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A porcelain veneer is a thin shell of ceramic, made by a laboratory to our design and bonded to the front of a tooth to change its shape, size or color. Veneers are the right answer for teeth that are worn, short, chipped, undersized or too dark for whitening to fix, and the wrong answer for healthy teeth that are only crooked or a little yellow, which need Invisalign and whitening instead. At Vizcaya Dental Arts every case is designed with a master ceramist and previewed in your mouth before any tooth is prepared.
When veneers are the right answer
The cases where we recommend them readily:
- Missing or worn enamel. Teeth that have worn short, chipped or lost enamel through acid or grinding need structure added back, and porcelain is the most durable way to add it.
- Color that whitening cannot fix. Tetracycline staining and very dark teeth often do not respond enough to bleaching; a veneer can mask what whitening cannot change.
- Small teeth and gaps. Naturally undersized teeth, or spacing that alignment alone would not close attractively, are ideal cases, because we are making the teeth bigger and often need to remove very little.
Many patients who arrive asking for veneers leave with a smile they are happy with and no porcelain at all. Others finish orthodontics and whitening and find that the straight, lighter teeth are still the wrong shape, worn or short, and for them veneers are the step that addresses the problem.
Side by side, the four ways of changing the look of a front tooth:
| Whitening | Bonding | Veneers | Crowns | |
|---|---|---|---|---|
| What changes | Color only | Shape, small chips and gaps | Shape, size and color | The whole tooth |
| Tooth preparation | None | Usually none | Minimal, and permanent | More, and permanent |
| Who makes it | Custom trays, worn at home | Dr. Kottar, in the chair | A master ceramist, to our design | A ceramist, to our design |
| Visits | One, then nights at home | One or two | Three to four | Two |
| Upkeep | A maintenance night now and then | Repolished every year or two | Brush, floss, retainer at night | Brush, floss, checkups |
| Suits | Well-shaped teeth that are only yellow | One tooth, a chip or a small gap | Worn, small or deeply stained teeth | Teeth too damaged for a veneer |
Healthy gums and a workable bite first
The gums must be healthy and stable. In our experience the best results, and the lowest risk of the gum receding from the veneer edge later, come from starting with healthy tissue. If there is inflammation, we treat it first.
The bite also has to work. Worn front teeth often have a bite problem behind them, and porcelain placed on top of an unresolved bite problem will chip or fail. Some patients need orthodontic treatment to correct the bite before they can be restored. It takes longer, and the result lasts.
How much tooth is prepared
- No preparation. Possible when teeth are unusually small and need to be made bigger. For most teeth, no-prep veneers end up bulky.
- Minimal preparation. Our most common approach. A small amount of enamel is removed so the veneer sits flush. It works very well for changing shape when the underlying color is already reasonable, because a thin veneer cannot block much darkness; trying to mask a dark tooth with a thin veneer forces the porcelain to be more opaque and look artificial.
- Conventional preparation. Roughly 0.7 to 1 millimeter of reduction, still a small amount, used when the teeth are heavily discolored or noticeably out of position. It gives the ceramist room to build color and translucency in layers.
Natural or noticeable
Some people want teeth that look like naturally beautiful teeth: a little lighter, with the slight translucency, surface texture and small irregularities that make real teeth look real. Others want a smile that people notice, brighter, more uniform, a little squarer. We tend to recommend the natural end, and we tell you when a choice will look less real, but the smile is yours. The ceramist designs with your face and the character you want your smile to have in mind, softer or more defined.
Planning with a master ceramist
Before any tooth is touched, we take photographs and a digital scan and send them to the laboratory that will make the porcelain. A master ceramist studies the case and designs the proposed teeth as a wax-up, a physical or digital model of the finished smile. This is where we find out what is achievable and whether the approach is right, while everything is still reversible.
We review the wax-up with you. In many cases we can transfer it into your mouth as a temporary mock-up, so you can see the proposed shape and length on your own teeth, in a mirror, and tell us what you like and what you would change. When we agree on the design, we proceed.
What treatment involves
- Step 1 of 6 Consultation and records
Examination of teeth, gums and bite, photographs and a digital scan, and a conversation about whether veneers, or something simpler, will get you what you want.
- Step 2 of 6 Design and preview
The master ceramist produces the wax-up. You review it with us and, where possible, try it in as a mock-up. Changes happen now, while everything is reversible.
- Step 3 of 6 Preparation visit
A longer appointment under local anesthesia: the teeth are prepared as the design requires, impressions are taken, and temporaries shaped from the wax-up go on.
- Step 4 of 6 Two or three weeks in temporaries
You live with the proposed shape and length. Anything you would adjust is changed on the temporaries and passed to the ceramist.
- Step 5 of 6 Try-in and bonding
The finished veneers are checked for fit, color and bite, and bonded when all three are right.
- Step 6 of 6 Retainer
A retainer to wear at night keeps the veneered teeth where they were designed to be; teeth can shift at any age.
We generally treat all the teeth being changed on one arch together, so the result is harmonious. Cases range from two to ten veneers, almost always on the upper teeth. Where a tooth is too damaged or heavily filled to support a veneer, it gets a crown instead, and the two blend in the finished smile.
The porcelain we use
Feldspathic porcelain
Our standard material. It is built up by hand in thin layers by the ceramist, which allows the finest control of translucency, color and surface detail, and it is bonded to enamel very reliably. It gives the most natural result.
Lithium disilicate
A stronger glass ceramic, often known by the brand name e.max. We use it in selected cases where its strength is useful, and it can look excellent when customized by a skilled ceramist.
Zirconia veneers
A very strong, more opaque ceramic. In our judgment it is less suited to natural-looking veneers, and we are less confident in how reliably it bonds to the tooth, so we do not offer it. Other offices do, and its uniform look appeals to some patients; this is our preference, not a universal rule.
Our material choices
Feldspathic porcelain for most cases, lithium disilicate where there is a clinical reason, and no zirconia.
How long veneers last, and how to care for them
In our experience porcelain veneers commonly serve for twenty to twenty-five years, sometimes longer, and they rarely fall off. When they are eventually replaced it is usually for cosmetic reasons: the gum has receded a little over the decades, or the surrounding teeth have changed. Chips are uncommon; a chipped veneer is usually replaced, occasionally repaired. Care is the same as for your own teeth:
- Brush and floss.
- Keep your cleanings.
- Wear the retainer every night.
- Do not use your front teeth as tools.
Frequently asked questions
Do veneers ruin your teeth?
Veneers are a commitment, not a ruin. Most cases involve removing a thin layer of enamel so the porcelain sits flush, and that step is permanent: a tooth that has been prepared for a veneer will always need a veneer or a crown. That is exactly why we do not recommend veneers for healthy teeth that could be improved with whitening or alignment.
Does getting veneers hurt?
The preparation visit is done with local anesthesia, so it is not painful, though it is a long appointment. Some sensitivity while you are in temporaries is common and settles once the final veneers are bonded.
How many veneers will I need?
Usually the teeth that show when you smile, on one arch, treated together: two, four, six, eight or ten depending on the case. We do not treat every tooth in an arch by default, and most cases involve the upper teeth only.
Can veneers be whitened?
No. Porcelain does not change color with bleaching, which is why we whiten first and match the veneers to the shade you want to keep. Any whitening touch-ups afterward are for the natural teeth around them.
Veneers or bonding?
Bonding is composite resin added to the tooth in the chair, usually without any preparation; it suits single teeth and small changes and needs repolishing over time. Porcelain is made by a ceramist, looks more lifelike, does not stain and lasts longer in our experience, and it is what we recommend when several teeth are involved or length needs to be added.
Veneers or crowns?
It depends on how much of the tooth is left. A veneer covers the front surface and relies on sound enamel to bond to. A tooth with large old fillings or cracks may be too weak for a veneer and stronger with a crown. We often combine the two in one smile, and the finished result looks the same.
What happens if a veneer chips?
It is uncommon, but porcelain can chip just as a natural tooth can. A small chip can sometimes be smoothed or repaired; a larger one usually means replacing that veneer. Wearing your retainer at night and avoiding biting hard objects with your front teeth protects them.
Sources
Professional guidelines and peer-reviewed reviews this page draws on.
- Morimoto S, Albanesi RB, Sesma N, Agra CM, Braga MM. Main clinical outcomes of feldspathic porcelain and glass-ceramic laminate veneers: a systematic review and meta-analysis of survival and complication rates. International Journal of Prosthodontics. 2016;29(1):38-49. DOI
