Porcelain veneer emergencies.
What should you do if you have a veneer crack, break or come off?
First, carefully remove whatever parts are in your mouth without damaging them further.
Check to see if it's intact.
If you only find one piece, then your veneer may not have broken but instead debonded (come off whole without breaking).
If it has, your dentist may possibly be able to reattach it. If it's broken, your dentist's only option will be to make you a new one. (See below for more information about both scenarios.)
To get an idea of if it's whole or not; take a look at its overall shape. The outline form of a veneer is usually somewhat symmetrical and rounded.
You can also evaluate the tooth it came off. You may see broken segments still attached. If you do, be careful. Shards of porcelain like these can be rough or sharp to your tongue or lips.
Store the veneer carefully.
If you do have the whole thing as one piece, if you can get it safely to your dentist's office doing so may save you the cost of a new one. So, wrap it up in some tissue and then place it in a protective container, like a small medicine bottle.
If it's broken, you can save the parts to show your dentist, but most likely they'll only be a curiosity to them.
Let your dentist know you have a problem.
You will, of course, need to contact your dentist's office and report to them what has occurred. And they'll need to arrange an appointment for you so your dentist can evaluate what has happened.
What to expect in the mean time.
In most cases, when your veneer was originally placed only a minimal amount of your tooth's front surface was trimmed off.
If that's the case, then it's unlikely that your tooth will experience any significant problems between now and when you get to see your dentist. (Remember, in many cases teeth are left uncovered for the entire one to two weeks while their veneers are being made.)
Since it's lost its front covering, your tooth might have increased sensitivity to hot or cold foods and beverages, or it may be rough or irritating to your lips or tongue, so be careful.
If you notice a lot of thermal sensitivity or roughness, placing a protective layer of wax over your tooth can provide relief.
Most drugstores sell white dental wax in their dental section. (It's usually used by orthodontic patients to cover over sharp brackets and wires.)
Your dental appointment.
When you get in to see your dentist, if parts of your veneer remain on your tooth and are sharp and irritating, your dentist can trim them off or round them down. That should only take a few moments.
Reattaching your veneer.
If your veneer is in one piece, your dentist may be able to bond it back on.
From a practical standpoint, this is worth a try but it's likely that the bond created will be sub par. The more predictable (although more expensive and time consuming) solution is to make plans to have the veneer remade.
Repairing your veneer.
If only a relatively small portion of your veneer has come off, it may be possible for your dentist to create a patch. Once again, this is not a first choice but one that may provide a practical solution. There are two main problems with this approach.
1) Your veneer is porcelain but the only material your dentist has to make a repair is plastic (dental bonding). Even if the repair looks satisfactory initially (which it very likely may), over the long haul the bonding will deteriorate and a distinction between it and the veneer will become obvious.
2) With some repairs (like those involving the biting edges of teeth), being able to create a lasting bond between porcelain and the dental bonding used to patch it is difficult if not impossible.
Repairing minor chips.
If only a small bit of porcelain has flaked off, one solution is for your dentist to simply trim back the rest of the veneer so the chip's divot is removed.
This makes a very lasting solution. However, neighboring teeth may need to be recontoured in a similar fashion so the symmetry of your smile is maintained.
Cracks in veneers.
There can be instances where you just notice a crack in your veneer; otherwise it remains whole and in place on your tooth.
The crack indicates that something has flexed (tooth or veneer), so it's hard to know how firmly the porcelain is still bonded to the tooth. Additionally, over time the crack will tend to accumulate stain and this will spoil your veneer's appearance.
There really isn't any type of repair that can be made in this type of situation. There is no way for your dentist to fill in the crack or bond the two pieces of porcelain back together. You'll simply need to make plans with your dentist to have your veneer remade.
What if your porcelain veneer can't be replaced?
Sometimes replacing a veneer either isn't possible or doesn't make a reasonable choice.
Case selection is a very important aspect of creating porcelain veneer success. And it may be that now that problems have occurred (possibly more than once) that it's obvious that your situation really wasn't (or is no longer) a suitable application for this technique.
If that's the case, then dental crown placement is the next step for your tooth.
Learn from past events.
For future reference, it makes sense to take note of what activity broke, or immediately preceded the breaking of, your veneer. And then, obviously, do your best to minimize or eliminate it (stop biting finger nails, clenching your teeth, etc...).
Discuss your circumstances with your dentist. They may be able to suggest some solutions.