Veneers

Veneers were invented by a California dentist named Charles Pincus . At the time, they fell off in a very short time as they were held on by denture adhesive. They were, however, useful for temporarily changing the appearance of actors’ teeth.

Research started in 1982 by Simonsen and Calamia revealed that porcelain could be etched with hydrofluoric acid, and bond strengths could be achieved between composite resins and porcelain that were predicted to be able to hold porcelain veneers on to the surface of a tooth permanently. This was confirmed by Calamia in an article describing a technique for fabrication, and placement of Etched Bonded Porcelain Veneers using a refractory model technique and Horn describing a platinum foil technique for veneer fabrication. Additional articles have proven the long-term reliability of this technique.

Today, with improved cements and bonding agents, they typically last 10-30 years. They may have to be replaced in this time due to cracking, leaking, chipping, discoloration, decay, shrinkage of the gum line and damage from injury or tooth grinding. The cost of veneers can vary depending on the experience and location of the dentist. In the US, costs range anywhere from $1000 a tooth upwards to $2500 a tooth as of 2009. Porcelain veneers are more durable and less likely to stain than veneers made of composite.

Indications

Veneers are an important tool for the cosmetic dentist. A dentist may use one veneer to restore a single tooth that may have been fractured or discolored, or multiple teeth to create a “Hollywood” type of makeover. Many people have small teeth resulting in spaces that may not be easily closed by orthodontics. Some people have worn away the edges of their teeth resulting in a prematurely aged appearance, while others may have malpositioned teeth that appear crooked. Multiple veneers can close these spaces, lengthen teeth that have been shortened by wear, provide a uniform color, shape, and symmetry, and make the teeth appear straight.

The problem of overuse of porcelain veneers by certain cosmetic dentists has been profiled in the book, ‘Confessions of a Former Cosmetic Dentist’. The author suggests that the use of veneers for ‘instant orthodontics’ or simulated straightening of the teeth is harmful, especially for younger people with healthy teeth. Many cosmetic dentists agree that porcelain veneers can be used improperly and can exploit patients.