In the ‘old days’, if a tooth or teeth needed to look very different, dentists would invariably crown it. The procedure required the removal of at least 1-1.5 mm of the external tooth around the tooth crown; a substantial amount.
Since the advent of ‘bonding’ technology (basically the ability to ‘glue’ material to the surface of a tooth), it has been possible to attach just an outside, single layer, of synthetic material, often much thinner in thickness. This obviously is a much less ‘invasive’ and so more conservative approach to achieve the same result.
The only downsides of veneers compared to crowns is that they are not as ‘retentive’ (depending on the bonding to one surface instead of ‘all the way round’) and they are more prone to failure long term; not just ‘detachment’ but also fracture. There, of course, situations where crowns are the preferred treatment option, most evidently when the natural crown is so badly damaged or missing, that a veneer simply ‘doesn’t do the job’.
A veneer is a synthetic cover attached or bonded to the outside surface of a tooth.
There can be a number of reasons for carrying out this treatment:
- To change the shape of a tooth. Widening a tooth can close unsightly gaps on one or both sides of it. Lengthening may restore its shape to what it should have been if it has been damaged or worn down.
- Bulking out may restore its appearance to be ‘in line’ with the arc, if it is naturally positioned too far ‘inside’.
- Whitening a tooth or teeth that cannot be ‘bleached, particularly if they have been root canal treated.
- Restoring the tips and so the length of canine teeth to protect the dentition from destruction caused by tooth grinding (bruxing).
- To complete a full ‘smile makeover’.
This is a plastic-like material applied in various layers and shades, by the dentist in the surgery and ‘hardened’ with a special light, then shaped and polished. The treatment is carried out in one appointment.
The material is much ‘softer’ than natural tooth enamel, and as such, cannot be called truly ‘long term’. Although it should look excellent when placed, over a few years the surface texture may dull and degrade. It is obviously more prone to natural wear and possible fracture.
Its advantages are that it costs less that the alternative (porcelain) and it may require very little or almost no underlying tooth ‘preparation’ at all. However, composite veneers need more ‘maintenance’ (polishing up every year or so) and are likely to need replacing after a few years.
Cost: £185 – £385 per tooth.
This is essential ‘china’; made by a dental technician in a small furnace on a model of the tooth to the design and ‘prescription’ of the dentist. Consequently, it takes at least two appointments; the first to ‘prepare’ and send to the lab; and the second, to ‘fit’.
Porcelain is actually marginally harder than human tooth enamel and far more so than quartz composite. The porcelain needs no ‘maintenance’ and should last for many years; as basically it does not degrade or wear down, (as does composite), so the appearance remains the same many years after the restoration is placed. These porcelain veneers do cost more and usually slightly more tooth preparation is required. In some cases that should be very minimal as the veneers would be almost entirely ‘add-on’. Occasionally after a number of years a veneer can ‘pop off (and so need re-bonding) or fracture (and need replacing) due to differences in flexure between porcelain and enamel.
As good as the composite can look, an excellent porcelain restoration always looks a little more ‘life like’. Unlike composite, porcelain certainly can be considered a ‘long term’ restoration and may well last ‘decades’.
Cost: £900 – £1,300 per tooth.
The fee ‘ranges’ quoted are determined by the degree of ‘difficulty’, the time required and the number of units (teeth) hat are being treated at the same time. Costs obviously vary across practices, depending on their location and the experience and expertise of the practitioner.