Procedures

Veneers

Talk to your dentist about...

Visualization Software Limitations—Many dentists now use software to demonstrate what the teeth "could be made to look like". However, since making the veneers is still a manual process, there are no guarantees your teeth will turn out the way they look in a computer simulation program.

Resin Mockup—Ask whether the dentist can perform a "resin mockup" on your teeth. This can be a very useful process and takes very little time. In the resin mockup procedure, the dentist places the desired shade of tooth-colored composite resin filling material on the teeth and quickly sculpts what he/she intends to achieve with the actual veneers. The process can tell you how you like the shade and the basic contours of the teeth.

You can then interact with the dentist about any fine-tuning you'd like to see in the actual veneers, and discuss the best option for achieving your goals (whether traditional veneers, minimally invasive veneers, or direct veneers). The resin mockup may also give you some insight about the dentist's ability (and willingness) to deliver your desired outcome with direct resin veneers, should you desire them.

How Many Teeth?—Depending on your problem, you may need only a single veneer. It is possible with modern dental materials and excellent dental lab technicians that one tooth can be restored to match the other teeth, without involving more than one tooth. There may be dentally valid reasons why your dentist recommends more than one. Be sure you understand them.
Learn more: Procedures › Cosmetic restorations, one tooth

If your main concern is the appearance of your teeth, try to figure out as closely as possible what it is you do not like about them before seeing your dentist, and decide how many of them you think should be treated. If there is a big discrepancy in the number of teeth you think should be treated and the number your dentist recommends, seek additional opinions and learn as much as possible about your options. Keep in mind, you can always treat more teeth.

Biases and Controversies—Direct composite resin veneers have received some negative press in the cosmetic dentistry literature, centering mainly on their appearance compared to porcelain veneers. In reality, they can provide excellent esthetics if care is taken to do them well. However, it is significantly more challenging and potentially frustrating for the dentist to produce excellent outcomes with direct veneers than with lab-made veneers for several reasons:

First, from an ergonomic perspective, it is much more difficult for the dentist to work on a tooth in the mouth than it is for a lab technician to work on a replica of the tooth in a lab (where there is no saliva, no fidgety patient, and no problem setting things down and walking away for a few moments). Second, there is a limited amount of "sculpting" that can be done to a direct veneer once it is bonded to the tooth. Ideal contours and surface texture can be more difficult to achieve in the mouth.

Third, it is more challenging to produce ideal contacts between the teeth with direct veneers than with lab-made veneers, because in the lab, the individual teeth can be removed from the stone model to work on them. Finally, it takes more "dentist time" to have direct veneers placed than it does to have lab-made veneers done. The dentist is doing two jobs—the preparation, and the "lab work". A reality of dental economics is that dentist time costs more than lab time. So the dentist may be faced with an unpleasant choice—do more work for less money, with the potential for an inferior outcome; or less work for more money, with a predictably better outcome.

These arguments aside, dentists have effective techniques for compensating for the difficulties. Moreover, the articles denigrating direct veneers may not be reporting relevant parameters of satisfaction. For example, they do not generally report on patient satisfaction with the treatment compared to the way their teeth looked before treatment; or the cost/performance ratio of the direct veneers, which may be significantly better than porcelain veneers.

The argument is interesting and controversial, and there is no "right" answer. Talk to your dentist about what has worked best for them. If cost is not a factor in your decision, lab-made veneers should certainly be considered. If cost is a big factor in your decision, take comfort in knowing that great results can be achieved for less money with direct veneers. If you have this discussion with your dentist, your treatment outcome is more likely to be one you are happy with.

What is clinically acceptable?—If your main goal of a more attractive smile is met, should the procedure be considered successful? The answer is "at least partially." A successful restoration is one that can be effectively cleaned by the patient (free of "overhangs", "flash", and other "plaque traps", which can lead to cavities and inflamed gums). If floss shreds around your veneer margins, or if your gums remain continuously inflamed, they should be evaluated and adjusted/replaced as needed to ensure good long-term dental health.