“Does it hurt? How long will it last? How long will it take? How much does it cost?”
These are common questions from patients looking for cosmetic dentistry.
If you’re interested in cosmetic dentistry to get yourself a winning
smile, whether the problem is mis-alignment, cracked or chipping teeth,
unsightly spacing, uneven or dark colored dentition, uneven or too much
(or not enough) smile showing, or even gum erosion, the eternal
question always arises: What would be the best solution?
In the past, crowns were the primary choice for masking tooth
problems, but since the late 1980s, cosmetic dentistry has offered both
bonding and veneers to improve your smile. This leads to the eternal
question: “Bonding or veneers?”
Dental bonding involves the application of a durable composite
material directly to the surface of the tooth, by your dentist, which
is then sculpted and artistically shaped to the exact look the patient
desires, to blend naturally and seamlessly with the patient’s existing
teeth. A laser (or high intensity light) is then used to cure the
composite material, hardening and reinforcing it to the surface of the
tooth. This bonding technique has many applications, not only for
aesthetic uses but also for prosthodontics and pediatric dentistry. The
advantages to dental bonding are a quick treatment time (can be
completed in one office visit after a consultation), and a relatively
low cost per tooth when compared with porcelain veneers. Durability of
bonding will be affected by the oral environment. Since composite
bonding is a mixture of quartz particle (70% – 80% filled) and resin,
discoloration and breakage is inevitable if your mouth has a high
acidic pH value (if you are a soda drinker, lemon lover or candy
sucker), if the bonding was not supported by a solid tooth structure,
or if you are a night grinder.
Porcelain veneers are fabricated in the laboratory. They are 100%
filled with hard mineral particles, and are fired at a high temperature
with a vacuum (to procure the best physical properties to sustain the
veneer’s strength in the harsh oral environment). Compared to bonding,
there is more procedural work involved with porcelain veneers. There
are different techniques to fabricate the veneer pieces (which call for
different methods of preparation for the tooth); the pressing technique
produces a stronger veneer, but requires 0.8mm thickness of the veneer.
The porcelain powder build-up technique can produce super thin veneers
(0.3mm), which produces a very conservative look on your tooth
structure, while at the same time keeping a natural silhouette. The
veneer piece lays on top of the tooth structure and is similar to a
press-on nail. They chemically adhere to the tooth with bonding
composite cement; since porcelain is acid resistant and stronger in
physical properties than composite material, this restoration provides
long-term service. When getting the veneers, the first visit consists
of preparation and imprints f the teeth (which might involve
anesthetic). After this, you will leave the office with temporary
veneers which look like natural teeth. A wafer-thin veneer is then
crafted out of porcelain which is seamlessly cemented to the front side
of the tooth on the second visit. In addition to straightening teeth,
porcelain veneers can close gaps between teeth, whiten teeth that do
not respond well to bleaching, and can also be used to protect damaged
tooth surfaces. The advantages to porcelain veneers over bonding is
that veneers are much longer lasting (and stronger) than composite
bonding material.
Whether you decide to invest in dental bonding or porcelain veneers,
make sure you have all work done at a reputable dentist, preferably at
a practice which has its own in-house ceramic lab. When ceramic work is
done by an in-house lab with an in-house ceramist, any changes that
need to be made to the length or color of the veneers can be done
without requiring an additional office visit. Remember, the result of
the cosmetic procedures are truly varied depending on the ability of
the dentist, ceramist, your clinical situation and the communication
between all parties involved. Do your research!
Both bonding and veneers are additive procedures, depending on the
position, alignment and shape of your teeth, which is the foundation
for any new restorations. This foundation will need to be in the right
fundamental situation to receive restorations to result in a fabulous
smile. In other words, sometimes, you do not need to do much to your
own teeth before applying cosmetic restorations. It might be necessary
to reduce or modify the tooth structure before anything can be added
onto it to make it look perfect.
There is some risk involved with cosmetic bonding or veneers, so be
cautious with any cosmetic procedure. A comprehensive evaluation of
your present dental condition is absolutely necessary as a first step;
blue prints of your teeth and of your prospective dental project are
needed to establish clear verbal communication between all parties
involved (including you), including possible mock-up or wax-up models
to preview possible changes, which could avoid costly mistakes.
