Over the last decade, porcelain veneers have become increasingly popular. People even post pictures of their porcelain veneers on Instagram as if they were works of art. Indeed, porcelain veneers can be thought of as a type of artwork, for making one that is perfect for a patient’s mouth tests not only the technical but aesthetic skills of the cosmetic dentist.
When dental veneers were first developed. they were used by the rich and famous to make their teeth, which were merely okay, exceptionally beautiful. It may surprise some people to know that this was just about the time when movies were evolving from silents to “talkies,” and actors and actresses had to present perfect teeth to the camera. Back in those days, veneers were removable.
Porcelain veneers are permanent now, and they’re not just for celebrities who want to enhance perfectly nice teeth. They are now an option for people whose teeth are chipped, gapped, discolored, or crowded, even though they remain pricey. A single porcelain veneer can set a patient back between $1000 and $4000.
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The Porcelain Veneer Consultation
A patient who seeks veneers in Manhattan first has a consultation with the cosmetic dentist to make sure they’re a good candidate for the procedure.
Trimming the Tooth
After the patient is accepted as a candidate, the enamel is reduced on the surface of the tooth by a diamond burr. Some dentists use the burr to first place depth grooves as points of reference before they trim about 3/10 to 1/2 a millimeter from the tooth. More enamel is removed in the area of a cavity. Teeth that are just slightly crooked can also be realigned at this time, and small cuts are taken from the teeth. This can be done without anesthesia though some patients ask that the area be numbed.
The dentist and patient have already decided on the shade of the veneer, especially if the front teeth are being treated. To do this, the dentist employs a shade guide. Often, the shade of the veneer is chosen to match the color of the patient’s natural teeth, but it can be a shade or two lighter. Some veneers are even a blend of shades to match the patient’s teeth.
Making an Impression
After the tooth is prepared, the doctor takes an impression of it and the gums and teeth around it. The dentist fills a tray with paste or putty and has the patient bite down into it, and hold it for a few minutes. It’s removed when it’s set, then sent to a dental lab as a guide to help the technicians create the veneer. The creation of the veneer takes about two weeks.
Sometimes, a dentist packs a retraction cord in the space between the patient’s tooth and gum before taking an impression. This happens if the veneer will be made so that its edge slips just beneath the gum line. The cord pushes the gum up from the tooth, but it’s removed just before the dentist gives the patient the impression tray. Even though the cord is no longer there, the gum stays pushed up long enough to take an accurate impression.
Instead of a tray, the dentist can use a milling machine and a camera to take the impression of the tooth. Because the milling machine can create a veneer out of a ceramic block using the camera, an impression doesn’t need to be sent to a lab and the patient won’t need to wait two weeks for their veneer.
The drawback of this is that it doesn’t allow for different tooth shades, as the ceramic block is all one shade. The resulting veneer is nowhere near as realistic as it would be if it was fashioned by a lab technician. Because of this, these veneers are sometimes used for teeth outside of the “aesthetic zone.”
About Temporary Veneers
Some patients are self-conscious about the look of their teeth after they’ve been prepared for veneers. Besides their look, the teeth are sensitive to hot and cold and have a rough feel. In that case, the dentist can give the patient temporary veneers, though most dentists prefer not to. Temporary veneers have to be strong enough to stay on until the permanent veneer is made, yet be pliable enough for the dentist to remove it easily. They can also irritate the patient’s gums.
Placing the Porcelain Veneer
When it comes time to set the permanent porcelain veneer, the dentist takes time to put it over the tooth, check it, take it off and trim and evaluate it until they are satisfied. This may take some time. Though the shade of the veneer was chosen beforehand, the dentist may make modifications to it through the color of the dental cement. The dental cement’s shade can change that of the veneer because the veneer is translucent.
Finally, the veneer and whatever trial paste the dentist used is cleaned. The surface of the patient’s tooth is also cleaned then etched with an acid gel. This takes a few seconds. The dentist then washes the etching acid off the tooth, dries the tooth, and adds a bonding agent. They add the cement inside the veneer, then place the veneer over the tooth. After that, the dentist cures the cement with a blue light and the veneer is permanently set. Veneers generally last about ten years.