The Initial Consultation
Before undergoing any type of dental procedure, it is important to first have a thorough consultation with the dental professional. However, as veneer placement is a highly customized treatment, the initial consultation is even more significant. During the first appointment, the dentist will analyze a patient’s oral health ensuring she or he is a suitable candidate for veneers. The consultation often includes photographs, x-rays, and dental impressions. Cosmetic goals are also discussed during this consultation so that the dentist can assess whether or not veneers are the most effective treatment option.
Before a patient commits to receive porcelain veneers, the dental professional will create a mock-up version. The mock-up provides an example of what the final result will be following the treatment. Dentists utilize different methods to create mock-up models with some using old-fashioned impressions for wax-ups. Advanced technology can also be used to create a three-dimensional computer mock-up image for the patient to view. Neither technique is better than the other; the important thing is the dentist uses precision and care to develop an accurate representation of the veneers.
No-Preparation Veneers Vs. Traditional Veneers
There are different types of veneers available, and the most notable difference is between the no-preparation (or no-prep) and traditional veneers. To position traditional veneers, the dentist removes a thin layer of enamel from the patient’s teeth. Minimal or no-prep veneers are thinner than the traditional option meaning the dentist removes even less enamel from the teeth. most dentists are able to fabricate and position no-prep veneers in one day.
In certain cases, a no-prep veneer treatment can result in a bulky appearance making patients with larger teeth unsuitable candidates for this treatment. Moreover, as porcelain is already a thin and transparent material, the no-prep option is not the most beneficial for patients wishing to fill gaps between teeth. It is important to speak with the dentist about the options and discuss which is most beneficial to meet your cosmetic goals.
Removing The Tooth Enamel
The first step to placing veneers is the removal of a thin layer of enamel from the tooth front. The specific amount of tooth enamel removed is dependent on the patient’s requirements and the type of veneers being used. In most cases, however, the dental professional removes approximately 0.5 to 0.7 mm of enamel from the front of the tooth. Typically, the amount is so minimal that no anesthetic is necessary during the procedure.
The Dental Impressions
Once the tooth enamel is removed, the dentist takes impressions of the teeth. The most common method is to place soft putty into a tray, and as the try rests in the patient’s mouth it hardens around the patient’s teeth. However, if the dentist opts for advanced technology a detailed sequence of images is taken using a digital scanner. The images are fed into a chair-side computer and a three-dimensional image of the patient’s mouth is created using dental software. Once the impressions are created, an in-office milling system develops the veneers with the precise measurements.
The Temporary Veneers
Dentists will often provide their patients with a set of temporary veneers. In some cases, the patients are concerned with the appearance of their teeth following the tooth enamel removal; therefore, dentists will position temporary veneers to protect their vulnerability and the underlying dentin. In most situations, the dentist will assess if the temporary veneer is required based on the amount of tooth enamel removed.
Fabricating The Veneers
Veneer fabrication is a process that varies slightly from patient to patient. It is dependent on the type of porcelain being utilized; however, the primary aspects of the procedure do remain the same. Using the initial impressions from the patient, a ceramist will design working models of the veneer. In this replica, the ceramist builds several layers of porcelain using intense pressure or heat to increase the durability of the material. All of the porcelain layers will be the same shade unless the ceramist hand-paints the layers to obtain a more realistic appearance.
Positioning The Veneers
Once the veneers are completed, the dentist checks the shape and appearance. This is a vital step as the dentist must ascertain whether or not the porcelain will influence the patient’s bite or cause the patient alignment issues. If necessary, the veneers can be trimmed and the porcelain reshaped. The color of the veneers must also be reviewed against the natural shade of the patient’s teeth. While a veneer is made of custom-matched porcelain, it is possible for the dentist to “fine-tune” its appearance by choosing the correct shade of bonding material. During this process, the patient should work with their dental practitioner to ensure the outcome meets their cosmetic goals.
Etching The Existing Tooth
Immediately before positioning the veneers, the dental professional applies a layer of acid gel to the teeth. The gel is used to dissolve minerals on the surface of the tooth; thereby creating a rough surface on a microscopic level. The tooth is coated using a bonding agent, and this solution adheres inside the minute fissures on the tooth’s surface. The “etching” procedure is essential to ensure a stronger base for the porcelain veneers.
The final step is to cement the veneers to the teeth. The dental professional spreads dental cement on the back of the veneers, then places the porcelain to the front of the relevant tooth. The cement color is chosen to match the veneers and provide a natural appearance for the patient. The dentist applies the veneer with a gentle force to set the porcelain, and then he or she utilizes a curing light to harden the cement. The curing light stimulates a chemical reaction within the bonding material hardening the cement within minutes.
Combining Veneers With Other Treatments
While it is possible to have only one or two porcelain veneers, it is also possible to combine this treatment with other treatments forming a comprehensive cosmetic dental plan. Some of the treatments available include the following:
• Gum reshaping
• Teeth whitening
• Restorative treatment
The Recovery Period
No recovery time is required after undergoing a porcelain veneers treatment. However, if the patient opted for dental sedation during the procedure, they will not be able to drive themselves home from the dental practice. After enamel removal, and before the positioning of veneers, it is possible to experience mild discomfort. Once this sensitivity wears off, patients can return to normal routines.