porcelain veneers / dental veneers / cosmetic dentistry

The steps outlined below are those that are usually needed when a porcelain veneer (porcelain laminate) is made for a single tooth. Although we only describe and illustrate one tooth being veneered, many teeth can undergo the veneering process simultaneously, as a group.

In most cases two dental appointments will be required for the veneering process. Usually the time span lying between these two visits will be one to two weeks.

Trimming a tooth for a porcelain veneer.

When a tooth is prepared to receive a porcelain veneer the enamel on the front side of the tooth, the side where the porcelain veneer will be bonded, must be trimmed back. In most cases the dentist's goal will be to trim the tooth's surface about the same amount as the thickness of the veneer that will ultimately be bonded into place. This way the overall size of the tooth will not be changed dramatically.

Usually the amount of tooth enamel that the dentist will shave off is on the order of .5 to .7 millimeters. This amount is similar to that of the thickness of a chicken egg's shell. And when compared to most other dental procedures this is a very small amount. Before this trimming is begun, you and your dentist will decide if your tooth should be numbed with a local anesthetic ("novocaine").

Taking an impression of the trimmed tooth.

Once the proper amount of enamel has been trimmed, your dentist will need to make a copy of your tooth (take an impression). Your porcelain veneer will then be fabricated using this impression. There are two scenarios by which this impression taking process can occur:

• A)  Most dentists will take an impression (create dental molds) of your tooth using impression putty. This copy of your tooth will then be sent to a dental laboratory who will in turn make your porcelain veneer. Depending on what arrangements your dentist has made with the dental laboratory, the amount of time required to fabricate a porcelain veneer is usually in the neighborhood of one to two weeks.
  
  
• B)  Your dentist might have a dental milling machine. These machines are coupled to a camera that can take an impression of your tooth optically. From this image the machine can subsequently create your veneer by grinding it out of a block of dental ceramic ("porcelain"), in a matter of some minutes. The obvious advantage of this technique is that a tooth can be trimmed and the veneer bonded into place, all in one visit.

If your dentist does not have a milling machine it can be for good reason. Many dentists feel that the esthetic and physical properties of a porcelain veneer that has been crafted by hand are superior to those of a veneer milled by a machine, and therefore worth the wait.

After the tooth has been prepared for the porcelain veneer.

In those cases where your veneer will be created by a dental laboratory technician, you will have to wait the one or two weeks while your veneer is being made. The question at this point in the procedure is whether or not a temporary veneer will be placed on your tooth during this waiting period.

• Those cases where no temporary veneer is placed.
  Since some enamel has been trimmed away from your tooth you can expect that its front side will feel a little rough. You might also find that there is a prominent corner or angle on your tooth that your tongue finds irresistible to investigate repeatedly. Despite these new irregularities it's expected that you will become accustom to the shape of your tooth soon enough.

  Because some enamel has been trimmed from your tooth you might experience an increase in sensitivity to hot and cold foods and beverages. This is very normal. You simply need to moderate your exposure to these types of items.
  
  

• Those cases where a temporary veneer is placed.
  It may be possible that your dentist can create a temporary veneer for you to wear during that time period while the dental laboratory is fabricating your porcelain veneer. There are certainly reasons why your dentist might be hesitant to do so, not the least of which is that these temporaries are often dislodged fairly easily.

If you feel that it is of paramount importance that you do have a temporary veneer placed on your tooth, you absolutely must discuss this fact with your dentist in advance of the appointment when your dental work is begun. Your dentist will need to set aside enough treatment time so the task of creating and placing the temporary veneer can be completed.

Don't be surprised if the cost of the temporary veneer is not included in your dentist's standard fee for porcelain veneers. If your dental work requires additional treatment time, such as that needed to place a temporary veneer, your dentist will need to adjust their fee accordingly.