Sep 20, 2009

Porcelain veneers What Can They Do For You? San Diego

Porcelain veneers are thin shells of tooth coloured material that are bonded on to the front of teeth to improve their appearance. Teeth that are discoloured, marked, chipped or otherwise damaged can be made to look new again.

Gaps between teeth can be closed and crooked teeth can be straightened - provided they're not too crooked. If they are very crooked, your best option is to have some form of orthodontic brace to move them into the correct position. Unlike veneers which are a 'quick fix', orthodontics can take a year or more to achieve a satisfactory result.
 
If a tooth is heavily filled, then a crown (see separate guide) will probably give you a better long-term result than a veneer.

Veneers can be made of either porcelain or composite filling material.

Porcelain tends to be stronger and more durable than composite. It's not prone to staining and it has a natural translucent 'sparkle' just like tooth enamel. When providing porcelain veneers, it is usually necessary to remove a small amount of tooth substance so that the finished veneer won't make the tooth bulkier than it was before - unless, of course, you want to bring a tooth forward to align with those either side of it.

In this case you can often add a veneer to the front of the tooth without taking anything away.


Composite is cheaper than porcelain but it is more prone to chipping, wearing and staining, so it will have to be replaced or repaired more often - which can mean it ends up costing more. The advantage of composite is that it can be repaired. When porcelain fails, you usually have to replace the whole thing. Composite is the material of choice for small chips as you often don't need to remove any sound tooth.

Porcelain veneers can last and look great for 10 years or more if properly maintained with good oral hygiene. Eventually, however, they will need to be replaced. The life-span of a composite depends on the size of the restoration and upon the individual's diet - which may cause wear and staining. In general, you would expect a composite to need attention within 2-3 years.

THE PROCEDURE

Composites can be completed in a single visit, like a filling.
With porcelain, it's a little more complicated.
I use a five-step procedure which gives you maximum control over how your finished veneers will look. For simple cases, involving only 1 or 2 veneers, it should be possible to obtain a perfect result using the conventional 2-step approach.
For anything more involved, I feel the superior results we achieve with the full 5-step procedure more than justify the extra work involved.

Step 1: The consultation. You tell us what you want to achieve and we discuss how we can, safely and effectively, help you achieve it. At this stage, depending on the complexity of the job, we may take photographs and impressions (moulds) so the technician can cast models of your teeth. He will then try out various designs on the models to see which works best.

Step 2: We show you the 'trial smile' our dentist and technician have created on the models of your mouth. When you're happy with what you see - and of course you can take the models away to think it over at leisure - we proceed to Step 3 (By the way, we used to - as some dentists still do - use computer-manipulated photographs to show you how you would look with your new smile. We no longer do that because it's too easy to create fantastic results that are not reproducible in real life - and that's a sure fire way to create disappointment and resentment.

Step 3:
a) First, we numb your teeth and gum's so you will feel no discomfort during the procedure. Then we gently shape the front surface of your teeth and take impressions of the prepared teeth. These will be sent, together with any other necessary information, to the laboratory where the technician will create your veneers.

b) We fit temporary veneers which are exactly the same as the 'trial smile' you approved on the model. Then we give you a mirror and get your immediate reaction. If there is anything you wish to change at this stage, we change it, adding a bit here and removing a bit there, until you're completely happy.

Step 4: A few days later you come back in to report on how you're getting on. By this time, you will be accustomed to the change from the 'old you', you'll have eaten a few meals with the temporaries and people may have commented on how you look. So you'll be in a much better position to judge what you do and don't like. We adjust the temporaries accordingly. When they are exactly as you want them, we take further photographs and another impression so the technician can see precisely how the finished restorations should be.

Step 5: We remove the temporaries and check the finished veneers for fit and appearance. When everything is perfect, we cement your veneers into place - and you have your beautiful, natural looking smile!

For the next day or two, you may have some slight discomfort and sensitivity to hot and cold while your teeth settle down. If you experience anything more severe or if the discomfort lasts beyond a few days, please contact your dentist.
And remember: to keep your smile beautiful and healthy, you must maintain a high level of oral hygiene and visit your dentist and hygienist regularly.

Dr Tom D Nolan is a dentist working in Birmingham City Centre, in the UK. He does a lot of cosmetic work and runs half marathons for charity. His immediate goal is to stop moaning about how his knees won't allow him to play football any more (apart from with his 9 year old son - and even then, the tackles are starting to feel a little heavy).
Check him out at:
http://www.dentistintown.co.uk
http://www.dentistintown.blogspot.com

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