Behind the hype of thin veneers

Iwas thumbing through one of those glossy consumer magazines recently, and noticed an article on thin veneers.

I was thumbing through one of those glossy consumer magazines recently, and noticed an article on thin veneers. Upon first glance, I was reminded of the old adage, “If something sounds too good to be true, then it probably is.” The more I read, the more I realized that the adage certainly applies to these veneers.

The article on thin veneers listed two major claims that I found very interesting. First, the company in the article said the veneers can be applied with little to no prep at all. Second, this company claimed to give patients a beautiful, natural-looking, whiter smile. Let’s examine these two issues and separate the truth from the hype.

Not prepping a tooth before applying a veneer is definitely too good to be true. Common logic tells you that if you place a veneer onto a tooth without removing any of the tooth structure, that tooth will become bulkier. The bottom line is that with any veneer - even the thin ones - some prep is necessary to achieve natural-looking and healthy results. Applying veneers without prepping the teeth will result in thicker teeth than the mouth and gums are accustomed to. This may increase the likelihood of periodontal problems and gum inflammation. Esthetically speaking, no-prep veneers often appear awkward and unnatural.

Another type of veneer that is made solely with feldspathic porcelain (the original veneer material) does not go so far as to state that no prep is needed. However, it does claim a small amount of tooth preparation compared to pressed ceramic materials, the state-of-the-art porcelain currently available. The truth is that prep for high-end, pressed ceramic veneers, such as MAC Veneers by MicroDental, only requires the removal of 0.5 to 0.75 millimeter of the tooth. This is a minute amount.

While the difference in prep between the two is inconsequential, the difference in the final results often can be dramatic. Because of their fabrication, pressed ceramic veneers are twice as strong as feldspathic. They allow for more dramatic changes in tooth color and shape, and are more stain-resistant. Using pressed ceramic veneers generally results in a smile that looks and feels healthy and more natural. Pressed ceramic veneers also tend to last longer than thinner veneers.

With regard to changing tooth color, it is nearly impossible to achieve a beautifully white smile with a thin veneer. They are so thin that the color of the natural tooth shows through the veneer. Since the tooth is not prepped, the prevailing color is often dark. Manufacturers try to overcome this by making the veneers ultra-white, which often produces an unnatural, monochromatic look. By contrast, pressed ceramic veneers are uniquely customized to match or change tooth color, and blend in seamlessly with the adjacent natural teeth, thus looking much more realistic.

Besides color, the shape and contour of the veneer are crucial in helping to give someone the smile of his or her dreams. Thin veneers do not address the shape of the smile. Because there is little to no prep involved, the teeth are bulkier and the smile does not look natural. Meanwhile, pressed ceramic veneers are customizable, and can change the actual shape of the smile to look more masculine, feminine, wider, smaller, or whatever a patient may desire.

Today, the marketing of thin veneers seems to be directed toward patients who want an easy fix and to dentists who might not be that comfortable prepping teeth, or performing the procedures required for pressed ceramic veneers. But in the long run, investing the time and effort to learn the art of pressed ceramic veneer prepping and bonding techniques will be worthwhile. The payoff will be more beautiful, natural-looking, and long-lasting results, and patients will have the healthy-looking smiles they have wanted.

Dr. Christopher Pescatore lectures worldwide on topics such as state-of-the-art esthetic procedures, techniques, and materials. He holds a U.S. patent for a nonmetallic post system to restore endodontically treated teeth. He is the former clinical co-director and current featured speaker at the Las Vegas Institute for Advanced Dental Studies. He has a full-time practice in Danville, Calif., dedicated exclusively to esthetic dentistry. Contact him at (925) 362-9330, or at chrisdmd@aol.com.

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