October 20, 2006

The Best Wealth is Your Health

A ‘Hollywood Smile’ with porcelain veneers

By Dr. Douglas W. Vierra, D.D.S.
Special to the Times

Over the past 20 years, dentist have applied veneers to teeth using various techniques to correct esthetic problems.

In the past decade, the use of porcelain veneers to restore discolored or malformed front teeth has become a significant component of esthetic dentistry. Today the use of porcelain veneers is considered the ethical choice for many esthetic restorations.

Porcelain veneers are wafer-thin shells of porcelain that are bonded onto the front side of teeth for cosmetic improvement. They are used to close spaces (diastemas) between teeth, fix broken or chipped teeth, mask stained or unsightly fillings, whiten dark yellow or stained teeth, and recontour misshapen or crooked teeth.

The introduction of porcelain veneers brought several distinct advantages to esthetic dentistry. They create a life-like tooth appearance that is relatively resistant to stain. These veneers are strong, durable, and do not adversely affect the gum tissues. They maintain their color in the oral environment. The bond of the porcelain to tooth is strong, and the bonded porcelain veneer has excellent resistance to fracture.

The ability to utilized porcelain veneers to color, shape, and contour front teeth provides dentists a proven technique to develop a “Hollywood smile” for their patient. However, this does not come without cost, and one should be aware of disadvantages and alternatives to porcelain veneer treatment.

Primary disadvantages of porcelain veneer treatment include irreversibility of treatment, potential for porcelain fracture, and relatively high cost.

Although minimal, a noticeable amount of tooth enamel is trimmed in preparation for a porcelain veneer. This means once the tooth has been trimmed, its appearance will never be acceptable without the veneer in place (or some other type of dental restoration that has been created for the tooth). While you can expect a porcelain veneer will remain cosmetically pleasing and structurally sound for many years, it is unrealistic to expect it will last forever. There is no definitive answer to porcelain veneer longevity, but with good home care and sound judgment, it appears likely a porcelain veneer will last in excess of ten years.

Porcelain veneers can fracture or break off. When this occurs, the dentist often must replace the veneer. Porcelain veneers are very strong, but in cases where excessive tooth structure is lost or in individuals that clench or grind their teeth, potential porcelain fracture can be a concern.

Compared with veneers, utilizing alternative material such as acrylic resin porcelain can be two or three times more expensive.

Alternative treatments such as orthodontics, bonded acrylic resin fillings, or simply tooth whitening should be considered prior to porcelain veneer treatment. Often the desired esthetic result can be obtained without going to the restorative extent of porcelain veneers. If tooth alignment is the concern, orthodontic treatment can often correct the problem. If small tooth chips or esthetic concerns are the issue, a simple bonded acrylic resin filling is a more conservative form of treatment.

Finally, if the concern is simply color, there are excellent techniques for whitening teeth without the need to mask the discoloration with a porcelain veneer. These and other alternative treatments should be part of a cosmetic consult with a dentist prior to porcelain veneer treatment.

Porcelain veneers are beautiful, state-of-the-art esthetic restorations when indicated they are clearly the treatment of choice for esthetic dental restoration. If you are looking to improve your smile, have a cosmetic consultation with your dentist and ask how porcelain veneers may help you achieve that “Hollywood smile.”

Douglas W. Vierra, D.D.S., is the owner of Plaza Dental Group, 1654 E. Capitol Expressway, San Jose, California, 95121. Call (408) 270-4333 with questions or to schedule an appointment.