As a dentist performing cosmetic therapy in Charlotte NC, cosmetic porcelain veneer therapy is the most common cosmetic procedure Dr. Plascyk performs. Cosmetic porcelain veneers are thin sheets of porcelain that fit over the front surface of anterior teeth.
Cosmetic porcelain veneers make teeth more attractive by changing the appearance of discolored, misshapen or mal-positioned teeth. Dr. Plascyk has done thousands of cosmetic porcelain veneers over the last 20 years. Some of these cosmetic porcelain veneer cases can be seen on the cosmetic photos page of this website. Dr, Plascyk often has to combine cosmetic porcelain veneer therapy with dental implant therapy and Clear Correct therapy as well. On all these cases, people cannot distinguish between natural teeth, teeth with cosmetic porcelain veneer therapy and teeth that were replaced with dental implant therapy.
Ideally, a cosmetic porcelain veneer can be as thin as .3mm. However, the thickness can vary depending on the particular tooth. For example, if a tooth is rotated or tilted toward the inside of the mouth, the cosmetic porcelain veneer thickness would be greater to “bulk” the tooth out toward the lip and make it appear straight. The more correctly positioned the tooth, the thinner the cosmetic porcelain veneer can be. In an ideal cosmetic case, a cosmetic porcelain veneer requires only .3-.5mm of tooth structure removal. However, if a tooth is positioned too far out toward the lip or overlaps an adjacent tooth, more tooth structure will need to be removed to bring the tooth into a better cosmetic position.
If a patient has mal-positioned teeth, (crooked, crowded, tilted, rotated) Invisible braces may be recommended prior to applying cosmetic porcelain veneers. This will reduce the amount of tooth structure removal that is required and allow for a more uniform thickness of cosmetic porcelain on all the teeth. If a patient does not want to straighten the teeth first, Dr. Plascyk can still create a beautiful cosmetic result but will have to remove more tooth structure. Teeth whitening may also be recommended prior to cosmetic porcelain veneer placement to ensure the best shade for you.
I would like to make a comment about doing cosmetic porcelain veneers without reshaping of the teeth first. In other words, placing cosmetic porcelain veneers on the teeth without removing tooth structure (no drilling). There is a company that is doing some heavy marketing to the public for their brand of porcelain veneer. In my opinion, if you are looking for the best cosmetic and functional result, cosmetic porcelain veneers that require no preparation (drilling,) are not the best solutions in most cases. Oftentimes, when these cases are completed, the teeth appear too bulky and thick. The color of the cosmetic porcelain veneers is less than ideal, and the edges of the teeth project too far out over the lip. I am certified in this type of cosmetic porcelain veneer, but I do not offer them in my practice. I want my Charlotte, NC area patients to have the best and most natural looking cosmetic porcelain veneer and cosmetic porcelain crown therapy available.
Also, when I took the training course for these "no drilling" cosmetic porcelain veneers, the vast majority of the cases presented to us required the same amount of tooth reshaping as a traditional cosmetic porcelain veneer. Therefore, in my opinion, the advertising is misleading.
I am often asked how long cosmetic porcelain veneers will last. Cosmetic porcelain veneers could last a lifetime if properly completed by the dentist and maintained by the patient.
Dental work (cosmetic porcelain veneers, crowns, fillings) bonds extremely well to enamel but poorly to dentin. Enamel is the hard outside layer of the tooth and the dentin is the softer less calcified tooth structure under the enamel. The best situation involves a cosmetic porcelain veneer bonded completely to enamel. If too much tooth structure is removed, revealing extensive amounts of dentin, the bond between the cosmetic porcelain veneer and tooth will be weak. In cases where teeth are extremely rotated or tipped out toward the lip, more tooth structure needs to be removed to create proper esthetics. However, because more tooth structure is removed, more enamel is removed and more dentin is exposed. This means a weaker bond of the cosmetic porcelain veneer to the tooth. As a minimally invasive dentist, ideally, I want to straighten mal-positioned teeth first so I can minimize the amount of tooth structure I will be removing before placing the cosmetic porcelain veneers.
Occlusion, or how top and bottom teeth come together when the mouth is closed, is another issue. It is the dentists' responsibility to make sure your jaw position and bite are balanced and are unstressed. I almost always balance the bite for a patient before placing a cosmetic porcelain veneer case. This decreases the stress on the cosmetic porcelain veneers and helps to prevent them from popping off or cracking. Comprehensive balancing of the bite is not the same as adjusting the cosmetic porcelain veneers into the bite once they are cemented on the teeth. Balancing the bite involves a comprehensive analysis and set of procedures that will not only extend the life of the a cosmetic porcelain veneer case but also help prevent disease and breakdown of all the structures in and around the mouth.
It is also the responsibility of the dentist to have an effective disease control program? We monitoring your oral bacteria closely with a microscope each time you come in for your cleaning. This level of disease diagnosis is not done by most dentists. Also, our patients are experiencing excellent results with our all natural office cleaning and disinfection program.We also recommending effective products and techniques for your home care?
I have been able to meet the long term cosmetic and functional expectations of my Charlotte, NC area patients with my cosmetic porcelain veneer therapy.
The patient’s responsibility is simple. Practice meticulous home care, come in as often as recommended for checkup exams and cleanings and finally, wear a night guard if recommended by the dentist. So, if you eliminate the infection and stress from the teeth you will prolong the life of your cosmetic porcelain veneers and other dental treatment as well.
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More thoughts about Cosmetic Porcelain Veneer Therapy:
I just want to make some more points about cosmetic porcelain veneer therapy. When browsing websites and other information about cosmetic porcelain veneer therapy, you pretty much get the same basic information. They describe what a cosmetic porcelain veneer is, what type of dental problems they can treat and the cost and durability of them. For example, typical information about cosmetic porcelain veneers would sound something like the following:"Cosmetic porcelain veneers are contact lens-thin sheets of porcelain that fit over the frontsurface of the teeth ......""Cosmetic porcelain veneers require only a minimal amount of the tooth to be reduced or shaped ....""Cosemtic porcelain veneer therapy can treat the following dental problems:Chipped or broken teethWorn teethMalpositioned or crooked teethTeeth with spaces between themDark or stained teeth ...... ""Cosmetic porcelain veneers can range in cost from 800-2000 dollars each .....""The lifespan of cosmetic porcelain veneers can be from 10-20 years ....."The above facts are true but it is very superficial information and does not give you all the information that you really need. Let's go into a little more depth than the typical information you will get about cosmetic porcelain veneer therapy. In an ideal situation a cosmetic porcelain veneer can be "contact lens-thin". This will happen if the tooth that the cosmetic porcelain veneer is going on is ideally positioned in the mouth. In other words, the tooth is not rotated or tilted, it is not incorrectly positioned vertically (too short or too long) and it is not incorrectly positioned horizontally (tilted in toward the tongue or palate or tilted out toward the lips or cheeks). The more incorrectly positioned the tooth is relative to where it should be, the thicker the cosmetic porcelain veneer will generally need to be. If the tooth is tilted toward the inside of the mouth, a thicker amount of porcelain will need to be used to build the tooth out toward the cheek or lips. If the tooth is rotated, then the part of the tooth that is rotated away from the lips and cheeks will need to be "built out" toward the lips or cheek. Teeth with thicker porcelain could be more difficult to clean on a daily basis. Also, the thicker porcelain could place more stress on the cosmetic porcelain veneer which could put stress on the bond between the cosmetic porcelain veneer and the tooth. Having a thicker edge on the cosmetic porcelain veneer will also make slicing into food with the front teeth more difficult then it would be if there was a thinner edge to the cosmetic porcelain veneer.As far as the amount of tooth structure that will be removed from the tooth in order to place a cosmetic porcelain veneer, again, the more ideally positioned the tooth is, the less tooth structure needs to be removed. So if a tooth is too long or too far out toward the lips and cheeks then the more tooth structure will need to be removed before placing the cosmetic porcelain veneer in order to get the front surface and biting edge of the tooth in a more ideal position. You can imagine in situations like this how unattractive a cosmetic porcelain veneer would look if no shaping of the teeth was completed and a veneer was placed on top of the protruded tooth. Not only would the cosmetic porcelain veneer be too thick on the one tooth but all the other cosmetic porcelain veneers would have to be built out further to match the tooth that was too far out to begin with.Another problem with placing cosmetic porcelain veneers on poorly positioned teeth that require more drilling to get them into alignment is that more of the enamel is drilled rom the tooth and more dentine (soft tooth structure under the enamel) is exposed. As I mentioned before, cosmetic porcelain veneers do not bond well to dentine. The longevity of the cosmetic porcelain veneers are more compromised as more and more dentine was exposed on during the drilling process.Remember also that if the teeth are ideally aligned before cosmetic porcelain veneer therapy is started, there will be a more uniform thickness of porcelain on all the teeth. This will also cause the cosmetic porcelain veneers to look unifirm, more natural and attractive. When teeth are not ideally aligned when starting a cosmetic porcelain veneer case then the thickness of porcelain will vary greatly and take away from the attractiveness of the cosmetic porcelain veneer case.For all the above reasons, I always try to get the teeth in ideal positions before starting a cosmetic porcelain veneer case. So I recommend straightening teeth with either invisalign or traditional braces when the teeth are not ideally aligned.The last point I want to make is the importance of getting the occlusion or bite balanced when doing a cosmetic porcelain veneer case. I have frequently observed patients who have received cosmetic porcelain veneer therapy to fix teeth that were worn, chipped, crowded or spaced. However, the cause that made the teeth worn, chipped, crowded or spaced was never corrected when the cosmetic porcelain veneer therapy was completed. This is not the way I do my cosmetic porcelain veneer therapy. I spend a lot of time educating my patients on the importance of having a balanced and stress free bite. Part of what my patients learn is the importance of the position of the uper and lower front teeth when it comes to a balanced bite. Properly positioned upper and lower front teeth will relieve stress on all the teeth, the jaw joints and the oral muscles. If upper and lower front teeth are not properly treated and positioned when cosmetic porcelain veneer therapy is completed then the comfort and longevity of the case will be compromised. Often times a patient will receive a bite guard to be worn at night to "protect" the veneers during tooth grinding that occurs at night. The problem is that the teeth and cosmetic porcelain veneers are only protected 1/4 - 1/3 of the day. The rest of the time the veneers, teeth, jaw and muscles are stressed out.So to sum things up, teeth ideally need to be properly positioned before cosmetic porcelain veneer therapy then the cosmetic porcelain veneers need to properly positioned and shaped on the teeth to give the best function, comfort, eshthetics and longevity of the case.