Veneers for teeth is a cosmetic dental procedure that is used to improve the appearance of your teeth by altering their shape and color. This is accomplished by shaving away 1 mm of enamel and then bonding a thin piece of porcelain laminate over it.
This treatment is typically done electively since most patients desire them for aesthetic purposes. That means the tooth is otherwise healthy and functional.
Table of contents:
Overview
What is a dental veneer?
A veneer is a thin piece of porcelain that is bonded onto the enamel in order to change the shape and color of teeth. It is considered an elective cosmetic procedure so it is not covered by dental insurance.
It is an irreversible procedure because it requires shaving away a millimeter of enamel to fit the porcelain laminate over the teeth. If no enamel was removed, the final result would end up looking very bulky.
When it's needed:
Misshapen teeth - Can be peg laterals or malformed looking teeth.
Teeth that keeps chipping despite repeated bonding repairs.
Severely stained teeth such as tetracycline stains.
Patients don't want to maintain teeth whitening.
Smile makeovers.
To close tooth gaps such as diastemas.
Appearance
The veneers look like a very thin piece of porcelain that is in the shape of a tooth. It gets placed on the front of your teeth and bonded on permanently.
Notable characteristics:
Thin piece of porcelain.
Covers front half of the teeth.
Tooth colored or can be hollywood white.
The color is often tooth colored but for those trying to change the color of their teeth, they often select a whiter shade. All of the available colors can be seen on the veneer color chart.
Veneer material
Dental veneers are made of porcelain that is tooth colored so it can blend in with the rest of the mouth. Although there are different types of porcelains or ceramics that it can be made of.
Types of porcelain:
Feldspathic. This type of porcelain is nearly 100% glass in structure so it is very beautiful but that also makes it fragile.
Lithium disilicate. This type of ceramic is a mix of glass and crystalline structure so it is more durable. It is less "pretty" than the feldspathic but it is still significantly better looking than zirconia.
Leucite. High glass content porcelain with durability that is in between feldspathic porcelain and the lithium disilicate.
You can decide with your dentist, which option is best for you. Both materials are still bonded onto the teeth so you don't have to worry about them coming off.
Types of veneers
The most common type of veneer for teeth would be the porcelain laminates but there are other types as well.
Porcelain veneers. These do require preparing the teeth by shaving off a thin layer of enamel prior to bonding the porcelain laminates on.
Composite veneers. These use a composite resin that is identical to cavity fillings which get bonded onto the tooth. The disadvantage is that they aren't as durable as porcelain.
No prep veneers. If you're a candidate for no prep veneers, you won't need any drilling or shaving down of your teeth. Essentially the porcelain veneers get bonded onto the teeth with zero drilling involved.
Removable veneers. The most common type of removable veneers would be the snap on smiles or the lumineers. Yes, you can call them "veneers" but dentists don't really consider them as such. In our opinion, they're more like temporary dentures.
We wholeheartedly recommend against any type of removable veneers.
Compared to crowns
Both veneers and dental crowns are indirect porcelain restorations that are placed over teeth. They can both be used to alter the shape and color of the dentition.
The primary difference between these two procedures is that the veneer is a lot more conservative than a tooth cap.
Teeth veneers only require shaving away the front half (180 degrees) of the tooth.
Dental crowns require shaving the entire tooth all around (360 degrees).
A simplified way to understand the difference between the two is to consider a veneer as a partial crown. A veneer procedure can be converted into a crown by completing the last 180 degrees of tooth shaving.
Procedure details
The process of getting laminates for your teeth will take two visits because the dental lab needs to make them and that takes time. In between visits you will have temporaries on your teeth to protect the prepared teeth.
What to expect:
Visit 1 (60 mins) - prepare the teeth, take an impression, choose a tooth color, and make temporaries.
Visit 2 (60 mins) - try the veneers on and bond them in if they look good! If not, it will require a redo and needs to be sent back to the lab.
First appointment:
Administer local anesthesia. Numbing gel with Lidocaine injection.
Tooth preparation. Shave down the front half of the tooth to make space for the veneer.
Pack cord. Place a thin cord around the gums to push them down and reveal the prepared margins for a more accurate impression (mold).
Take an impression. Take a mold of the prepared teeth with PVS which gets sent to the dental lab for fabrication of the porcelain laminates.
Fabricate a temporary. Depending on your dentist's preference, there are multiple ways to make temporary veneers. It will be made out of a type of acrylic and temporarily cemented.
Select veneer color. Pick the tooth shade that you want from the veneer color chart.
Second appointment:
Administer local anesthesia.
Remove temporaries. This is so you can try on the permanent porcelain laminates.
Try on the veneers. The try-in process is to make sure that it fits before it gets bonded in. If it doesn't fit, it will need to be sent back for a do over.
Adjustments. If the new veneers on teeth feel too tight, the contacts need to be adjusted. If the bite feels high, the occlusion will need an adjustment. If it is too long, it can be shortened. These can be done chairside by your dentist with a fine diamond football bur.
Polish. After all adjustments, polishing is needed to smooth it down.
Permanent bonding. They will be permanently bonded on the teeth meaning you cannot take them out at night.
Recovery
The recovery for each of the veneer appointments is about 2-3 hours because that is how long it takes for the anesthesia to wear off. Aside from your mouth being numb, there isn't anything else that you need to be cautious of healing wise.
The entire procedure is very conservative and typically less drilling is required than a simple dental filling. You will recover and heal from these visits faster than cavity fillings! But yes, the recovery time is same day.
Aftercare
Immediately after having the veneers bonded onto your teeth, you should avoid chewing gum and eating sticky foods for 24 hours. You don't want those foods to pull on the restorations while the bonding is hardening.
We recommend giving the bonding a solid 24 hours for it to fully harden before you begin to treat them as any other teeth in your mouth.
Other precautions:
Minimize hard foods. You can eat with the veneers like you normally do but you can extend its longevity if you minimize the amount of hard foods that you eat. Ice cubes and crab legs will crack your natural teeth so of course they can damage the laminates.
Avoid biting directly into hard foods with front veneers. You can extend their longevity if you use a fork and knife to cut up difficult to chew foods. Once again you can eat with them but you do risk damaging them if you happen to bite into something hard the wrong way.
Wear retainers or night guard. It would be prudent to wear a retainer or night guard to help prevent veneers from shifting. As an added bonus, they will also protect them from chipping especially if you grind/clench at night.
The best analogy that we can think of for the precautions above is if you had a ferrari, you wouldn't drive it off road. That's an expensive car so you do want to take care of it. The same can be said for your new porcelain teeth.
How long do they last?
Most porcelain veneers on teeth can last more than 10 years if they are well taken care of. We'll include two different research studies about their 5 year and 10 year survival rates.
Veneer Type | 5 year survival | 10 year survival |
|---|---|---|
95.7% | 64-95% | |
92.4% | 66-94% |
Risk factors that decrease survival rate:
Bruxism. If you grind your teeth, you may very well grind the laminates off.
Propensity to eat hard foods. You just love eating hard foods without a care in the world about the veneers.
Sports injuries. Contact sports such as hockey can wreak havoc on teeth and dental restorations.
Pros & Cons
This type of porcelain while conservative does come with its own set of advantages and disadvantages.
Pros:
Conservative smile makeover.
Color does not change over time.
Can dramatically whiten your teeth.
Change the shape of your dentition.
Close gaps between teeth.
Can blend in seamlessly with the rest of your teeth.
Cons:
Expensive since you often need more than 1 to redo your smile.
Do require more cautious eating habits.
Irreversible procedure.
Laminates can break or debond.
Cost
The average cost of a porcelain veneer is $1300 per tooth and that is without insurance. Just to be crystal clear, that $1300 price is for each tooth so if you need more than one you can multiply that number by however many teeth you're doing it for.
Depending on the cost of living, the national cost range for veneers is $1000-$1800 per tooth. What it will ultimately cost you will be dependent upon the cost of living in your area.
Cost with insurance
Unfortunately, we've never seen a single dental insurance which has coverage for veneers on teeth. Every time we've submitted a pre-approval for this cosmetic procedure, it returns with a denial of benefits. The cause for denial is that it is a cosmetic procedure and that it is unnecessary for the teeth to function.
In other words, if you want this you should expect to pay for the entire cost out of pocket.
Alternatives
The only two alternatives to getting veneers would be crowns or dental bonding.
Dental crowns. A full coverage restoration that is also made of porcelain. It can also be used to change the color and shape of teeth. The biggest difference is that this procedure is less conservative than the porcelain laminates since it requires more tooth shaving.
Teeth bonding. A direct restoration that is made of a composite resin. Your dentist can hand sculpt a new shape for your tooth with this bonding material. The downside is that the color and wear is not as good as porcelain. It is however, more conservative than veneers.
If you're on the fence about both of these irreversible procedures above, you can actually try teeth whitening before deciding upon veneers. More often than not, most people find a huge improvement in their smile once their teeth look whiter and sometimes they stop thinking about the laminates afterwards.
