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Please read the entire article if you are considering veneers. It will give you the information that you may need in order to make this elective decision.
Michael Teiniker (dental technologist and ceramist) writes:
Why did I get porcelain veneers?
Throughout my career I have consulted with many patients about porcelain veneers . These are thin porcelain coverings that are glued to the existing teeth to change their colour, shape and alignment. The treatment is an instant and permanent fix to having straight, white teeth, without orthodontics and/or bleaching. I had changed the smiles for many patients, including celebrities, with an incredible result. This led me to believe that in some way I was marketing a product of superior quality, yet my own teeth were extremely different from what I had imagined they could be like. ...The test for me, as a person and professional involved in cosmetic dentistry, was to manufacture such a product for my own mouth, so that I could criticize the product from a patient's perspective.
How did I make my veneers?
No anaesthetic was required, because I wanted to widen my smile and bring my teeth forward. My teeth were healthy without decay and my gums were in great shape. The filing was kept to a minimum, in order to keep the teeth untouched where possible and to avoid any damage.
This task was easily done. Through my years of experience I had gained the ability to visualize the end result and knew exactly how my teeth should be prepared for veneers. Once the teeth were filed to size, a standard bonding technique was used to seal them. There was no pain, only a little bit of sensitivity. (Phosphoric acid) was applied to the tooth surfaces for 15 seconds per tooth, to open the tubules and then sealed the surfaces with a bonding agent. The acid had a bitter taste and careful removal was necessary to avoid contamination into other areas of my mouth. Once the bonding agent had been applied, it was cured/hardened with an ultraviolet light. The teeth heated up and I felt pressure, but soon after, the sensitivity subsided.
A plastic tray, filled with a liquid rubber (Improgum), was inserted into my mouth and placed over my teeth. There was a waiting time of approximately six minutes for the material to harden. It had a nasty taste and the wait seemed long. Saliva began to flow out of my mouth and occasionally I felt like gagging. The material got so hard, that removal of the impression was difficult. It required wriggling to and fro and it seemed like my teeth and jaw were going to dislodge. However, once the seal had broken, the impression released itself.
Usually temporary plastic veneers are made to cover the tooth preparations to protect the teeth and to make the patient look normal. These would either take the shape of your own teeth or teeth that would resemble the finished veneers. In my case I chose not to have temporary plastic veneers, as my teeth were not sensitive and I knew that I could make my porcelain veneers in a short span of time. I planned to try in my permanent porcelain veneers at home and temporary veneers would have obstructed this procedure. Looks/ aesthetics was not important to me, so going home with filed teeth was not an issue to me. Coverage was not necessary. The entire clinical procedure took around an hour and a half for ten veneer preparations.
After ten veneers
Two plaster models were poured into the rubber impression. One of them was heat resistant, so that porcelain could be applied and fired in a furnace at 920 degrees. Sculpting a new smile on a plaster model is not easy and it involves art and science. The veneers were glazed upon finishing by the application of a thin layer of glass. The entire laboratory procedure took around six hours. The heat resistant plaster was removed from the porcelain veneers by a sandblasting technique. The veneers were then placed on the other plaster model to check the fit.
It was time to try the veneers into my mouth and evaluate them. I looked at my new teeth with amazement... Wow!!! ... white and straight!!!
A few adjustments were needed...I felt that my front teeth were too short, so I added a lower fusing porcelain to lengthen the two veneers. The veneers went back into the furnace at 670 degrees. I felt that one premolar veneer was a little longer than the other side, so I cut the veneer. I adjusted the veneers for another half an hour in my mouth, then decided to have them bonded next day.
The surfaces of the veneers were prepared in a special way to avoid de-bonding. This was done by the application of a hazardous acid, called hydrofluoric acid to roughen the surfaces. The teeth were etched again with the bitter acid (phosphoric acid). No anaesthetic was needed, because there was no pain. The veneers were glued on one after the other, sequentially, so that the fit could be checked and the glue could be cleaned away. An ultraviolet light was shone onto the veneer and tooth to make the glue set. There was a feeling of heat and a feeling of pressure/contraction as the light shone on it. This was uncomfortable. It is not uncommon for the glue to ooze out of the sides of the veneer and settle between the adjacent teeth. This is removed with a thin metal strip or saw. The edges are serrated and with a sawing motion between the teeth, the glue is removed. It was possible for the saw to have cut my gum, as it moved between the teeth. The pain was felt a few days later. Once all the veneers had been glued and the excess glue had been removed, I checked the bite/occlusion, so that I could close my teeth and bite on my back teeth. It was necessary to file down the veneers at selected points, where my lower teeth slid across my top teeth and when the jaw shifted from side to side. If this is not done, the veneers may chip or pop off. I looked in the mirror with amazement. My teeth and smile had changed!! There were a few other minor adjustments to achieve a symmetrical appearance. This was done by filing down certain areas, so that I could achieve the look that I had imagined.
How do they feel?
My teeth felt horrible from the first day to about the forth/fifth week! My upper lip was pushing harder on my upper teeth and I felt a constant irritating pressure. I felt like there was something stuck to my teeth and often wished I could pick it off to remove the sensation. The tooth contacts seemed tight, so I they were relieved by flossing a sandpaper strip through them. This eased the sensation a little.
My lower lip felt horrible! The edges of the top veneers settled on a different location on my lower lip, when my lips were sealed. My lower lip actually felt raw in the mornings. The edges of the veneers were filed a little to alleviate the sensation. Perhaps the edges were a little too sharp? It seemed to work, yet the sensation remained for another few weeks.
One of my veneers (lateral tooth) chipped slightly along its edge, due to a side to side shift of the jaw. This was polished with a diamond file.
For the first five weeks I was conscious of my veneers, they did not feel part of me. I avoided hard food, like biscuits, chocolate, crackers, apples. I bit food using my back teeth. I realised that I could not bite my nails or fishing line any longer. The edges of the top teeth did not meet with the edges of the lower teeth, as they used to. It was impossible to cut little things with my front teeth.
Initially I could push air through the front of my teeth and between them. As the gum settled between the teeth, I could no longer do this.
The incisal edges of my two front teeth felt thicker and there seemed to be a small indentation, between the incisal edges of the veneers and the incisal edges of the natural teeth. This was something I had to get used to.
I could feel the glue junction line of the veneers with my tongue in certain areas. This was polished down to alleviate the sensation.
After five weeks the veneers started to blend in with my natural dentition and the fear of biting disappeared. The veneers felt like my own teeth. Sometimes I have the fear of my veneers popping off. However, the thought that only a few veneers had come off during the last six years, put my mind at ease. The success rate was high!
People commented on my new teeth from the first day and said how perfect they looked. My smile was wider now and my facial muscles had accommodated to the new facial dimensions. It has become easier to show my teeth, because they are more forward. Less facial energy is required to present a smiling pose. My teeth are larger and longer than before and hence the teeth are more visible. My top teeth are whiter than my lower teeth, but this is not obvious as my lower teeth are not constantly visible. I can choose to whiten my lower teeth at a later stage.
More information
Veneers are an alternative to orthodontics (braces) in selected cases. It is a quick way of fixing a smile, but the procedure sometimes needs a little extra work after placement and it is essential to see a cosmetic dentist familiar with these procedures. Minimal tooth reduction avoids the risk of pulp exposure, sensitivity, tooth devitalisation and root treatment. This is a risk worth considering when getting veneers and additional costs will certainly be added if something goes wrong. Dentists do not work for free. Make sure that you know EXACTLY, tooth by tooth, so that you are fully aware of the procedure.
It is essential to have the veneers made by an experienced dental technologist/ceramist who is able to visualise the end result and is prepared to work with you and your dentist. The teeth should be shaped in certain way to allow a "new smile" to be fabricated.
Veneers are handmade by a dental technologist. A dentist prepares the teeth prior to veneer fabrication and then glues the veneers on after fabrication. It is essential, in my opinion, for the technologist/ceramist to have direct contact with the patient to discuss the shape, colour and alignment of the teeth and to do any adjustments after trying them in.
Veneers have to be glued/bonded correctly, so that they do not come off. Patients should be aware that de-bonding can occur. Our bonding success rate has been high, because we use a stringent protocol by Dr Pascal Magne. (research dentist).
The more the teeth are filed the easier the veneers can pop off. Veneers stick well to tooth enamel, but not as well to the underlying dentin.
It is essential for the teeth to be sealed with a bonding agent, prior to impression taking, else the microscopic pores of the teeth will become clogged up or contaminated. This will have an effect on the bond.
Veneers are made from a porcelain material of hardness similar to tooth enamel. Veneers can wear down or crack like natural teeth.
They are subject to expansion and contraction as you eat hot and cold food and it is important that the veneers have a similar coefficient of thermal expansion to natural tooth enamel. Else they will crack! It is important that the veneers have a close fit to the natural teeth, because the glue has a high expansion when heated and cooled and any thick areas of glue may cause the veneers to crack.
It is important to clean around the glue line, which may be below the gum line and have a dentist check the veneers every six to eight months to eliminate any stressful areas. Hygiene work below the gum line is essential, as dental adhesives may attract bacteria and cause gum inflammation, which causes gum recession.
It is not always necessary to have anaesthetic. (ask your dentist if you really need it) In my case I experienced NO pain throughout the entire procedure and I had ten veneers covering the entire smile in the upper jaw.
The veneers were added to my existing teeth to bring them forward and to widen my smile. I have seen many dentist file teeth to little stubs to obtain the ideal "tooth preparation". This is not recommended, in my opinion and increases the danger of tooth devitalisation and sensitivity and ultimate failure.
A veneer that overlaps the incisal edge has shown to strengthen the overall tooth. A veneer that covers the front surface only, may be subject to excessive forces. (Dr Pascal Magne)
The above procedure has been experience by myself and this may differ from patient to patient. It outlines what may be expected and gives insight into this elective procedure.
Was it worth it? Yes, and I'll be happy to show off my teeth and my product. Veneers cost around $1500- $2000 each.
If you are considering veneers or crowns contact us by submitting the form on the first page and we will have one of our preferred dentist contact you for an appointment.
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