Composite veneers on upper teeth only

[CompVeneers]

Hi there,

I'm 23 and have a relatively small gap between my two front teeth as well as a slight "kant" (I think it's spelled that way!). My dentist recommended invisalign to improve my smile - but after close examination then instead recommended composite veneers - but only on my 8 upper teeth.

From what he's told me - there are no drawbacks and no dangers to getting composite veneers.

My aim with the veneers would be to make my smile look "good", or at least "normal". However, my dentist has also told me that there will be a slight colour difference between the veneers on my upper teeth, and my natural lower teeth. Won't this look odd and ruin my smile?

I'd really appreciate your thoughts!

 

[Busybee]

Can you post a photo of your smile?

Composite veneers are not drawback free. To attach the material you have to etch the tooth enamel with a type of acid. Despite whatever dentists tell you, the composite cannot be removed easily and your teeth will never be quite the same if you try to remove it. It gets bonded to your teeth. I'm not sure whether your dentist plans to have these lab made or to put them on freehand. If the latter then you are basically reliant on the dentist being really talented at making teeth that look natural and attractive. This is not a skill all dentists have. Some dentists think something looks natural when it looks nothing like a real tooth.

It is the least invasive cosmetic dentistry process you can have but it's not as simple as you have been told. The next alternative would be porcelain veneers which require removal of almost half the tooth. It's find to do all these things as long as you are aware of the risks and the fact that it is never going to be an untouched natural tooth again. You may need retouches and that might mean changing them all to ensure a good colour match. Eight teeth is a lot of work. But the best thing about going down this route is that you can keep having it redone with minimal trauma to your teeth. Whatever you do, do not be talked into porcelain veneers.

I honestly do not understand why your dentist is thinking of doing this using a different colour from your natural teeth. That makes him sound unethical and inept. If your natural teeth are darker then that would force you to bleach them going forward. Perhaps that is his plan, because bleaching is a nice little earner.

There is no risk free dentistry but if you go down the composite route find a dentist that is really experienced at this and is really good at using the technique. Some dentists are gifted at this but they will have examples of their work. Or you can just have one peripheral tooth done to see how it will look and how you feel about it. There's not much risk to that compared with all eight.

If it were me then I'd find someone good and just have the two front teeth done and see how you feel after that. If done well you may not want any more work..

 

[MattKW]

Show us a photo of your teeth.
Full coverage veneers sometimes just make it more compolicated than necessary, and make the front teeth noticeably thicker. In many cases it is easy enough to do a quick mockup of the composites without using etchant. After you have a look to see if you approve of shape and colour, they are flicked off. Takes me 5-15 minutes.

 

[CompVeneers]

Thank you for the responses!

Pictures of my teeth before & after mock ups below:

Price quoted for 8 veneers: £2,200 ($2,765)

Since the original pictures, I have had whitening as recommended.

Many thanks!

 

[Busybee]

I prefer your natural teeth to the mock up. Not only is yours a nice natural colour but the shape is normal too. The lateral incisors are a little smaller that's all. If I were you I would not let anyone talk you into having 8 teeth done.

There's nothing wrong with the canines and premolars. The gap between the front teeth is tiny. You don't need a bright white smile and composite is not the material to try to achieve that. If you start having your canines veneered you could end up compromising your bite in future years. Has the dentist said that he/she plans to cut into your natural tooth before placing these veneers? If you have lab made veneers then it's normal to shorten the tooth (to strengthen the restoration) and to reduce the front so that the veneers aren't too bulky. This is irreversible.
.
My personal opinion is that your natural teeth look nice, the shape is fine and the colour looks good. What is it that most bothers you about them?

The trouble is that once you start going down this route, if you don't like the result then you can't just change back, particularly if the dentist cuts into the tooth for a lab made veneer. With lab made veneers you can't bite your nails or get the kind of cutting edge that a natural tooth has. You can end up with sensitivity and they can chip over time.

I think you're being sold a pup. Particularly in being told you need 8 teeth done! The result does not look natural in my opinion and composite does not carry a long term guarantee for good reasons. Porcelain veneers only have guarantees of five years. This means having to go back and have it all redone every decade for the rest of your life. You may eventually end up with crowns or root treatments from all the trauma. You cannot turn back the clock once you touch your front teeth.

If I were you I'd go for a number of consults and get a few different opinions. There are some very good dentists who can advise you on the least invasive way to give you the result you would like. Go with the dentist who goes for the most conservative route.

 

[CompVeneers]

Thank you so much for the detailed response, I really appreciate it so much!!!

The dentist didn't mention anything about cutting into any teeth. The veneers are composite and will be put on by the dentist all in one day. I've been told that the composite veneers will need to be replaced roughly every 5 years.

Things that bother me about my teeth:
- Tooth gap
- Front upper teeth are not fully aligned with the rest of my face (dentist said they were at a slight "kant" but I can't seem to validate if this is a real word)
- Shapes could be better - the mock up veneers look a tad fake but also look amazing to me!

Can non-lab made composite veneers cause extra sensitivity? My teeth are already sensitive so I am quite scared about this.

 

[Busybee]

Yes non lab composite can cause sensitivity to get worse. The process requires the teeth to be etched with acid which can make the tooth more sensitive. Sometimes this fades, Sometimes it doesn't. It depends on how well the process is carried out and what is wrong with the tooth to start with. The worst case scenario is a root treatment if you end up with chronic sensitivity/pain by a badly done procedure.

Shapes could definitely be better. Has anyone checked that you will not have interference in your bite from these changes?

The front tooth gap itself is easy to fix and you don't need veneers for this. Just a bit of composite on both teeth bonded by someone who knows what they are doing. It's also very cheap (less than £200).

So spending £2000 every 5 years for the rest of your life is ok?

I would go for more consultations and focus on the gap in the central incisors if that is what bothers you. If you think about it, having to have these replaced every five years - what harm is there in starting with what bothers you most rather than having 8 healthy teeth tampered with?

 

[MattKW]

1. I think you're going the wrong way about this. Bleach your teeth first as much as you can first, then add composite to close the gap between your centrals, matching in the colours of your newly whitened teeth.
   
2. Any veneer added onto the front of a tooth makes it thicker, and that makes it much harder to clean; I have seen a number of sad cases with decay develop unnecessarily and catastrophically between the teeth. I see this as a particular issue with your lateral incisors which are slightly set back mesially.
   
3. The rounding of the tips on your canines is very questionable. Usually the way you chew won't allow this, and they will fracture off. How many times do you think the dentist will replace them for free before he gives up altogether?
4. Keep It Simple Stupid - the KISS principle. Don't do more than you have to, taking into account all the risks. You cannot ever get natural teeth back once you go down the restorative path.

 

[CompVeneers]

My dentist hasn't even mentioned anything about bite - I'm not sure what this is? I also have wisdom teeth still to come through but the dentist said it is a myth that these move the other teeth and so they will have no effect on the veneers.

Is there any way to perfect the surface and shape of the upper central & lateral incisors without the veneers? If not, do you think it would be possible to just have veneers done on these to improve the look of my smile, without leaving my smile looking odd?

Really appreciate all the help!

 

[MattKW]

By "bite", I mean when you move your teeth through all the motions of eating, the canines with their sharp points often pass tightly against the lower canines. Bulking out the upper canines will sometimes stop this easy movement, and the veneers will get a lot of pressure and snap off.
True about wisdoms - they have no effect on the alignment of front teeth. The action of chewing as we do in a hinge produces an anterior vector of force unless you take out ALL the molars! A bit drastic.
As you might perceive, I am conservative in my dentistry. I'm not keen on veneers because they are often for cosmetic reasons, rather than functional reasons or If you have really discoloured teeth then it becomes a psychological issue. They come with risks that i don't see often explained to laypeople - this is not like having false fingernails. Your teeth are normal colours, so at most I would suggest bleaching as a non-invasive procedure. My teeth are off this scale at ~D4.
If you want to tidy up the appearance, then maybe consider simple orthodontics, Just be ready for life-long maintenance.

 

[CompVeneers]

So overall, you heavily recommend against the procedure right?

 

[CompVeneers]

Sorry - I've just re-read everything all in one go.

The recommendations are to:
- Go for various consultations and see what other dentists recommend for improving the shape of the lateral incisors and also the shape/slant of my central incisors
- Try to go for the most conservative treatment
- Don't get all 8 upper teeth veneered

I'd just like to say again - thank you SOOOOOO much for all your help and patience with me! I really, really, really appreciate it! You may have saved me years of trouble and thousands of £!

 

[Busybee]

That sums it up. Please let us know how you get on.

 

[CompVeneers]

Received an ultimatum from my dentist, need to let him know by 1PM today!

I asked four questions:

1) Damage to natural teeth - I believe you said there would be no damage to the natural teeth from composite bonding (and damage would only occur if a dentist made a mistake, or something along these lines?). I was told that the teeth are etched with acid during the process and the "natural teeth will never be the same again" - and that as a result of this I'll always have to get veneers going forward - I wouldn't be able to go back to just having my natural teeth without veneers and them looking the same. Are there any guarantees or is there a safety net in case of this?

2) It was heavily recommended to me not to have my canines and premolars veneered as "there is nothing wrong with them", my "bite could be compromised" in future years and that given the shape of my canines, veneers would be likely to frequently fracture off. My real issues are with the slant of my two central incisors, the gap between them and the shape of the lateral incisors. Would it look weird or sub-optimal to just have these done?

3) I've been told that the acid etching can in some cases cause chronic sensitivity. Is there any insurance or guarantees protecting me if this were to be the case?

4) Would you be able to do a mock up on the day of whichever teeth we go forward with - as the mock up on the three teeth looks great - but I still don't know how my real smile would look with the mock ups done on either side of my mouth?

Response:

1: I mentioned no damage as I’m not drilling your enamel. Etched is needed for any kind of treatment of bonding nature. Whether for braces, ceramic or composite veneers or normal white fillings
The only guarantee we give is that if the veneers are chipped within 2 years of placement then free repair or replacement is available

2- the reason we agreed on the 8 veneers was for slightly wider smile. You could only have treatment on your 4 front teeth and forget about other teeth, etch is still needed for bonding on those,
Your centrals not only slanted but slightly misaligned therefore you need some sort of full coverage on one to align with others otherwise best is Invisalign to align first and need to go about 5-6 months and then just some edge bonding which you didn’t want in the first place.
Your canines may need edge bonding
These veneers won’t compromise your bite.

3- I haven’t had any patient who has experienced chronic sensitivity however again there is no guarantee for this as normal teeth could become sensitive for various reasons.

4- further mock up could be done in addition to the complimentary one you had before
It would however be chargeable.

Please do let us know by 1pm today should you want to go ahead with your treatment as I have booked you for the entire 5 hours. In case you would like to cancel or alter the appointment we need to hear from you by this time to avoid administration fee which is equal to your deposit.

Does this seem a reasonable response? Any recommendations on whether to cancel (which would leave me too embarrassed to ever go back to this dentist) or proceed with having a mockup with just 4 veneers and seeing whether they look good?

 

[Busybee]

Hi, you should not be psychologically pressured to have treatment if you are still not sure. We cannot make the decision for you. But it's perfectly reasonable to postpone such treatment if you are not ready to make a decision and you are not sure whether you are doing the right thing. You should not feel embarrassed about doing that. If you do not feel comfortable going back then how can you feel comfortable you will be able to communicate any concerns to this dentist? You have already paid a deposit? You said you already have sensitive teeth. Is your dentist aware of that? The dentist mentioned that no patient had "chronic sensitivity" which indicates some have experienced short term sensitivity. Etch is not needed for invisalign as far as I am aware. But that comes with other risks and the need to wear a retainer usually for life.

There is no risk free dentistry so if you don't need any it's best to leave your teeth alone. But if you do want something changed on your front teeth it is best not to rush that decision because you will be living with the results.

 

[CompVeneers]

Phoned up and was quoted £35 for the mock up on each tooth so I've cancelled that appointment. Will book consultations with other dentists to see what they recommend.

Thank you so much for all your help! Feels like a huge weight has been lifted off my shoulders now !

 

[Busybee]

If you feel like a weight has been lifted then you have definitely made the right decision. You should never feel pressured to have cosmetic work done on your teeth when you are not ready. Please keep the thread going when you have updates with different opinions. I'd love to know what they recommend and the outcome.