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Learn about veneers from a patient's perspective. Be informed!!

Michael Teiniker (dental technologist/ceramist) writes:

Why did I get porcelain veneers?

Throughout my twenty years of dental experience, I had seen many patients transform their teeth with porcelain veneers. These are thin coverings, that are glued to the existing teeth to alter their colour, shape and alignment. The treatment is an instant and permanent fix to having straight, white teeth, without lengthy orthodontics and/or bleaching procedures. I had been involved in changing 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 ultimate test for me, was to manufacture such a product for my own mouth, so that I could criticize the product from a patient's perspective and share it with you..

How are veneers made? Surgery time

No anaesthetic was required in my case, 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 surfaces of the teeth had to be filed away in certain areas, but it was kept to a minimum to avoid any damage. There is a risk associated with the cutting/filing of teeth. You should always ask your dentist about these risks...(you may require anaesthetic...)

Once the teeth were filed to size, a standard bonding technique was used to seal the surfaces.  There was no pain, only a little bit of sensitivity. (Phosphoric acid) was applied to the tooth surfaces for 15/20 seconds per tooth, to open the tubules and then they were painted with a bonding agent (Single Bond Adper). The bitter tasting acid was careful removed 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 pressure is felt, 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.  The waiting time is approximately six minutes for the material to harden. (nasty taste, so be prepared...). Saliva began to flow out of my mouth and occasionally I felt like gagging. Removal of the impression was difficult, because the material gets so hard.  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 easily....

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. However, 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.

Looks/ aesthetics was not important to me, so going home with filed teeth was not an issue to me... You however, would go home with your teeth covered. In some cases, patients have reported loosing their temporary veneers...They can come off, so be warned...(...and it is frustrating for the dentist and patient...)

The entire clinical procedure took around an hour and a half for ten veneer preparations... this can take up to three or four hours...(you can ask your dentist to stretch your legs from time to time, so don't be shy to raise your hand or foot...)

After ten veneers

Laboratory time

Two plaster models are poured into the rubber impression. One of these models is heat resistant, so that porcelain can 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 is removed from the porcelain veneers by a sandblasting technique. The veneers are then placed on the other plaster model to check the fit.

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,  then decided to have them bonded next day.

Surgery Time

The surfaces of the veneers are prepared in a special way to avoid de-bonding. This is done by the application of a hazardous acid, called hydrofluoric acid, to roughen the surfaces. The teeth are etched again with the bitter acid (phosphoric acid). No anaesthetic was required, in my case, because there was no pain...the teeth can also be blasted with sand...

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 is uncomfortable, so be prepared (if there is no anaesthetic...)  

It is not uncommon for the glue to ooze out of the sides of the veneer and settle between the adjacent teeth. The glue 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, the bite/occlusion was checked, 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 fracture.

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....(you may have to go back to your dentist for a few adjustments....)

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....(this can happen, because teeth slide from side to side....)

Natural teeth wear down over many years of service to function properly. Veneers are not given this opportunity, so it is necessary to grind them into a working function. Any high spots may lead to problems.

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 and corn on the cob.  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. (Do not open "PUMP" bottles with your veneers when you go to gym...)

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 glue with my tongue in certain areas. This was polished down to alleviate the sensation. (this is usually done at the final check with your dentist...)

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.

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 and smile, 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. Orthodontics (tooth movement) should always be the first choice to straighten teeth. Ask your dentist about this procedure.

Veneers 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 may be added  if something goes wrong. Make sure that you know EXACTLY, tooth by tooth, so that you are fully aware of the procedure.

Some dentists will ask you to sign an informed consent document. There are risks involved in any cosmetic elective procedures.

Photography and study models aid in the fabrication or veneers.

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 a certain way to allow a "new smile" to be fabricated.

For extremely discoloured or devitalized (dead) teeth, veneers may not be a good choice. The discolouration may transmit through the veneers.

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 come off. Veneers stick well to tooth enamel, but not as well to the underlying dentin. If a veneer comes off, your dentist may or may not be able to rebond it.

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 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 experienced by myself and this may differ from patient to patient. It outlines what may be expected and gives insight into this elective procedure.

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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