During the first consultation for porcelain veneers, it is important that the dentist examines the patient’s teeth thoroughly; to check for signs of infection or gum disease; if there are any dental problems present then it would be quite irresponsible of them to move ahead with treatment at this point. It’s not a good idea to fit any kind of veneer over the top of unhealthy teeth, as the results won’t last long and the patient will have to return at a later date to have the issues dealt with anyway. In order to build an accurate picture of the oral condition, the dentist may choose to take photographs, x-rays, or bacterial swabs, to test for infection. However, in most cases, if the patient has no history of dental problems, then they will be happy to move on to the next stage of treatment fairly quickly.
After the dentist has approved the use of porcelain veneers, they will refer the patient to an oral hygienist for a cleaning procedure, before beginning the restructuring process. Because a veneer is a solid structure that is made to fit over the natural tooth, it will take up space and this means that a certain amount of the enamel must be removed to make room for the laminate; if none of the enamel is cut away, the veneers will look bulky and unnatural. It should also be mentioned that there are new products on the market that mean the patient can avoid having too much reconstruction and possibly be able to have the procedure reversed at a later date; these durable veneers are made from treated porcelain that can be cut much thinner than the traditional variety, which means there is less remodelling required.
The process of removing the hard outer shell is not particularly invasive but a local anaesthetic may be required if there is extensive reconstruction to be done – sometime very little enamel has to be removed so anaesthetic is not needed. Using a filing tool, the dentist will shave away sections of the teeth that are misaligned or over-sized, reducing the teeth to a peg-like structure; you should be aware that this does render the process irreversible, so think carefully about your decision before committing to anything. In general, this shouldn’t take longer than an hour as part of a single appointment, but the treatment time can vary greatly according to the patient’s needs.
After enough of the enamel has been shaved away, the dentist will take an impression of the new teeth using dental putty – this will be used at the laboratory to create the porcelain veneers. It normally takes around eight to fourteen days for veneers to be manufactured, during which time the patient will be fitted with a temporary veneer; this works to protect the reshaped teeth, keep them functional, and it gives the patient an idea of what their new smile might look like once the treatment is complete.
When the veneers are ready the patient will be called back to the surgery to have them fitted; this should also take no longer than a single appointment. The temporary veneer has to be removed first, and the teeth cleaned in preparation for the permanent version – it’s important that there are no barriers to the bonding process, such as plaque or particles of temporary adhesive; otherwise the veneers will not be fixed as firmly. Using hard-wearing dental cement, the dentist will carefully glue each individual shell in place over the corresponding tooth, in order to create a perfectly straight smile. They should also trim any areas that are overlapping onto the gum line, and smooth any rough edges to make the patient as comfortable as possible.