The creator of The Online Dentist, Andrew Wilson is an award winning dentist working in Central London. He offers cosmetic solutions for patients to improve their smiles while preserving their natural teeth. We’ve asked Andrew to explain dental veneers.

If the general shapes or appearance of your teeth are something you would like to change then veneers may be an option.

A veneer is a thin covering, traditionally made of porcelain that covers the front of your teeth. They can be made from other materials but porcelain tends to be the strongest and gives the best end appearance.

The massive downside with veneers is that you will usually have to remove some enamel to make space for the veneers. Once you take the enamel off, you can never put it back. Treatment like veneers is going to cost you some enamel. This is irreversible.

Dental veneer diagram

veneers

No dental work will last forever. Things like veneers and crowns will hopefully last over ten years but they will need replacement at some point. At the risk of sounding a little mean, it does depend on your stage of life whether you should really consider these types of destructive treatments. Let me try to explain. If you are 24 years old and you want veneers, how many sets of veneers are you going to need in your life? How long are you going to live? If you live for another 60 years into your eighties then you could end up needing to replace the veneers 4 or 5 times.

The other thing to consider is that every time the veneers are replaced, you may lose a bit more enamel. There may be bits of decay around the edges. The dentist may have to take a bit more enamel away to get the old veneer off. It may be that part of the tooth breaks away. So a veneer may have to be swapped to something that covers more of the tooth like a crown. It may be that one or two of the teeth die after going through the treatment and need root canal. It may be that one tooth completely fractures away and needs to be replaced by a bridge or an implant. Then 15 years later the bridge breaks and you have an even bigger gap. It may be that after replacing all of this treatment for the 4th time, there is no option but to go for something like a denture.

It might not happen but it could. Once you start treating teeth and removing enamel, you get into a cycle that you cannot get out of.

Someone who is a little older may not have to go through so many repairs or replacements and so may consider it a more appropriate option.

This is something that you have to consider very carefully and discuss in detail with your dentist.

If you discuss it with your dentist and decide that porcelain veneers are for you, it has to be planned properly. Beware of anyone who is ready to just slap on a load of porcelain without doing a load of planning before hand. Your dentist needs to plan with you and then the laboratory what you are aiming for. The lab can mock up the shapes to give the desired end appearance. If the lab have done this planning before any treatment is started, it has a couple of huge benefits.

It means that your dentist can make you some temporary veneers before you start to check that you are happy. Your dentist can make these temporary veneers in your mouth and you can even wear them for a few days to see how you feel about them. If you want changes made at this stage, it’s still possible and means that you have a good idea of what it is all going to look like at the end.

The other big benefit is that if it has all been planned properly, your dentist will know exactly how much enamel has to be removed and can keep it to the minimum possible. If your dentist doesn’t do the planning phase then he or she will inevitably remove more enamel than necessary.

Front 4 dental veneers

dental-veneer

Risks

Some enamel may have to be removed so the nerve in the tooth may be irritated by this. There is always a risk that the tooth could die as a result of this irritation. If this were to happen, there are two options. The tooth would either need root canal treatment or extraction. Proper planning minimises these risks but it is always possible.

The other risk is the need for replacement in future. Most of the time, veneers don’t fail because they break. Veneers fail because they stain around the edges or the gums shrink back so they don’t look as good as they did originally. Veneers will all stain and weather with time and may need replacing for this reason.

In some situations, I think veneers are a nice option. They will look great as long as they are planned properly. However, you just need to be aware of the drawbacks with them. They should not be undertaken lightly. You should be fully aware of what you’re signing up for. Hopefully the information above is useful and gives you most of the key points you should know.

An alternative to veneers is bonding. This is a simple treatment that allows you to change the shape of your teeth without having to remove healthy enamel.

Wonky or crowded teeth

Veneers are NOT appropriate for treating crowded teeth.

Some people still do this but I do not believe that this is appropriate at all. If you straighten teeth by putting veneers on them, you are just drilling them into a line. This is not a good idea. It is so destructive. You are going to have to drill away so much perfectly good enamel.

You will shorten the life of your teeth. You will weaken them irreversibly.

I cannot emphasise this enough.

If you don’t like the way your teeth are crowded or overlap, don’t ask your dentist for veneers. And please don’t go to a dentist who is offering to straighten your teeth with veneers. Thankfully, I don’t think many dentists would still do it.

The only way to treat wonky teeth is with some form of brace.

Andrew practices in Central London. If you would like to know more about Andrew or how he could transform your smile, visit his website or contact him.

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