Dental Veneers


Definition:

A Dental veneer is a layer of material placed over a tooth. Dental veneers can be used to:

  • improve the aesthetics of a tooth, or
  • to protect the tooth’s surface from damage.

They are often referred to in slang as Teeth Veneers, or Tooth Veneers.

Materials used in Dental Veneers:

There are 2 types of material which can be used to make a veneer:

  • Composite – either direct or indirect
  • Porcelain – indirect only

Porcelain veneers are more durable and less likely to stain than veneers made of composite. When placing a veneer directly, it is built up in the mouth there and then by your dentist.

When placing an indirect veneer, an impression or mould of your teeth is needed and sent to the lab which will build the veneer on the model of your teeth. The veneer is then sent back to your dentist to stick onto your teeth using a special glue. Often this method allows a better aesthetic result, but requires very careful attention to the colour and impression making process.

Lumineers

A brand of veneers is Lumineers. These are custom made, very strong veneers which are very thin and aesthetic as they have natural transparency and are only stuck to the surface of your existing teeth. They cannot be used in all situations – they can only usually correct mildly displaced teeth, but should be considered by your dentist.

Surfaces of Dental Veneers:

A full veneer crown is defined as “a restoration that covers all the tooth surfaces above the gum (Mesial, Distal, Facial, Lingual and Occlusal)”. The benefits of this is as follows:

  • there is a higher surface area for the glue to stick onto the crown / tooth.
  • by covering more tooth, there is more support for the veneer, and this offers it more ‘resistance form’

The disadvantages are:

  • the tooth requires more drilling and this may weaken the tooth
  • the nerve is more likely to be irritated by the drilling and may devitalise and need a root filling as a result.

A laminate veneer is a thin layer that covers only the surface of the tooth and generally used for aesthetic purposes. The benefits of this are as follows:

  • the tooth needs no drilling or less drilling, which may irritate the tooth less and allow the tooth to retain its natural strength.

The disadvantages are that:

  • the retention of such veneers is less. Where the glue fails, the veneer can just come off.

Indications of Dental Veneers

Dental veneers are usually used to disguise or reshape teeth. This maybe where:

  • A tooth has been fractured or dis-coloured,
  • The patient wants a “Hollywood” type of makeover.
  • There are small teeth resulting in spaces that may not be easily closed by orthodontics.
  • The edges of the teeth are worn out resulting in a prematurely aged appearance
  • The teeth are mal-positioned tooth/ teeth that appear crooked and the patient does not want orthodontics.
  • The patient wants to fill the black triangles between teeth caused by gum recession
  • The patient wants to provide a uniform color, shape, and symmetry, and make the teeth appear straight.
  • The teeth are yellow teeth that won’t whiten, or the patient prefers not to whiten them.

How many Veneers will I need?

The dentist can let you know how many veneers will be required to give the required aesthetic result. However, aesthetics is always driven by the patient’s expectation and ultimately the number of veneers will be the patient’s choice.

In order to help you decide, the dentist can arrange for a ‘diagnostic wax up’. This is where the laboratory makes the veneers on the models of your teeth and you can safely see what the end result will be before committing to treatment and taking a drill to your teeth. This can help you visualise and communication with the dentist about what you want and it also helps the dentist plan exactly how to go about preparing the teeth and the impact it will have on how you bite and slide your teeth over other.

Contraindications and other options

It is very important to have considered the risks before committing to any dental treatment. Take your time to understand the social, financial and time implications of Dental Veneers. What would you do if one breaks or comes off ? Are you able to commit to looking after then and having them checked regularly.

You should be particularly careful if you have a tendency to grind your teeth, or excessive forces apply on your teeth. It has been found that after 10 years, 50% of veneers are either displaced, need re-treatment, or are no longer in satisfactory condition.

Think about how important having dental veneers are and make sure that you have considered other treatment options such as teeth whitening to give your teeth a better colour, and teeth straightening to change the location of the teeth to make them look better.

Further Considerations

Depending on the individual case, the dentist can choose whether to involve the incisal edge (the tip of the tooth with which you bite), half involve the incisal edge, or whether to overlap the incisal edge.

The other factor to consider is whether to place the dental veneer to cover the surfaces between the teeth next door or not, or just to meet that surface.

Are Dental Veneers right for me?

The decision to take Dental Veneers is a complex one and needs to be made on a case by case basis. The best thing to do is to book in for a free consultation with your dentist. He will offer you the best personalised advice. Often you should have a full check up before proceeding with treatment because we would want to make sure that your entire mouth is healthy and clean before you proceed with aesthetic work. This would give the veneers the best chance of success.

How Dental Veneers are made

Appointment 1:

  1. Prepare the teeth. The first step is to prepare the teeth. This may or may not need a injection, depending on whether the drilling will involve dentine which is the sensitive part of the tooth.
  2. Make an impression (mould). The impression allows the exact shape and size of your teeth to be replicated in the laboratory, so that the veneers can be made to fit onto them.
  3. Make temporaries (if needed). Sometime the amount of drilling is so little that you do not even need temporaries. If you do, the composite type material (like plastic) will be shaped and stuck onto you teeth.

In the laboratory

  1. The impression is used to make a model of your teeth, usually out of Plaster of Paris
  2. Porcelain is painted onto the surface of the model as a powder, to the colour, size and specifications given by the dentist.
  3. The porcelain is fired in a furnace to melt the porcelain into its final shape.
  4. The porcelain is adjusted and smoothed to the correct shape
  5. Steps 2, 3 and 4 are repeated until an aesthetic dental veneer is made. There are different shades and translucency of porcelain used in different areas to replicate that look of your natural teeth.
  6. The dental veneer is returned to the dentist.

Appointment 2:

  1. An injection, if required, is given
  2. The temporaries are removed, if they are present
  3. The Dental Veneer is tried in to check for shape, fit and aesthetic result. If not suitable they can be sent back to the laboratory with another impression of the teeth if required.
  4. If the patient is happy, the veneers are stuck in using a special glue that sticks to the tooth surface and the veneer.

Gold veneers

Some people prefer to have a Gold tooth. They may want different shapes, sizes and qualities of Gold. Dentists can do this, but particular attention should be given to the consent process. All of the implications and complications that can occur should be considered before you start the treatment. For example, what if the nerve inside the tooth is irritated and consequently needs a root filling. Would you then regret placing a veneer ?

Nationally recognised advice:

The Dental Health Foundation also offer advice about Dental Veneers. It can be found here: https://www.dentalhealth.org/tell-me-about/topic/cosmetic-dentistry/veneers

Dental Veneers Cost

As of April 2016 we charge £499 per tooth for each Emax veneer and £599 per tooth for each Zirconia veneer. Generally speaking Emax can be used on your front 3 teeth, but behind that, the stronger Zirconia veneers are recommended. Everybody is different though, so please come in for your free consultation. We also offer interest free credit over 12 months for amounts over £2000. Please note that our prices change every April and check our price guide for the latest prices.

We do also offer cheaper veneers at the cost of £233.70 each. We don’t tend to recommend these veneers as they are weaker, need to be thicker and do not look as good. However, sometimes patients request us to make these veneers when they already have the same cheaper materials and they have come out or have broken and they want a cheap replacement.

Interest free credit on your Veneers

If you spend over £2000, you can benefit from our interest free credit offer. You can split the payments over a 12 month period. For example. For example if 6 veneers cost £2996. This works out to be £250 per month.

Free no-obligation consultations for veneers

It is difficult to know what you need and what you can have – every client is different ! Therefore to help you understand what options there are for you and the implications of those options, you are welcome to come for a free of charge initial consultation. We promise no to pressure you into anything, just give you a fair and honest evaluation of what you could have and what it would involve.

Dental Veneers consent form

This is a copy of the text that we use for our consent form:

VENEERS

Veneer restorations cover and protect teeth that have been weakened or dis-coloured by decay, prior restorations, or root canal treatment. Veneers can be placed for cosmetic purposes. Veneers usually require at least two visits to complete treatment. At the first visit, the dentist will reduce the size of the tooth. This makes room for the Veneer itself to fit on the remaining portion of tooth, called the preparation. After the reduction is completed, an impression, or mould, of the preparation is made using a rubbery material. A temporary Veneer can be held on the tooth with temporary cement while the Veneer restoration is being made by a dental laboratory. It is important to return for the cementation of the new Veneer as soon as it is ready in order to reduce the chance of re-decay or other problems.

The intended benefit of a Veneer restoration is to replace or mask missing natural tooth structure and restore the tooth to normal function.

Depending on the diagnosis, there may or may not be alternatives to a  Veneer restoration that involve other types of dental care. I understand that possible alternatives to Veneer restorations may be:

– Other restorative alternatives, such as onlay, inlay, crown, or amalgam (silver) or tooth-colored filling

– Extraction. I may decide to have tooth removed. The extracted tooth usually requires replacement by an artificial tooth by means of a fixed bridge, dental implant, or removable partial denture.

– No treatment. I may decide not to have treatment performed at all. If I decide upon no treatment, my condition may worsen and I may risk serious personal injury, including severe pain; localized infection; loss of this tooth and possibly other teeth; severe swelling; and/or severe infection.

– Teeth Straightening

– Teeth Whitening

I have been informed and fully understand that there are certain inherent and potential risks associated with Veneer restorations. I understand that the nerve inside my tooth may be irritated by treatment and I may experience pain or discomfort during and/or after treatment. My tooth may become more sensitive to hot and cold liquids and foods. I understand that root canal treatment may become necessary at any time during or after treatment and may not be avoidable. I understand that a Veneer restoration may not meet my expectations.

I understand that once prior fillings and decay are removed, it may reveal a more severe condition of my tooth. This condition may require periodontal (gum) surgery to uncover more of the tooth, may require root canal treatment in addition to a  Veneer restoration, or may instead require the extraction of the tooth.

I understand that I may notice slight changes in my bite. I understand that during and for several days following treatment, I may experience stiff and sore jaws from keeping my mouth open.

I understand there may be injury to my gums adjacent to the tooth. I understand that my gums may recede after the completion of my Veneer restoration. I understand that poor eating habits, oral habits (smoking, fingernail biting, etc.), and poor oral hygiene will negatively affect how long my Veneer lasts.

I understand that I will be given a local anesthetic injection and that in rare situations, patients have had an allergic reaction to the anesthetic, an adverse medication reaction to the anesthetic, or temporary or permanent injury to nerves and/or blood vessels from the injection. I understand that the injection area(s) may be uncomfortable following treatment and that my jaw may be stiff and sore from holding my mouth open during treatment.

I understand that once a Veneer restoration is started, I must promptly return to have the Veneer finished. If I fail to return to have the Veneer finished, I risk decay, the need for root canal treatment, tooth fracture and loss of the tooth.

Case study

This patient came in complaining that she didn’t like the look of her teeth and asked whether we could do anything. After assessing that she didn’t want the “Hollywood smile” but instead wanted something which looked natural and blended in with her own teeth, we opted for a natural shade and uneven edges to give the appearance of natural wear and tear.

We noted that her main concern was the gap in the center, and there was an old, badly done filling contributing to this. She was mildly unhappy with the unevenness of the teeth either side. She also didn’t like the yellow dentine showing at the bottom of the teeth where the gum had shrunk. She did not want to alter anything behind the front 4 teeth. As a result we agreed to veneer the front 4 teeth only after a period of focusing on the gum health.

One week later she had her smile just the way that she wanted.

Book in for consultation

We offer free initial consultations and interest free credit available when you spend over £2000 so that we make the benefits of Dental Veneers available to all. Call now on 01922 624900 to book in.