Veneers

What a veneer changes, and what it does not

A veneer covers the front of a tooth, the part seen when you speak and smile. That changes the shape, the colour and the line of the edge. It does not change what is behind: if a tooth has been root-treated and weakened, or a larger part of the crown is missing, the answer is a crown, not a veneer. The difference from a crown is explained in a separate article.

Where colour is the only problem, whitening is considered first: it does not touch the tissue of the tooth and costs less. A veneer comes into it when the colour will not shift, or when the shape is being changed along with the colour.

Two kinds

• Composite: built up in the mouth, in one visit, from the same white material as a filling. Cheaper and repairable, but it picks up staining more readily over time.
• All-ceramic (a porcelain veneer): made in the laboratory from an impression or a scan and bonded at a second visit. It holds its colour better and needs more precise preparation.

The choice depends not only on what you want but on the bite and the state of the teeth. Where there is marked clenching, a thin shell takes a load it was not designed for, so the cause is dealt with first — for instance with a splint worn at night.

How the work goes

1. Examination and discussion: what bothers you and what is feasible on your teeth.
2. Photographs and a scan or impression, the basis for the plan and for the making.
3. Preparing the tooth: a very thin layer is taken off the front, as much as the thickness of the veneer.
4. Temporary veneers while the laboratory works, for all-ceramic ones.
5. A try-in, then bonding; finally the bite is checked and the edges polished.

A composite veneer is usually finished in one visit. An all-ceramic one takes two, a few days apart. The number of teeth decides how long the visit takes and what it costs; the price is per tooth.

What preparing the tooth means

For a veneer to sit level with the neighbouring teeth, a layer as thick as the veneer itself is taken off the front. That layer does not grow back. So the decision to have veneers is one that cannot easily be undone, and everything that leaves the tooth untouched is considered before it.

Care

They are brushed like the other teeth, with cleaning between them. Coffee, tea, red wine and tobacco stain the line of the join, faster on composite than on ceramic. Opening packaging with your teeth and biting your nails are the commonest ways to chip a veneer’s edge.

A composite veneer can in most cases be repaired on the spot. An all-ceramic one is replaced if it fractures, which is why a night splint is advised where there is clenching.

How many teeth are usually done?

As many as show when you smile, most often four to eight upper front teeth. A smaller number can show as a difference in colour against the teeth beside it.

Can the tooth under a veneer decay?

It can, on the parts the veneer does not cover and along the line of the join. So brushing and check-ups stay exactly as they were without it.

Does whitening change the colour of a veneer?

No. Whitening works on the tooth’s own tissue, not on the material. If you are planning both, whitening comes first and the shade of the veneer is chosen to match the new colour.

How long do they last?

It depends on the material, the bite and your habits. Composite needs touching up more often; ceramic holds its colour longer. Nobody can promise an exact span, but we can say what shortens it.