Patients frequently ask me about Veneers for their teeth. It shows a great deal of awareness on the patient's part to know that this treatment is available to them to renew or improve a tooth or a whole smile. Veneers are a thin porcelain or resin (tooth colored filling material) bonded to the front and sides of a tooth or teeth. They can be used to restore or renew slightly to moderately worn, broken, stained, malformed, or slightly crooked teeth. They can also be used as a cosmetic approach to improve a smile. A tooth with more extensive needs may require a crown which covers the whole tooth. Natural teeth have different colors, hues, and translucencies throughout which can be mimicked with well-made porcelain or resin veneers. How to choose between resin and porcelain veneers depends on several factors, like number of teeth requiring veneers, desired esthetics, and affordability.

Resin (tooth colored filling material) is the same material used to fill cavities. When using resin as a veneering material, it is usually placed in several layers one tooth at a time. Each layer has a different amount of color, hue, and translucency mimicking natural teeth. This is a long process when veneering several teeth and layering from one tooth to the next can vary because one tooth needs to be finished before going to the next tooth. Resin material is not as strong as porcelain but for slight changes it can be excellent. It is particularly good when only one or two teeth need to be renewed because color, hue, and translucency can be adjusted to match the adjacent teeth more easily than porcelain. Resin longevity is usually not a long as porcelain, but less expensive.

Porcelain veneers are stronger and usually last longer than resin veneers. Porcelain veneers can be done in one or two visits but there is a difference in the final product. The one visit approach involves preparing the teeth, making the veneers, and delivering the bonded veneers in one appointment. This can be convenient for the patient, but the esthetics suffer. This approach uses a single block of porcelain that is milled in the office and bonded the same day. The result is not as cosmetic as layered porcelain since layers of color, hue and translucency cannot be accomplished. Porcelain has its best cosmetic look if it is made in layers mimicking natural teeth, this cannot be done in one day.

The two appointment approach involves preparing the teeth and placing temporary veneers while the final veneers are made in a lab by a master ceramist. A few weeks later a second visit is made to remove the temporary veneers and deliver the final bonded veneers. Master ceramists are artists who make teeth out of porcelain. Because ceramists are working in a lab, not in the patient's mouth, they can work on several teeth at a time, over several days matching each layer of material to mimic natural tooth layering of color, hue, and translucency. This allows for a more natural and less variable result with the strongest material.

Both porcelain and resin veneers usually require some tooth preparation (cutting) to allow for the new material to be added. If there were no preparation of the tooth the new material would protrude out beyond the adjacent non-treated teeth causing an uneven appearance and would bump against the lips. It is rare for no preparation to be needed. The amount of preparation depends on the outcome desired. If the desire is to brighten dark teeth or make slightly crooked teeth look straight more preparation is needed. For the best long-term cosmetics, the veneers should be wrapped in between the teeth so the junction of tooth and veneer is not showing.

Depending on the patient's habits and the material used, veneers can last 10-20 years. Porcelain veneers usually last longer than resin. Patients with habits like grinding their teeth, biting their nails, or chewing on the end of a pen or pencil will have more problems with chipping, fracture, and debonding over time. The biting edges of veneers may chip through normal wear and tear. The edges can usually be renewed without having to replace the whole veneer.

Veneers are an excellent option to restore, renew, or cosmetically change teeth and smiles. Your circumstances and desired outcome will determine the best material and how many teeth to treat. If you think this may be an option for you, ask your dentist.

Dr. Robert A. Gallegos is a Fellow in the Academy of General Dentistry, visiting faculty at Spear Education, alumnus of Pankey Institute, a member the American Academy of Cosmetic Dentistry, the American Academy of Dental Sleep Medicine and the American Dental Association. Dr. Gallegos practices dentistry in Middleburg, VA. www.MiddleburgSmiles.com.