Most people need three appointments for porcelain veneers, sometimes more, spread over several weeks. The first one matters most. At that consultation you and the dentist settle the things that are hardest to undo later, like how many teeth get veneers and how much enamel comes off them.
It is also the point where you can still change your mind. Whitening or composite bonding sometimes gets close to the same result while leaving more of your own tooth in place, and a good dentist will tell you if that applies to you.
The American Dental Association describes a veneer as a thin shell of porcelain bonded to the front of a tooth. Fitting one usually means removing some enamel first, and enamel doesn't grow back. Once a tooth has been prepared, it will need a veneer or something similar on it for good.
Dentists mostly suggest veneers for front teeth that are structurally sound and bother you because of how they look. Typical reasons include:
Staining that whitening won't remove, such as tetracycline staining or a tooth that went dark after root canal treatment.
A small gap between two teeth (a diastema), when you'd rather not close it with braces or aligners.
Chipped or worn edges. This works only if enough enamel is left for the porcelain to bond to.
Teeth that are slightly misshapen or a little out of line.
Some problems rule veneers out, at least for a while. Decay and untreated gum disease have to be treated first. Grinding or clenching (bruxism, often during sleep) chips porcelain and can make a veneer come off, so most dentists want it under control before they start. If very little enamel is left, you are probably looking at a crown instead.
Expect x-rays and either an impression or a digital scan of both arches. The dentist checks your teeth and gums for decay and inflammation, then watches how your upper and lower teeth meet when you bite and chew. After that you talk about shade and shape.
If you can, ask for a mock-up before any drilling. Not every practice offers one. The dentist shapes tooth-coloured resin from a model of the planned result and places it over your existing teeth for a short time. You see the new length and outline in your own mouth while the enamel is still untouched, and asking for "a bit shorter" costs nothing at this stage.
Decay or gum disease found at the exam gets treated before anything else. That can add several weeks to the whole process.
The second visit is usually done under local anaesthetic. The dentist removes a thin layer of enamel from the front of each tooth, around half a millimetre, so the veneer sits flush instead of looking bulky. Then comes a new impression or scan. It goes to a dental laboratory, where a technician makes your veneers over the following weeks.
In between, you wear temporaries made from acrylic or composite resin. They protect the prepared teeth and give a rough sense of the final shape. Don't expect them to look like porcelain. They can also come loose, so you will be asked to avoid hard or sticky food until bonding day.
At the third visit the temporaries come off. The final veneers are placed first with a water-based try-in paste, and you and the dentist check fit and colour together. Say so now if the shade looks wrong. This is the last point where changing it is easy, because once the resin cement sets the veneer is effectively permanent.
The tooth surface is etched first. Each veneer is then fixed with resin cement that a curing light hardens. Excess cement gets cleaned off and the dentist checks your bite, since porcelain shouldn't take heavy contact when your jaw slides from side to side.
Teeth are often sensitive to hot and cold for a few days. Most dentists book a short review a week or two later to see how the gums have settled around the edges.
How much enamel will come off each tooth? That question has the most permanent answer, so ask it early, along with whether no-prep veneers would work in your case. No-prep veneers keep more enamel. They suit a narrow set of cases, though, and can look bulky on teeth that already sit forward.
A careful practice checks tooth and gum health before anyone mentions colour. Gorgeous Smiles, a cosmetic dental clinic in Melbourne CBD that fits porcelain veneers, does that check at the consultation and treats decay or gum disease before veneers go on. If you grind at night, expect to be told to wear a night guard wherever you have the work done.
Ask how many teeth the dentist plans to treat, and why that number. When only the two front teeth get veneers, they can end up noticeably brighter than the natural teeth beside them.
If you want whiter teeth overall, whiten before the veneers are made. Whitening gel does nothing to porcelain. The veneer shade is matched to your teeth as they are on the day.
Two questions about cost and aftercare are easy to forget. What happens if a veneer chips or comes off in the first few years, and how is the repair handled? And what does the quoted fee cover? Some quotes include temporaries and review visits, while others bill them separately.
Look after them the way you look after your own teeth. Brush twice a day with a non-abrasive fluoride toothpaste and clean between your teeth once a day. Decay can still start at the margin where porcelain meets enamel, so keep up your regular check-ups.
Porcelain resists staining better than composite resin. The cement line at the edge is a different story. It darkens slowly over the years, and faster in smokers.
Chewing ice chips veneers. So does chewing pen lids. If you've been given a night guard, wear it every night, because grinding puts more force through your teeth than chewing does.
The Cleveland Clinic says well-maintained porcelain veneers commonly last ten years or longer. They still wear out. Replacement is due when a veneer chips or lifts at an edge, or when decay starts underneath it. Gingival recession (the gum pulling back from the tooth) can also expose a dark line at the top, and some people replace a veneer for that alone. Taking the old one off sometimes removes a little more tooth structure with it.
1. American Dental Association. Veneers. MouthHealthy. 2. Cleveland Clinic Health Library. Dental veneers.
MBTpg/MSM