that any tooth tissue which is removed is replaced with porcelain which is bonded in placed and is the closest material to enamel that can be produced in terms of strength and wear resistance. Therefore it could be argued that as much as possible we are replacing like for like.
What are the risks to the teeth of having veneers?
Removing even a small amount of tooth tissue increases the risk of bacteria entering the nerve system of the tooth and causing symptoms in the future. This would then need the tooth to have a root canal treatment to resolve these symptoms. The studies report that this can occur in 1 in 10 teeth in the first ten years following treatment. If this occurred it would require additional treatment at additional cost.
Removing even a small amount of tooth tissue can make the tooth weaker and increase the risk of future fracture. In our experience this is less likely but is still a potential future problem and if it occurred resolving the issue would require additional treatment at additional cost.
Will my veneers fall off?
In our experience it is extremely rare for a veneer to come loose from the tooth and it has happened only a handful of times in over ten years, and these have been for specific dental reasons which were then remedied.
Why do people choose to have veneers?
People choose to have veneers because they are unhappy about the shape, colour or position of their smile. Their teeth may be crooked, have a number of discoloured fillings, have teeth that are dark in colour and do not respond to whitening. Alternatively they may have very small or large teeth, or a smile where there is an uneven mix of small and large teeth making the smile unattractive.
For any number of reasons a patient may feel that their smile is unattractive and this causes them to lack confidence or not to smile confidently in photos or in public. We have seen over and over again the difference that an attractive smile makes to a patients confidence. It cannot be over emphasised that a smile is one of the first things you notice about a person when they speak or smile and giving a patient a smile they are proud of is of great emotional importance.
Who actually makes the veneers that Marcos fits?
Tony Knight at Knight Dental Design has won Best Dental Lab in the UK a record 6 times. He works with only a select group of dentists in the country. Marcos is the only dentist in West Yorkshire to work with Tony and fit these veneers to his patients.
How many appointments will I need?
Following your consultation you will typically only need to see Marcos for two appointments. The first is to prepare the teeth and the second is to fit the new veneers. You will also usually see our Treatment Coordinator between these appointments to confirm you are happy with the veneers that are being made for you before they are fitted.
What is the process?
At your first visit Marcos will add material to your teeth to create an initial design of what he feels your final smile ought to look like. He will then take a record of this and put it to one side.
Following this your teeth will be prepared and a record will be taken of your teeth. The preparation will be very minimal and will remove between 0.5 and 1.5mm of tooth tissue from the front, tip and sides of your teeth. This is to create shapes that are easy for the veneers to slide onto.
A high quality temporary material will then be applied to your teeth using the design and record Marcos created at the start of the appointment. This will then be shaped and smoothed further to create what is called the ‘trial smile’. Basically, you will leave the practice after your first visit with a draft version of your final veneers.
This allows you to get used to the feel and appearance of your new smile long before anything permanent is ever made or cemented in place. It is an extremely important part of the process as it allows you to confirm to us that you are happy with the proposed appearance of your new smile.
We usually leave a period of 2 weeks for you to live with your ‘trial smile’ before you attend the practice to meet with our Treatment Coordinator. At this appointment you will let us know your thoughts. Should you wish your teeth to be made rounder, squarer, longer, shorter then these comments are noted and an appointment can be made with Marcos to carry out these changes.
More often than not our patients are delighted with their proposed new smile and we can tell our award winning veneer technician to hand-make the porcelain veneers according to the records we have provided.
After this discussion an appointment will be made for Marcos to remove the ‘trial smile’ and fit your finished porcelain veneers.
How long does this take?
It takes 3 week for the veneers to be made by our veneer technician. Therefore in theory it could take just 3 weeks. In practice however, a case usually takes 2 to 3 months to complete as this allows for a review appointment between Marcos appointment. In addition it is common for our patients to carry out smile whitening in conjunction with their treatment and this allows time for this to take place.
What if I want my new smile to be whiter?
It is very common for patients to carry out smile whitening in conjunction with porcelain veneers. If a patient is having 4 veneers for their upper front teeth they often choose to whiten the rest of their teeth at the same time. This allows them to pick a whiter shade for the porcelain veneers.
To explain how this takes place you will need to know the names of some tooth colours. A3 is yellow. A1 is white. A2 is in the middle.
If a patient attended with A3 teeth and wanted an A1 smile, Marcos would carry out his first appointment and create the trial smile in A2. This would be whiter without looking wrong. The patient would then on a different day commence the whitening treatment, which may be home whitening or in surgery laser whitening, depending on their preference. This process would continue until their teeth were A1. Whiter than the trial smile without looking wrong. At this stage we would let our veneer technician know that he could make the new veneers in A1. These would then be fitted.
Does having veneers hurt?
Both Marcos’ appointments are carried out under local anaesthetic and are therefore comfortable. It is common for patients to experience sensitivity in the teeth after the initial appointment and after the fit of the final veneers. This should not last longer than 2 weeks and is never usually to a level where patients need painkillers. However everyone is different, as are their pain thresholds. In general though it is not an issue patients tell us about.
How long will my veneers last?
In the past studies have reported that veneers usually need replacing every five to ten years. When veneers do need replacing it is either due to chipping, fracture, staining or that they come away from the tooth. Often times it is just wear and tear. Natural teeth would typically suffer the same wear and tear over a similar period. The porcelain used these days is stronger than ever before and the cements used more reliable, so we would hope we could achieve better longevity than in the past.
That said, it is wise for patients to expect to need to invest further in their smile in the years to come for repair or replacement. Everything in life suffers wear and tear whether it be a car, clothes, a house or a smile.
What we hope is that over those five to ten years, our patients are more confident, smile more, are in more photos and receive more compliments!