What Influences the Success of Veneers?

How long your veneers will last depends on many different factors. It is not as simple as this type veneer will last this long, and this type that long.

Certain things will definitely influence the success of your treatment. I have divided the variables that must be taken into account into the following headings:

note. * relates only to porcelain veneers

The Dentist

• Their experience and expertise in placing veneers. All dentists do veneers but some favour certain types of veneer. The more of a particular type you tend to do- the better you become at them.

• The assessment of your expectations, mouth and teeth in selecting the most appropriate veneer for you.

• The quality of veneer preparation.

• *The accuracy of the impression* – This is the only thing the technician has to build the veneers on, so its accuracy is vital.
• The quality of the cementation or bonding procedure*- This is crucial for the strength of the veneer and any contamination with saliva or blood will weaken the veneers.

The Technician/ceramicist (lab)*

• Their experience and expertise- specifically in working with the type of veneer you have requested.

• The quality of communication with the dentist to get the shade right and incorporate any special considerations.

• The quality of the veneer construction itself. This includes the margins against the tooth and contact points with other veneers or natural teeth.

• The ability to match the shade to your existing teeth or create the natural colour requested by you and the dentist. This is where art meets science!

The Procedure

• Whether the veneer is composite or porcelain.

• The type of composite or porcelain used- different types of composite and porcelain systems are available. These are down to the preference of the dentist- some are more aesthetic and have more colour/shade choices than others.

• The preparation- selecting the right way to prepare the incisal edge (tip) of your tooth for the veneer is important. The dentist has a couple of different ways to do this depending on the strength of the tooth and aesthetics required; they can finish the veneer at the edge or reduce the height of the tooth to give the ceramist or themselves room to create a more natural looking result.

• The type of bond/cement used to attach the veneer*.

The Tooth/teeth

• The amount of enamel available for good predictable bonding of the veneer.

• The colour of the teeth to be veneered will dictate how much tooth needs to be removed in order to place a sufficient thickness of porcelain or composite to mask it out. This depends on the source of the discolouration- staining, such as that from the antibiotic tetracycline, can be quite dark so more tooth may need to be removed for a good final result. Consider whitening your teeth first!

• The position of the tooth or teeth- if it is out of position, it may require some more preparation, unless the tooth is too far back, in which case preparation can be kept to a minimal and the thickness of the veneer simply increased.

• Existing fillings- the more filling you have in a tooth the less strength the veneer will have. Sometimes bonding can be improved by filling at the time of cementing the veneer, or if it has a fractured edge, incorporating the filling part into the actual veneer. It is worth considering if a crown would be a better choice to protect the tooth if it is heavily restored.

• Teeth with Root canal treatment or a post – these are generally best restored with a crown. That doesn’t mean that other teeth cannot have veneers.

• The bite (how your teeth come together) – how do they move across each other. Do you have missing back teeth which will put extra stress on the teeth having veneers at the front?

You

• Your oral hygiene – poor care of your teeth will mean you are more likely to get decay around the veneers and problems with gum disease that can affect the look of your veneers.

• Your diet- heavy staining foods and smoking will discolour your veneers. A composite bonding veneer will stain considerably more than a porcelain veneer as a general rule.

• Your habits- if you have habits such as chewing ice, pencils, nails etc this can increase the chance of chipping or fracturing your veneers.

• Bruxism (grinding)- always deserves a separate mention due to the extra force it places on each of your teeth and any restorations you have, thus making them more likely to fail.

• Regularly seeing a dentist to check everything is ok
• Age- the definition of successful veneers to a young person can be quite different to an older person, so realistic expectations are important. For example, veneers at 50 may see you through the rest of your life and whilst they may not look perfect when you are 75 chances are you won’t be quite as concerned and happy simply to have your own teeth to chew with.

You and the dentist should always be looking to the future and thinking- what can we expect the condition of your teeth to be like in 10 years, 20 years, 30 years. This allows us to plan more effectively and be realistic about the outcomes- dentist are not miracle workers (there I said it!) though some of them like to think so.

There are no definite answers only treatment plans and honest discussions that best address the issues in question.