COSMETIC DENTISTRY

Veneers are made of very thin tooth-colored porcelain.

• Veneers can change the size, shape and color of teeth.
• Veneers are porcelain and will not stain.
• Veneers remove minimal tooth structure and are the most conservative porcelain restoration

In having a veneer, some inherent risks exist both to the tooth and to the veneer itself. The risks to the tooth are:

• Preparation for a veneer permanently alters the tooth underneath the veneer.
• If the cement seal at the edge of the veneer is lost, decay may form at the juncture of the veneer and tooth.
• Preparing for and placing a veneer can irritate the tooth and cause “post-operative” sensitivity which may last for up to 3 months.
• Teeth which have had veneers may need root canal treatment less than 1% of the time during the lifetime of the tooth.

The risks to the veneer are:

•  Porcelain may chip over time.
•  If the tooth needs a root canal treatment after the veneeris permanently cemented, the procedure may fracture theveneer and the veneer may need to be replaced.

Alternatives to placing a veneer are to either leave the tooth as is or to place a composite restoration. Composite restorations remove decay but are limited because they will stain more and do not change the size and color of teeth as well as veneers.

Bite problems may lead to the veneer chipping or breaking.

• Porcelain on a veneer may have a good color match with  adjacent natural teeth when the veneer is placed but less of a  match as your natural teeth age. 
• A veneer may chip or break if used for abnormal activities (e.g.,  biting fishing line, sewing thread, biting finger nails, opening  bottles). 

• When the rehabilitaiton of the mouth and bite need to be staged over time
• When the teeth are abnormally worn
• When patients have bite problems that cause muscle pain, joint problems, headaches, and other bite related disorders

• The material is a very hard tooth colored resin designed to last for the length of time needed to transition teeth to definitive restorations such as onlays or crowns
• The resin restorations are typically made either by a dental laboratory or milled in the dental office from 3D computer imaging

• Transitional Resin Restorations allow a patient to “test drive” the new bite. These restorations can be modified if changes are needed while adapting to the new bite
• Transitional Resin Restorations allow for phasing treatment over a longer period of time. The low cost, relative to final restorations (onlays and crowns), allows more patients the ability to have comprehensive dental care
• Transitional Resin Restorations are minimally invasive and easily repaired

• Transitional Resin Restorations are not meant to last more than a few years
• If a patient does not proceed with replacing the Transitional Resin Restorations, after a few years they may break or come loose
• If they are not monitored and repaired by your dentist, they may wear enough to change the bite, bringing back symptoms that were relieved with your initial treatment
• Over time, bonding can fail and decay can develop underneath the resin
• Sometimes, flossing and home care can be more difficult

Alternatives include :

•  Direct resin restorations – these require much more time in the dental chair
• Proceeding with the final restorations all at once

• Professional teeth bleaching can be done in the dental office or with a take-home kit. Both of these approaches typically use a peroxide-based bleach solution to bleach your teeth.
• Teeth bleaching done in the dental office involves applying the strong peroxide material to your teeth for a period of time. This bleach solution is removed at the end of the appointment. During the appointment, a laser or other light may be used to increase the effectiveness of the in-office bleaching. Regardless of whether the light is used or not, you will leave the office with noticeably lighter teeth.
• Some dental offices prefer to send patients home with professional take-home teeth bleaching kits. These include your custom-made teeth trays, plus a supply of peroxide-based bleaching solution. The trays are worn for a period of time each day according to your dentist’s instructions. Generally, the take-home kit lasts a few weeks during which your teeth become noticeably lighter.

• Professional in office bleaching provides the most immediate results.
• Professional take home bleaching has the most research proving its effectiveness and is less costly than in office bleaching.
• Combined in-office and home bleaching results in a more pronounced color improvement when compared to both techniques used individually.
• Non-professional bleaching systems have more risk of complications [i.e. tooth sensitivity] and are less predictable.

• Professional in-office bleaching is the costliest teeth bleaching option. It also usually requires some take-home treatment to achieve the most lasting outcome.
• Professional take-home bleaching often takes several weeks to produce the desired outcome. The effectiveness of the teeth bleaching depends on your ability to comply with wearing the trays as directed.

Some inherent risks exist with any teeth bleaching system. The following factors should be taken into
consideration when deciding to bleach your teeth.

• There is a risk that your teeth or gums will become sensitive to the bleach solution and the treatment may need to be discontinued before the desired color is achieved.
• In the most extreme case, teeth bleaching may lead to such a tooth sensitivity that root canal treatment is required in order for the sensitivity to resolve.
• Teeth bleaching will not alter the color of your existing dental restorations. Sometimes dental work must be replaced if you want to match the color of your new lighter teeth.
• Those people with poor dental home care or diets containing foods that stain such as coffee, red wine,
  tea or berries may find that their teeth become stained again more quickly than expected. Normally teeth bleaching must be repeated periodically to maintain the brightness of your smile.