Porcelain Laminate Veneers - What Are They Good For?

The media is full of images of people who owe their bright smiles to their dentist (perhaps even on this page). Some people lighten their teeth with professional bleaching. Others sport well fitting dentures or false teeth retained by dental implants. A very popular subject of dental marketing is porcelain laminate veneers. By their nature, advertisements are able to raise interest, but not educate. What are porcelain veneers good for? Why should people consider veneers?

Sometimes teeth are a darker color due to genetics or medication. Often, professional bleaching is adequate for lightening darker teeth. While impermanent, professional bleaching can be long lasting. Many patients are unsatisfied by the results.

Working closely with dental lab technicians, dentists are able to completely change the color of teeth with porcelain laminates. Ultra thin veneers can be made to be opaque and the dentist may apply them using an opaque cement. Ultra thin veneers, also known as no-prep veneers, are not the best veneering technique for everyone. Opaque no-prep veneers may appear artificial in that they lack the depth and range of color of nature teeth.

Removing as little as a third of a millimeter, less than a sixty fourth of an inch, allows the lab technician to build a range of opacity and translucency into each veneer while maintaining the natural size and shape of the tooth. This difference between conventional veneers (those that require the removal of a small thickness of enamel) and ultra thin veneers color dentists' preferences and recommendations. Many dentists prefer the no-prep veneers for their ability to conserve natural tooth structure, while other dentists prefer conventional veneers for their more natural appearance and gum friendly contours.

There are people who have teeth that are too small to fill out their smiles. These people might have gaps between their teeth. Orthodontic treatment (wearing braces) is often the best treatment. Orthodontics carries two disadvantages for these patients who have spaces between their teeth. First, orthodontic treatment takes time. There are many life events that precipitate interest in improving ones appearance that will not wait for teeth to move together. Porcelain veneers can complete the change within a couple of weeks. Just as important, if the teeth are too small, moving them together will not create a classic smile.

Teeth that are too short might benefit from treatment with veneers. This problem demands careful diagnosis and planning from the dentist along with the full understanding of the patient. The dentist must determine why the teeth appear short. Have the gums grown down over the teeth? If so, the treatment might be a simple gingivectomy - the removal of the gum tissue that covers part of the teeth that should be visible. Were the teeth worn short by grinding? Lengthening these teeth with veneers will not last unless the dentist is able to correct the way all of the patient's teeth fit together. Teeth that are naturally short in size can be corrected with veneers, but may require a combination of other treatments including gum surgery and orthodontic treatment.

A controversial technique for straightening teeth involves the application of porcelain veneers. Some call this "instant orthodontics". Using veneers in this way usually requires the dentist to remove a significant amount of tooth structure from the teeth that project in front of other teeth. Teeth that stand behind will become thicker, perhaps much thicker with the layer of porcelain required to make them seem to be in line with the other teeth. This treatment improves the appearance of smiles quickly, but does not address oral health issues posed by crooked teeth. Sometimes the resulting teeth are difficult clean well. This will lead to gum disease.

Gastro-Esophageal Reflux Disease (GERD) and bulimia propel stomach acid into the mouth. Acid erodes away enamel on the inside surfaces of the teeth. The loss of enamel leaves teeth sensitive to cold and much more likely to decay. Dentists can restore eroded teeth with porcelain laminates. Veneers will protect the teeth and restore them to their normal contours. While veneers are a very effective restoration technique, veneers will not hold up to continuing acid assault. The patient and the dentist must work closely with the primary care physician to treat the cause of the dental erosion.

In some cases, dentists recommend porcelain veneers to repair chipped or broken teeth. This is a very good use of the technique for small to moderate repairs. Full coverage with a crown is a better service to teeth that are weak due to damage from trauma or decay.

Endodontically (root canal) treated teeth are weaker than other teeth. Instead, restore these teeth by rebuilding them with crowns.

Composite veneers are a reasonable alternative to porcelain veneers. They require more chair time, but without the bill from the dental lab, dentists charge about a third to half the cost of porcelain. Porcelain laminate veneers cost about the same as a crown or cap. Since there is no wait for lab work, composite veneers can change a smile in a day. Another advantage is that the dentist is able to repair a broken composite veneer.

Conversely, the major disadvantages are that composite veneers are more likely to change color or stain than porcelain, and composite is more likely to wear away or break than the more expensive porcelain laminates. As a cosmetic procedure, most dental insurance companies will not cover the cost of porcelain or composite veneers.

Please discuss your cosmetic concerns with your dentist or dental hygienist. Your dentist will be able to tell you about your options and the expense of improving your smile.