Porcelain veneers are an important part of a total smile makeover. Although some people assume that such cosmetic dental procedures are the exclusive domain of celebrities, nothing could be further from the truth. Veneers have been a popular choice among students, homemakers, office workers—in short, anyone who desires a more attractive smile.

What are Veneers?
Veneers are ultra thin ceramics that are bonded to the tooth. The technique has been in use for many centuries by furniture makers; a thin piece of more attractive wood is bonded to a base.

The concept behind dental veneers is a similar one. Thin pieces of porcelain are bonded to the patient’s existing teeth. The results look and feel like natural teeth, and the resilience and strength of the veneers is similar to normal tooth enamel.

What Issues can be Addressed with Veneers?
A number of dental problems can be corrected with veneers. One commonly seen issue is to change or restore the color of the teeth. Not all people develop dazzling-white teeth, and some of those who do may find that certain medications, foods or beverages can stain their enamel. For these individuals, bleaching may not yield the desired results, and veneers are a viable alternative.

Another issue that is frequently corrected with veneers is to alter the size or shape of the teeth. Small gaps between teeth can be eliminated, teeth that are too small or oddly shaped can be remedied, striations in the enamel can be covered and even minor position alterations can be made. Veneers can also be used to cover minor chips or cracks in the natural teeth.

Veneers can also be used to restore worn teeth or crooked teeth. Sometimes as an alternative to traditional braces, veneers can straighten your teeth in under a week. Also for those patients who have ground down their own teeth, veneers are a minimally invasive option to restore ones own natural tooth.

Why is Porcelain Used?
Dental porcelain is an ideal choice for many cosmetic procedures, including veneers, crowns and bridges. It is biocompatible, so there is little chance of the body reacting negatively to it, and in fact, virtually all patients report that, the porcelain feels as natural as their own teeth.

Porcelain can be colored in a wide variety of subtle shades to achieve the perfect color for each patient. Although some patients believe that only an absolute, stark white is the proper shade, the actual choice requires evaluating a number of factors if a truly natural appearance is to be achieved.

Porcelain can be easily shaped into virtually any shape that is needed. This allows veneers to be “sculpted” to fit perfectly and look natural.

For cosmetic procedures, such as veneers, porcelain is also preferred for its aesthetic value. A porcelain veneer can be made to mimic the natural teeth in translucency as well as color and shape. It also reflects light in a manner that is almost identical to natural teeth.

Why are Veneers Important to a Smile Makeover?
A smile makeover is far more than just concealing damaged, stained or misshapen teeth. The idea is to totally transform the teeth to improve the smile’s attractiveness, patients dental health and function. This requires careful analysis of each patient’s face shape, coloration and history.

Prior to veneers, a smile makeover often involved painful, lengthy and intrusive procedures. Caps and crowns were commonly used to improve the appearance of a patient’s smile. In the early 20th century, there were even instances of patients who requested the removal of healthy—but unattractive—teeth so that they could be replaced with dentures.

The development of dental veneers gave patients an alternative. It was no longer necessary to take drastic actions to correct the appearance of a tooth. Veneers allowed cosmetic dentists to correct the shape, color and spacing of teeth simultaneously. The smile makeover can be completed quickly and easily with veneers.

How Does the Procedure Work?
A smile makeover begins with a dental examination and aesthetic evaluation to determine the health of the patient’s teeth and design of the smile. The patient should be prepared to explain precisely what he or she hopes to change. The dentist can then determine the best approach to achieving the desired results and explain the procedures required. Oral X-rays, impressions of the patient’s teeth and facial photographs are typically necessary.

If the decision of both patient and dentist is to proceed with veneers, the next step is to determine the best type of veneer. There are two basic types of veneers—traditional and minimal prep. With traditional veneers, the dentist must remove a small amount of the patient’s tooth enamel. This typically amounts to a thickness of approximately 0.5mm. This is less enamel than most people lose from normal activities, such as eating, consuming acidic beverages or improper brushing. The minimal-prep veneers require even less enamel to be removed, and in some cases, there is no need to remove any enamel whatsoever.

Prior to any preparation, the aesthetic evaluation from digital photography and video, the dentist will hand sculpt the tooth position of the veneers to ensure overall facial beauty enhancement as well as sound dental function. This final tooth position guides the dentist in being as minimal in preparation as possible.

The dentist will then make impressions, or molds, of the patient’s teeth. Molds are sent to the dental laboratory, where technicians use them to create the veneers. It can take as long as two weeks for the lab to finish crafting the veneer.

The completed veneer is sent to the dentist and the patient makes a return visit. The dentist tests the veneer for proper fit, and if necessary, he may make minor adjustments. Once he is satisfied, he can proceed with the bonding.

The tooth may need to be “etched” to roughen its surface and improve bonding. Afterwards, he will apply a special, light-sensitive cement to the veneer and the tooth. The veneer is placed into its correct position, and a light beam is trained on the veneer to expedite the hardening of the cement.

How much do Veneers Cost?
There is no simple answer to the question of cost—it varies by patient. The number of teeth involved and the work that must be done to create the veneers determines the cost. Other factors include the geographic location and the skill of the dentist/ceramist team.

The average cost per tooth is between $3000-$3500, but is always measured on a case basis.

Do Veneers Require Special Care?
Veneers are quite strong and durable. Virtually all patients can treat their veneers just like their natural teeth—they can eat what they like and continue to use their favorite toothpaste, for example. Porcelain veneers are resistant to staining but can pick up minor stains. They can be easily polished back to their original luster. For this reason, some dentists recommend that patients with veneers forego smoking, red wine, coffee and other products that have a high potential for staining.

Most dentists want to see patients with veneers at least once a year, and most prefer to see them every six months. This allows the dentist to check the patient’s overall oral health as well as the condition of the veneers.

How Long do Veneers Last?
The majority of patients can expect to receive a minimum of 10 to 15 years of useful life from their veneers. Some of the no-prep veneers now on the market provide as much as an additional five years of service, or 15 to 20 years. However, every patient is different, so the actual life may be slightly shorter or significantly longer.

Regular dental check-ups are an essential part of making sure that veneers last. With routine examinations, dentists have the opportunity to detect things that the patient may be doing—or not doing—that could result in a decreased life for the veneers.

Are Veneers Reversible?
Because veneers do not require filing down the teeth the way that caps do, some patients believe that the procedure can be reversed and that they can revert to the natural teeth. This is not the case. Veneers are considered a non-reversible procedure.

It is true that veneers can be removed when it is necessary to replace them. However, the teeth to which the veneers have been attached will never be completely the same as they were prior to the veneers. The enamel could need to be shaped slightly prior to installation as well as altering the surface for bonding changes the enamel surface.

Therefore, patients should be prepared to commit to veneers for as long as their natural teeth last. With proper care, a person’s natural teeth should last a lifetime, so maintaining veneers could also be viewed as a lifetime commitment.

Because every case is different, however, the best source of information on whether it might be possible to revert to the natural teeth is a dentist who has conducted a thorough examination of the patient. It should also be noted that dental procedures are evolving at a brisk pace, so what is irreversible today might be possible in the future.

A Cosmetic Dentist’s Point of View on Veneers
As a cosmetic dentist, I have seen the effects that a smile makeover can have on a patient’s life. I have seen patients who appeared introverted transform into outgoing, social beings. I have witnessed patients who were gruff or extremely quiet suddenly begin chatting amiably with strangers. I have had patients who, after a smile makeover, found the confidence to change other aspects of their appearance, ask for a promotion, decide to return to college after a prolonged absence or change careers.

In other words, cosmetic dentistry is not just about altering the physical appearance. Many patients find a renewed sense of self-worth, confidence or determination. This is not to say that a more attractive smile holds the key to personal happiness. True happiness is something that each individual must find for himself. However, I have witnessed many transformations in patients after a smile makeover.

Some people believe that getting veneers is all about vanity. Even if this were true, there is certainly nothing wrong with wanting to do all that is possible to look attractive. In my practice, however, I have noticed that it is far more than simple, vain pride—it is an emotional transformation.

As a cosmetic dentist, I understand the variety of reasons for seeking a smile makeover, and I have personally seen the results. I feel that veneers play an important role in the process. Veneers are long lasting, natural looking and can fix a multitude of dental issues. The procedure is so minimally invasive that many patients do not request any type of anesthesia or numbing at all.

I would like for readers to view the “before and after” pictures. I believe these demonstrate the impact a smile makeover can have far better than words can express.