There are two different types of dental veneer: porcelain veneers and composite resin bonded veneers.
Veneers are thin layers of one of the above materials which are bonded to the front surface of teeth to improve their looks. Think along the lines of a false fingernail. In the majority of cases it requires removal of part of the front of the tooth to accommodate the veneer so that the finished result does not make the teeth “stick out”.
They can be used to make:
dark teeth lighter
chipped teeth whole
multiple-stained teeth an even colour
crooked teeth even (thus avoiding the need for long-term orthodontic treatment, eg. “railtracks”)
Composite resin bonded veneers are essentially a white filling material applied and sculpted by a dentist onto the tooth surface without the need for a laboratory technician. This is then hardened and bonded in place by use of a blue curing light. It requires a dentist with an artistic eye and precise knowledge of tooth shape to produce a natural result. They are less hard-wearing than porcelain and more prone to staining with time and usually cheaper as a result.
Porcelain veneers vary in the method of manufacture. Feldspa veneers are made by a layering technique and are therefore very natural-looking as the technician can achieve high levels of reproducibility and match. They average about 0.3-0.5 mm in thickness. Pressed veneers are one-piece items and allow the technician less artistic license and because they are slightly thicker also require more of the tooth surface to be removed. They are however stronger as a result. These are more suited to patients with a grinding habit where the new veneers are used to produce an increase in tooth length.
However, porcelain veneers are’t suitable for everyone – if teeth are stained too dark, then these translucent layers won’t fully camouflage the tooth’s real colour. If this is the case, then a crown is usually the best alternative, unless the tooth has undergone a root canal – in which case it might be possible to bleach first.
When teeth are out of alignment, veneers can help – but not if the position of the tooth is too extreme. When it sits too prominently, too much of the front will have to be removed first which can cause problems when not enough remains to support the veneer. If the tooth is too far back, then the sheer force applied wen biting will cause the veneer’s bonding to fail because of the new thickness of the tooth and its recessed position. When either of these is the case, then it would be advisable to look into orthodontics instead. It’s so important to discuss with the patient their requirements from treatment before any plan is decided upon.
Fitting veneers is a fairly simple process. First, the patient is put under a local anaesthetic to prevent any discomfort as the surface of the tooth is scaled back to make room for the veneer, and then a mould is taken. This allows the laboratory to have a model on which to make the veneers. During the two week period whilst the veneers are made, the patient is given temporary veneers to wear, after which time the permanent pieces are fitted and bonded permanently.
Whether the patient only requires one veneer, or many, it’s really important that they get to know their dentist well so that, throughout the process, there is a relationship of trust and understanding – after all, the patient is hoping to leave the surgery after the process with a completely new smile, and a great deal more confidence.