How long do porcelain veneers last?
A veneered tooth.
This page discusses the issue of porcelain veneer (dental laminate) longevity, as determined by research studies. It also outlines precautions you can take that can help to extend the lifespan of yours.
(For an explanation about why veneers fail and what to if you have one that does, visit this page.)
How long do porcelain veneers last?
A number of studies have concluded that it can be reasonably expected that a porcelain veneer will last on the order of at least 10 years, and more likely beyond.
However (and as we explain below), this estimated life expectancy will be influenced by the protocol that was followed during their placement.
A) Research
Here are some examples of studies and literature reviews that have reported about porcelain veneer longevity. [reference sources for this page]
1) Layton (2007)
This study evaluated 304 porcelain veneers (100 individual patients) that had all been placed by the same dentist over the course of a 16-year period.
Findings.
The survival rates reported were: 96% at 5 to 6 years, 93% at 10 to 11 years, 91% at 12 to 13 years and 73% at 15 to 16 years.
(The paper stated that the rate reported for the 15-to-16-year group was likely skewed to the downside because one person in that group, which was already only composed of a small number of restorations, was no longer available for participation in the study.)
Reasons for failure.
The three most common reasons for failure were: 31% - failed esthetics (the veneer's appearance was no longer satisfactory), 31% - structural complications (chips, cracks, etc...) and 13% - loss of retention (the veneer came off).
2) Beier (2012)
This study evaluated 318 porcelain veneers (84 individual patients) that had been placed over a 22-year period.
Findings.
The survival rates reported were: 95% at 5 years, 94% at 10 years, and 83% at 20 years.
Reasons for failure.
The most common reasons given were: Fracture of the ceramic 45%, crack in the ceramic 28%, chipping 10% and debonding (laminate loss) 10%.
3) Land (2010)
This paper reviewed the findings of 50 published research articles (including our Layton reference above) that studied the subject of how long porcelain veneers can last.
It determined the following failure rates: 1) Less than 5% at 5 years. 2) Less than 10% at 10 years.
B) What level of longevity can you expect?
From the studies mentioned above, it's easy enough to expect that:
- Most veneers should be able to last for a period of at least 10 years (95% survival rate).
- Beyond that, failure rates increase but not overwhelmingly so.
The patient's dilemma.
We should point out that while the expected survival rate is high, it's not 100%.
That places a prospective patient in a position where they must decide if it's high enough to have what is typically an elective procedure performed. Especially when reasonably equivalent alternative procedures might exist.
1) As compared to other types of restorations.
a) Dental Crowns
The estimate above jives with the expected survival rate of dental crowns placed in areas where their cosmetic appearance is important. Jacobson (2008) states that otherwise serviceable crowns are frequently replaced at an interval of 7 to 10 years due to deteriorated esthetics.
b) Composite veneers.
Veneers crafted using dental bonding tend to fare less favorably than porcelain ones. A literature review by Wakiaga (2004) reported a 2-year survival rate of 74% vs. 94% for porcelain.
2) Veneering technique plays a vital role in restoration longevity.
When it comes to long-term success, the placement of porcelain veneers is a technique sensitive process.
When placed in accordance with accepted tooth preparation and adhesive guidelines, they can be expected to provide the level of service mentioned above. But if not, a reduction in longevity can be expected.
a) Operator skill.
Your dentist's experience and skills can play a significant role. As an example of what degree of variability might be involved:
- A literature review by Swift (2006) cites a study that found the failure rate for porcelain veneers placed by dental students to be almost 80% higher than those placed by dentists on their faculty.
The ideal situation is one where the tooth surface a porcelain veneer is bonded to is 100% enamel.
b) Is the veneer bonded primarily to dentin or enamel?
Porcelain veneers can be highly serviceable restorations but only when bonded to the proper substrate.
- The strongest bond possible (veneer to tooth) is created when the entire surface of the tooth's preparation is enamel.
- A bond can be created with dentin (the tooth layer underneath a tooth's outer enamel surface) but doing so is far less strong and predictable.
(DiMatteo 2009)
Background.
When porcelain veneers were first introduced in the 1980s, the protocol used to place them primarily involved bonding them onto tooth enamel. And due to that, it's easy to explain the high success rates reported in many long-term studies (like those cited above).
Nowadays.
More recent trends in tooth preparation for laminates include greater (deeper) tooth reduction. And as a result, many veneer preparations nowadays contain large regions of tooth dentin, a situation that will likely negatively impact the high success rates previously reported.
At least a part of this trend is due to an (inappropriate) expansion of the applications for this procedure. Ones that require extensive tooth trimming so to be able to either:
- Realign severely misaligned teeth ("instant orthodontics").
- Mask the color of very dark teeth.
(With either of these applications, dental crown placement would be expected to make the more suitable type of restoration.)
What does research say about deeper veneer preparations?
The issue of how the current trend of greater tooth reduction (and therefore more dentin exposure) may affect veneer survival was the subject of a literature review performed by Burke (2012).
- This paper cited one study that concluded that roughly 25% of the cases they evaluated were "over-prepared" (involved tooth dentin) when compared to the original protocol for this technique. (Thus demonstrating that the suggested change in trends is occurring.)
- It also made mention that for at least one dental liability insurer in the UK, claims against dentists involving porcelain veneers doubled between 2005 and 2010. (Suggesting that current trends are affecting veneer success rates.)
- Of the 24 studies evaluated, 1/3 specifically related veneer failure to excessive exposure of dentin in the tooth's preparation, thus resulting in a conclusion by the reviewer that there is "reasonable evidence that a veneer preparation into dentin adversely affects survival."
An article by Newsome (2009) cites from dental literature:
- "Recent reports of 50% failure at six years and 34% fracture are disturbing when compared with 93% to 100% success rates of 15 years observation in the 1980s."
It also states ...
- "Recent UK data indicates a success rate for veneers placed within the General Dental Services in England and Wales of just over 50% at 10 years."
What should you do?
We understand that it's beyond the scope of the average patient to know if their case makes a reasonable application for the placement of porcelain veneers (in terms of the amount of tooth reduction needed). But it is easy enough to ask your dentist simple questions using terms that directly address this issue.
- The primary question at hand is simply if the veneer's entire preparation will lie solely in enamel.
- If not, will at least the margins (edges) of the veneer be bonded to enamel?
If the answer to either question is no, you have reason to ask your dentist to elaborate. There is no question that some degree of dentin exposure in the preparation is permissible, it's simply a question of how much and where.
Your dentist will need to explain the specifics of your case and how far from the ideal it lies. As well as to what degree this can be expected to affect longevity.
On their answer, you'll need to decide if the increased risk involved makes choosing veneers, especially as an elective procedure, a reasonable choice for you.
Tips (care and precautions) that can help your veneers last longer.
The lifespan of your porcelain veneers will be influenced by the way you use and take care of them. Here are some suggestions.
A) Practice good oral home care.
Around 6% of veneers that fail due so related to the formation of tooth decay. And about 13% due to complications with gum disease. (Bona 2008)
That means your veneered tooth, just like all of your teeth, should be brushed and flossed thoroughly on a daily basis. Ask your dentist for their recommendation but, in general, any non-abrasive toothpaste that contains fluoride should be suitable.
Since a veneer's edge lies right at the gum line, just a little gum recession can spoil its tooth's appearance.
Gum recession.
One reason to be extra diligent with your oral home care is related to gum-line recession.
The edge of a veneer ends right at or else just below the gum line. And if it recedes enough, although your laminate is still in excellent shape, its overall appearance may be one where it needs to be replaced.
Recession can be caused by not brushing well enough, brushing too vigorously or even a habit of clenching and grinding your teeth. Your dentist should be able to help you monitor what's going on in your case.
B) Avoid excessive forces.
While durable, porcelain veneers are not strong. They're not able to withstand extreme forces.
That means you should avoid activities that direct forces to them. This would include things such as biting your fingernails, hairpins, pencils, ice, or any other hard objects. Biting into hard foods, like raw carrots, could be a concern too. If you engage in sporting events, you should wear an athletic mouthguard.
C) Avoid clenching and grinding your teeth.
Due to the excessive forces that can be created, people who clench or grind their teeth (dentists term this habit bruxism) place their veneers at increased risk. One study (Beier 2012) found failure rates for people who brux to be 8 times higher.
Some people may be able to successfully control their bruxism during their waking hours. But during sleep, that's not possible.
If a person who bruxes does have laminates placed, they must be committed to wearing a plastic nightguard when they sleep, so to minimize the level of stress their veneers are exposed to.
The cement layer that lies between a veneer and its tooth has the potential to stain.
D) Minimize staining influences.
Due to its glass-like nature, a porcelain veneer will resist staining well. But the cement that's used to bond it in place is plastic, and it may discolor.
If it does, and this edge of the veneer is visible, its appearance will be spoiled.
Studies have reported that this type of staining (called marginal discoloration) occurs to some degree with roughly 20% of veneers. (Beier 2012)
Practicing good oral home care (meaning keeping plaque and debris from accumulating in this area) can help to prevent this problem.
Probably more important, you should minimize your exposure to staining agents such as tea, coffee, red wine, colas, and tobacco products. Beier (2012) found that people who smoke have a significantly increased risk for this type of discoloration.
E) Minimize temperature extremes.
A veneer that's been placed is a sandwiched affair. In its entirety, the restoration is composed of porcelain, cement and the surface of a tooth's enamel.
Each of these materials will expand and contract at different rates when exposed to the same temperature variations. And after many years, a point may finally be reached where restoration fatigued results in it cracking or breaking.
- Veneer basics -
- Placing veneers -
- Veneer emergencies.
- What to do if you have a veneer break or come off.
- Related pages -
