Veneers

A veneer, as explained by the American Heritage Dictionary, is something you fit over something else to produce "an outward show that enhances what lies beneath."

In this case, a thin shell of porcelain is bonded to your good tooth to correct crooked, chipped, discolored, or worn teeth.

And what it enhances, is your smile.

The use of porcelain veneers is quickly becoming one of the most exciting and revolutionary advancements in cosmetic dentistry. It's extremely popular, not only among models and film stars whose smiles are a professional asset, but average citizens who simply want to look good. In fact, literally tens of thousands of porcelain veneers have been placed during the past ten years alone. It's easy to understand why.

This virtually painless procedure can repair damaged top or bottom front teeth and side teeth, correct gaps, conceal discoloration and change the shape and size of your mouth. Veneers can even replace braces for those patients with top or bottom front teeth that require only minor movement.

They're highly resistant to permanent staining from coffee, tea, red wine, cigarette smoke, and even chewing tobacco. What's more, porcelain veneers can last for well over a decade with the regular care and maintenance of a normal tooth.

About the Procedure
Usually, it requires four dental appointments to place porcelain veneers: diagnosis and planning, preparation, placement, and follow-up. One veneer is placed per tooth.

Diagnosis and Planning
It's essential that you work with your dentist to plan and design your smile before taking the dramatic step of placing the veneers. Have more than one consultation if necessary to feel comfortable. The veneers will be with you for a long time.

The consultation begins with an evaluation of the present condition of your teeth. This includes a visual examination as well as X-rays and photographs. The dentist will also take impressions of the teeth that are used as study models.

In some cases a wax mold will be formed to help design the shape of the veneers. This mold also helps patients visualize the new shapes of their teeth.

Still in other cases, computer-imaging systems are used to allow patients to preview results.

Preparation
This appointment takes approximately 1-2 hours and is used to prepare the teeth to accept the porcelain veneers.

The teeth are lightly sanded to shave off a thin layer of outer enamel to allow for the added thickness of the veneer. About half a millimeter (less than the thickness of an egg shell) is removed. This may require a local anesthetic.

Afterward, an impression, or mold, is taken of the teeth. This impression is sent to a dental laboratory to be used as a guide for the fabrication of the veneers. This is where the shape, size, color and teeth arrangement are determined for your new smile. The process generally takes from 1-2 weeks.

Because the teeth have been sanded, they'll look and feel a little rough until the veneers are placed. When more enamel is removed, life-like temporaries are often placed. Your teeth will also be more sensitive than usual. You should avoid extreme temperatures until your next appointment.

Placement
This appointment will also take 1-2 hours depending on how many veneers you are having placed.

First, the dentist will place the veneers on your teeth using water or glycerin to get a sense of the shape and color.

It's important, while the veneers are resting on your teeth, that you view the esthetic results from many angles and under different lighting. Use a full-face mirror so you can see your entire face. Pay particular attention to color. At this point the color of the porcelain veneers can still be adjusted. But once cemented, it cannot. Also, if a veneer must be removed after it's cemented into place, more of the tooth structure will be lost and a second veneer will not bond as well.

Once the final decision is made, the teeth are brushed with a pumice and then a mild etching solution is applied that roughens the surface to aid adhesion. A special cement adheres the veneer to the tooth. Then a visible light beam - most dentists use a white light gun for this - initiates the release of a catalyst to harden the cement. Bonding is achieved in minutes

Are You a Candidate for Veneers?
Porcelain veneers can mask undesirable defects in side teeth and top or bottom front teeth. Teeth that are stained, chipped, worn, misshaped, discolored by fillings or have gaps may be helped with this procedure.

However, in order to use porcelain veneers, you must have a sound tooth structure. Patients with periodontal disease, whose teeth are severely damaged, or who have little or no enamel remaining on their teeth, are not good candidates.

Patients with very crooked teeth should consider braces first. The appearance of crowded top or bottom front teeth can be corrected with porcelain veneers, but only if minor movement is required and the back teeth have a good bite.

Patients who clench or grind their teeth might fracture the porcelain veneers at the edges. Veneers will not last as long for these patients. If you clench or grind, you will be encouraged to wear a night guard while sleeping.

Pain
A local anesthetic might be needed during the preparation of the teeth for porcelain veneers. And the teeth will be more sensitive than usual during the period between preparation and the placement of the veneers. Sometimes, depending on how sensitive your teeth are in general, the sensitivity may linger for a short time. Other than that, there should be no pain and no side effects of any kind.

Recovery
There will be a period of "adjustment," during which you will need to get used to the new size and shape of your teeth after the porcelain veneers are placed.

Beyond that, you should follow normal hygiene procedures - brush and floss regularly. At first, flossing might seem "tight" because of the tiny amounts of excess cement that might remain. This excess cement will be removed during your follow-up examination.

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