The Skin of Your Teeth: Porcelain and Composite Veneers and Lumineers

Sometimes, the dentist can save the day. Jill, A young woman planning her wedding, fixates on her single, less attractive feature, short, dark teeth. Despairing, she runs to her family dentist. Her dentist offers her a variety of treatments to brighten her smile. The surprising solution will only take a couple of weeks and will cause no discomfort, porcelain veneers. In plenty of time for her special day, she makes a lasting change. She becomes even more beautiful.

Jill's problem, the dark color of her teeth, is the side effect of a childhood medication, tetracycline. Jill's dentist sees this occasionally. He has the information ready to show Jill. Dental bleaching is a simple, effective treatment for discoloration. Unfortunately, tetracycline stains are deep, internal stains. Bleach will not be very effective for Jill.

If Jill had more time, her dentist would take a photo of Jill and send the photo to a special dental photography lab, Smile Pix (www.smilepix.com). The technicians at Smile Pix are able to change the photograph to show the patient how cosmetic dentistry may change their appearance. The dentist and the patient may direct the technician to make changes to the photo such as enlarging the teeth or changing their color. Dentists transmit the final product to the dental lab to show the dental lab technician exactly how the final crowns, veneers or dentures should appear.

Smile Pix photos are not a guarantee of a final product, and that is a problem. It is very important for the dentist and lab technician to analyze the Smile Pix photograph with a critical eye; photo technicians are able to create smiles that dentists and lab technicians cannot duplicate in life.

Another way to visualize the final product before changing the patient's teeth is to make models of the teeth and build up the teeth where they are too small with wax, or making them smaller with the dental drill. As with altered photographs, the models or "wax up" allows the dentist and patient to communicate their desires to the dental lab tech.

Jill is very fortunate; her teeth have a nice shape to them. She wore braces as a child, so her teeth are straight. Her dentist believes that the dental lab will be able to create beautiful veneers that change the color of her teeth, lengthen them slightly, and repair a small chip on one tooth, without requiring models or photographs.

Jill's dentist recommends marrying her teeth to a material that will change their color and slightly increase their length. A cover that surrounds the tooth is a crown or cap. A mask for the front of a tooth, like a fake fingernail, is a veneer. Jill's dentist offers two kinds of veneers, direct veneers of plastic and glass composite, and lab fabricated veneers of porcelain.

Composite veneers test the dentist's ability. The dentist must hand form direct veneers on the tooth while the patient reclines in the dental chair. Often, the dentist or a lab technician will fabricate a kind of mold or guide from a wax up to aid in creating uniform veneers. Composite veneers are comparatively inexpensive, but the material, a mélange of plastic and ground glass, may stain over time. Additionally, composite is much more likely to chip, pit, or roughen with age. Composite veneers may appear as lovely as porcelain at first, but over time, the limitations of the material will show.

Porcelain veneers are the darling procedure of dentists everywhere. Patients and dentists love their apparent ease and simplicity. They are strong and long lasting. Porcelain veneers look natural. Porcelain will not stain. Porcelain veneers show off the best efforts of the dental lab and the dentist. Experienced providers are able to make the procedure seem effortless. Porcelain veneers cost four or more times the cost of composite veneers.

Porcelain veneers take two appointments about two weeks apart. Classic veneers require the porcelain to be at least a half-millimeter thick, so the dentist must remove a half-millimeter or more of the front surface of the tooth. Jill's dentist would numb her teeth with an anesthetic before removing that bit of tooth. When building the veneer, an artistic lab technician is able to build in color and character (lines and stains) to mimic natural teeth. Many dentists and patients prefer classic veneers believing that they provide a deeper, more natural appearance than other choices.

Lumineers (http://www.lumineers.com) are a brand name of veneer that uses proprietary porcelain that the lab is able to form into veneers only one tenth of a millimeter thin. In many cases, Jill's included, the dentist does not alter the shape of the natural tooth before applying Lumineer veneers. That is why Jill's dentist calls Lumineers the painless alternative. There are dentists and patients who feel that the ultra thin Lumineers will appear less natural or that the 0.1 millimeter of porcelain on the front of the tooth will feel unnatural. In practice, neither effect seems to be noticeable.

Jill, our storybook bride, chooses the Lumineer approach.

Her dentist creates models of Jill's teeth and ships them to the Cerinate dental lab. About two weeks later, the veneers arrive. They are in a special organizer case that indicates clearly, which veneer should be applied to which tooth. The dentist applies all of the veneers to their corresponding teeth using try in paste - weak cement that is easy to remove from the tooth and veneer.

Jill stares expectantly into the mirror the dental assistant hands her. She appreciates the shape and color of the new veneers. Her dentist notices that one tooth is slightly darker. He removes that veneer and reapplies it using a lighter color try-in paste. Now, the dentist is as happy with Jill's veneers as is Jill. The dentist and his assistant remove the veneers and clean away the try-in paste from the teeth and veneers.

Finally, the dentist applies the veneers to Jill's teeth using permanent cement that corresponds in color to the try-in paste. When the cement sets, the dentist cleans away the excess cement and finishes the edge of the Lumineer veneer to an imperceptible knife-edge. Ready to smile brightly, Jill leaves her dentist's office.

If you are unhappy with your smile and feel that veneers, dental bleaching, or another technique may give you the confidence you need, speak with your dentist.