You may have heard the term “veneer” with reference to woodworking, where it means a thin layer of attractive wood that covers and enhances the surface of a piece of furniture. Exactly the same principle applies to porcelain veneers used in dentistry: A thin layer of ceramic material is used to cover parts of a tooth in order to improve its structure and appearance.

Porcelain is a non-metallic ceramic material that is fired in an oven at a high temperature to make it hard and durable. Dental porcelain veneers are thin layers of ceramic that can be applied to the outside of the tooth so that the end result mimics the natural color and translucency of tooth enamel. The underlying tooth structure has to be prepared by removing a small amount of the enamel, about 1 mm, which the veneer replaces. The veneer is then bonded to the prepared surface using a light-sensitive resin.

In woodworking, a veneer may be used to match the grain between the left and right sides of a piece of furniture, creating a beautiful effect on a curve, or simply to bring the appearance of expensive wood to a backing that is less expensive.

Just as a wood veneer improves the appearance of a dresser or table, porcelain laminate veneers may be used to improve teeth that have a number of cosmetic and functional problems. These include staining that cannot be removed by tooth whitening, teeth that are too small, misshapen, chipped or spaced too far apart. After an assessment of your teeth and your smile, we can create a mock-up using temporary tooth-colored materials so you can decide whether the suggested changes will work for you, or you can make suggestions for further improvements.

Porcelain laminate veneers may not be the best solution for you if your teeth are severely stained or damaged. In cases where a large proportion of the original tooth must be replaced, porcelain crowns may be the best solution. The crown is the part of the tooth that is visible above the gum line, and it can be covered with a porcelain crown that looks exactly like a tooth in shape and color. After studying your needs, together we can decide on the most satisfactory method to restore your most attractive smile.

Contact us today to schedule an appointment to discuss your questions about porcelain veneers. You can also learn more by reading the Dear Doctor magazine article “Porcelain Crowns and Veneers.”

Even with good dental hygiene and care, your teeth may show signs of wear as you age. Fortunately, we now have ways to treat these symptoms of aging and restore a youthful look and function to your teeth and jaws.

How Do Teeth Wear?

All the tissues in your body are constantly in a process of breaking down (catabolism) and rebuilding (anabolism). During childhood the anabolic processes exceed the catabolic processes. But after you have reached physical maturity the balance changes and the breakdown process begins to draw ahead of the building up. The result: signs of wear.

In your teeth, the outer layer, the enamel, is a hard, mineralized substance that is resistant to wear. Under the enamel is a layer called dentin, which is a living tissue something like bone. As teeth age, the dentin layer thickens, causing teeth to lose some of their whiteness. Most wear to your teeth comes from the pressure of the upper and lower teeth's biting surfaces against each other. How much wear occurs depends on your bite or occlusion (how the teeth are aligned, and how they meet) and the ways in which you use your teeth.

Constant interactions between the biting surfaces of your teeth result in removal of small amounts of enamel. Your body naturally compensates for this wearing away of material. As teeth wear, they erupt from your jaws by tiny amounts, moving slightly up or down to stay in the proper occlusal relation with the teeth on the other jaw. They also slowly move toward the front of your mouth.

If the wear becomes excessive, your body can no longer compensate for it. At this point you may find that your bite relationships are not working correctly, and the lower third of your face loses height. This creates or accentuates an older appearance.

Some people clench or grind their teeth, applying greater than normal — and damaging — forces to their teeth. This problem, often a reaction to stress, is called bruxism. It can cause a number of problems from jaw pain to loose teeth or excessive wear or tooth fractures. If you suffer from excessive wear due to bruxism, a professionally made mouthguard may prevent further damage.

Modern Dentistry Can Restore a Youthful Look

Modern dentistry can successfully restore the normal shape, appearance and function of worn teeth by installing porcelain crowns or veneers. These not only replace the tooth structure lost through wear, but they also restore the bite relationship. Crowns on excessively worn teeth can dramatically improve tooth color and facial appearance, resulting in a more harmonious, younger look.

Contact us today to schedule an appointment to discuss your questions about dental wear and aging. You can also learn more by reading the Dear Doctor magazine article “How and Why Teeth Wear.”

Your smile is one of the first things people notice, but if your pearly whites have lost their luster, chances are you might be hesitant to show them. As we age, our teeth naturally darken, and certain substances can leave teeth stained or discolored, making you appear older. One easy way to turn back the clock is to have your teeth whitened; a safe, painless, and non-invasive way of achieving a young, healthy-looking smile.

Causes of Tooth Discoloration: Exposure to high-levels of fluoride and taking tetracycline antibiotics during childhood can stain the teeth's structure. Smoking cigarettes and using chewing tobacco can also cause tooth discoloration, as well as foods containing tannins such as red wine, coffee and tea. In addition, poor brushing techniques and not flossing regularly cause bacteria to build on teeth resulting in yellow stains.

The Whitening Process: Our office can help you to achieve a brighter smile using either an in-office procedure or an at-home whitening kit. We can help determine the best treatment for your budget, time frame and individual needs. If you choose to have professional whitening done in our office, we will utilize a prescription strength gel sometimes even activated by a concentrated light source. This procedure offers immediate and long-lasting results in less than an hour. After a single treatment, teeth are typically six to ten shades lighter and with proper maintenance, can last five years or longer.

At-Home Results: For those seeking more gradual results, another option is to use custom-fit trays, which our office will make for you to use at home to whiten your teeth. This is generally less expensive, and is very effective at lightening teeth several shades, although it may take a week or longer to see optimal results.

Choosing the Best Procedure: For some people, teeth whitening may not offer adequate results. If you have thin enamel, chipped, uneven or crooked teeth, we may recommend applying porcelain veneers to restore your damaged teeth. Veneers are bonded to the front of teeth to give your smile a straighter, more uniform appearance.

Contact us today to schedule an appointment to discuss any questions you may have regarding teeth whitening. Read more about this topic in the Dear Doctor magazine article “Teeth Whitening: Brighter, Lighter, Whiter.”

You may have noticed, as you get older, that the enamel of your teeth is looking worn in certain areas. Sometimes tooth wear takes the form of a minor chipping or fracturing at the incisal (cutting) edges of the teeth, or a loss of tooth material from the area near the gum line. In more severe cases, worn teeth look quite a bit smaller than they used to. Why does this happen?

Some wear with age is natural. But too much wear can interfere with your bite, expose more sensitive inner parts of the tooth to decay, and give you a more aged appearance.

There are things you can control that affect wear:

Your habits: Clenching or grinding habits, also called “bruxism,” is a major cause of tooth wear. The motion of teeth sliding over each other with forces that are beyond what's normal for biting or chewing causes a mechanical removal of tooth enamel. This can happen during sleep or periods of high stress. In either case there are therapies available, such as a thin, professionally made mouthguard that prevents your teeth from coming into contact with each other. Holding foreign objects, such as nails and bobby pins, between your teeth can also cause wear.

Your diet: Tooth enamel can be eroded (dissolved away) by acidic beverages, such as sodas, sports drinks and juices. Frequent snacking on sugary foods encourages the growth of oral bacteria that produce acid as a byproduct — also leaving your teeth vulnerable to tooth decay. Your saliva can buffer the effects of the acid in your mouth in about half an hour; if you consume these types of foods and beverages continually, there won't be enough time for this to work.

We can restore the appearance and function of worn teeth in a variety of ways. Porcelain crowns and veneers, for example, can re-establish the normal thickness and length of teeth while improving their color and giving you a more youthful appearance.

If you have any questions about tooth wear, please contact us today to schedule an appointment for a consultation. You can learn more about tooth wear by reading the Dear Doctor magazine article “How And Why Teeth Wear.”

Designing a better smile sometimes requires a change in the size, shape, or color of your teeth. Porcelain laminate veneers (thin layers of dental ceramic material) enhance your appearance by replacing the natural enamel on the outside of your teeth. A veneer is physically bonded to the surface of a tooth, in essence, becoming part of it.

Traditionally, a small amount of the natural tooth enamel is drilled away to allow room for the veneer. But today, in some circumstances, it is possible to use an approach where enamel reduction or preparation is not necessary because the veneers can be bonded directly onto the tooth's natural surface. These are called “Prepless” or “No-prep” veneers, and are used to create aesthetically pleasing and natural looking restorations. An advantage of the prepless procedure is that the process is reversible so that you can give your new smile a “test drive.”

You may be a good subject for Prepless veneers if:

• Your smile is narrow because the teeth in the sides of your smile are positioned inward and do not show from a frontal view.
• There is spacing between your teeth, and the teeth appear too small.
• You have a fairly common genetic condition in which one or both of the teeth directly next to the two upper front teeth are very small and peg-shaped.
• There is an imbalance between the size of your lips and teeth (large lips and small teeth), which are not in proportion to show off your best smile.

Prepless veneers are probably not for you if:

• Your teeth are not aligned properly in your bite.
• Your teeth are very crowded, resulting in poor facial profile.
• Your teeth are already relatively large or positioned forward.

In these cases you may need to have some form of orthodontic treatment to move your teeth into better position. Sometimes veneers can be used to create an illusion of proper tooth alignment, but some amount of tooth reduction may be required.

We can assess whether prepless veneers are right for you. There is no substitute for an expert dentist's talent and expertise with the various cosmetic techniques available today. These skills combined with a thorough diagnostic evaluation, and a clear understanding of your goals, are the keys to providing you with a successful and beautiful smile.

Contact us today to schedule an appointment or to discuss your questions about cosmetic dentistry. You can also learn more about prepless veneers by reading the Dear Doctor magazine article “Porcelain Veneers Without the Drill.”