Advice on Veneers From: Kevin Cook (kevin.cook@mindspring.com) Subject: Advice on veneers Date: 2001-03-21 07:24:08 PST I am giving some consideration to getting several veneers, both for cosmetic and medical reasons. My dentist basically has me sold on them, but I would like to do some research on my own before getting started to ensure that this will be a worthwhile investment. Can anyone recommend some websites or internet resources to help me learn more about them? I am particularly interested in unbiased medical opinion as well as consumer opinion. From: Mark & Steven Bornfeld DDS (markh@peoplepc.com) Subject: Re: Advice on veneers Date: 2001-03-21 11:11:00 PST This is as good a place as you're likely to find on the internet. Anything specific you'd like to know? They're not a panacea, but done in appropriate instances they work very nicely and patients are usually very happy. What medical reasons do you have for getting them? Steve Mark & Steven Bornfeld DDS Brooklyn, NY 718-258-5001 http://www.dentaltwins.com/ From: Joel_Eichen (joel_eichen@excite.com) Subject: Re: Advice on veneers Date: 2001-03-21 15:08:13 PST How old are you and why are they being recommended? From: Kevin Cook (kevin.cook@mindspring.com) Subject: Re: Advice on veneers Date: 2001-03-21 21:05:38 PST I'm 34. I have a great deal of bonding covering a long history of decay, most of which is on the front surfaces of my teeth and are quite noticeable. Long story short, my teeth are pretty darned ugly, and I want to improve my smile. The recommendation is that the veneers will protect my teeth from further decay, and will be worth the expense as a better long term alternative to bonding. From: Kevin Cook (kevin.cook@mindspring.com) Subject: Re: Advice on veneers Date: 2001-03-21 21:06:05 PST Steve, "Medical reasons" may not have been the best choice of words - let me explain. Essentially, I have a mouth full of composite. Every tooth, top and bottom, has at least one filling, many have several. The majority of the decay has been on the outer (front facing) surface, primarily at or near the gum line, and many of the fillings are quite large. In some cases, so much tooth structure has been lost that my dentist has recommended some crowns (probably two or three teeth in various locations). A few others are on their way to the same recommendation. I am told that porcelain veneers are a better long term solution for the teeth that do not require crowns as they will protect my teeth from further decay and eliminate the need for periodically replacing my existing fillings (and some of the older ones do need replacement). As much as the state of my teeth may sound like I am pretty negligent when it comes to dental hygiene, trust me, that's not the case! I anticipate that what I believe to be a genetic proclivity to tooth decay will continue until all the enamel is gone! So by medical reasons, I really meant that there is a basis other than just cosmetic reasons for considering this, in that veneers may help to preserve what is left of my teeth. OK, so there is some vanity basis! Of course I don't need veneers for all my teeth, but if I am getting a few caps, and potentially some veneers for a few teeth whose future without them may be questionable, then this may be the best opportunity to voluntarily cover up some of the more noticeable teeth that are speckled with discolored bonding and really improve my smile. I just endured braces for almost two years, so I am committed to making improvements! I am not exactly wealthy, and veneers are certainly not cheap, so I need to be comfortable that this large expense is the right thing for me. I like my dentist a lot, and I don't doubt that his recommendations are what he believes to be the best thing to do. I just have some reservations about this, and want to make an educated decision because there is no going back once I've done it. Here are my concerns, and the questions that I hoped to answer by finding some sort of forum with feedback from others who have gotten veneers: -Are they secure enough that I can eat corn on the cob and bite into apples, and basically just not worry about them coming off? -How likely are they to last ten years at a minimum, perhaps 20, or potentially a lifetime (I'm 34)? -Could there really be a long term savings over doing bonding (and replacing it periodically) as an alternative? -Are they as comfortable as natural teeth? Thanks in advance for your insight and advice! Kevin Cook From: Joel_Eichen (joel_eichen@excite.com) Subject: Re: Advice on veneers Date: 2001-03-22 03:52:19 PST Teeth that are susceptible to decay may be better served with crowns. From: Mark & Steven Bornfeld DDS (markh@peoplepc.com) Subject: Re: Advice on veneers Date: 2001-03-22 07:28:08 PST Veneers are indeed restorations in the reparative sense, not just a cosmetic procedure. What Joel said is true; that for patients with uncontrolled decay, crowns sometimes are a better choice, since there is less tooth structure, and esp. less restorative margin exposed to the oral environment. But porcelain is hard, pretty, and resists stain. It does not have great shear or flextural strength. This means that chewing on pens, pencils and chicken bones is out. One could say the same for porcelain/metal or all ceramic crowns. I would give the edge on esthetics to porcelain laminate veneers or all ceramic crowns. The appearance of porcelain/metal crowns is usually quite acceptable though. The edge on strength goes to the porcelain metal crown. Of course, more tooth structure must be removed in order to prepare a tooth for a crown than for a veneer. Frequently any of the above options may be quite acceptable. The selection is a judgement call, based on the factors I mentioned above. Steve From: DrCnBseen (drcnbseen@aol.com) Subject: Re: Advice on veneers Date: 2001-03-23 11:09:09 PST Hi Joel, You wrote: << Teeth that are susceptible to decay may be better served with crowns.>> Although we may agree on this point, the bottom line is teeth that are susceptible to decay may be better served by improved home care. Stan From: Gabriel Schugurensky (gaboschu@sinectis.com.ar) Subject: Re: Advice on veneers Date: 2001-03-24 11:08:29 PST Kevin: Q: -Are they secure enough that I can eat corn on the cob and bite into apples,and basically just not worry about them coming off? A: Yes, they are secure, just do it slowly and carefully, do not abuse of crowns nor normal teeth (I mean don't bite like a hungry teenager and don't open beer bottles with your teeth) Q: -How likely are they to last ten years at a minimum, perhaps 20, or potentially a lifetime (I'm 34)? A: If you brush and floss enough, and might use some clorhexidine mouth rinse, or something like a Listerine (ask your dentist) to help you fight the bacterial plaque, they are likely to last longer than a lifetime. I agree with Dr. Bornfeld about metal-porcelain crowns having better flextural strength, and about that more dental tissue must be removed for the preparation, porcelain might crack in both kind of crowns, (but it would be a repairable accident) Q: -Could there really be a long term savings over doing bonding (and replacing it periodically) as an alternative? A: I would think so! remember the hole in a tooth gets BIGGER each time a filling is changed, so if you continue doing it at some point you'll reach the time when you do crowns or... crowns or...a removable prothesis after extraction. Q: -Are they as comfortable as natural teeth? A: Yes they are! Cheers ,Dr. Gabriel Schugurensky From: Kevin Cook (kevin.cook@mindspring.com) Subject: Re: Advice on veneers Date: 2001-03-24 11:22:18 PST I don't disagree that this is really the best advice of all! Honestly, I really do the best that I believe I can. I brush and floss constantly. In fact, having had braces recently, I am in the habit of carrying a brush and paste wherever I go! Still, despite a dental hygiene regimen more aggressive than anyone I know, I still have new cavities waiting for me at every six month checkup. From: TriStateF (tristatef@aol.com) Subject: Re: Advice on veneers Date: 2001-03-25 20:54:06 PST Just make sure you know the long term issues with all your options. For example, make sure you can afford all re-dos and touch-ups that may be needed in the future. From: DRLFINCHER (drlfincher@aol.com) Subject: Re: Advice on veneers Date: 2001-03-28 16:02:05 PST Veneers are better than bonding, being porcelain instead of plastic, but they won't protect cavity prone teeth from decay. Full coverage crowns will do this. But for optimum cosmetics you want ALL porcelain crowns. These are best available from a "CEREC" dentist. Look that up on a search engine. One of the most difficult aspects of cosmetic dentistry and crowns, or veneers is the effects of the temporary crowns you wear while you are waiting for the lab to make the permanent ones. CEREC eliminates this altogether. You can have your treatment finished in one visit and have no temporaries or impressions to worry about. If you don't like one of the CEREC's the dentist can make you another one on the spot. Check it out! Larry Fincher DDS From: JustDa2th (justda2th@aol.com) Subject: Re: Advice on veneers Date: 2001-03-28 18:05:04 PST One of the drawbacks to CEREC is the fact that they are monochromatic. If you're looking for the ulitmate in esthetics, this is a problem. BTW, this is also a problem with Emress, but it can be addressed by having the lab do a cut-away technique and then add some other shaded porcelain where you want it. CEREC doesn't allow for this. Sometimes monochromatic will work, but how many anterior teeth are truly monochromatic? From: Nelson (pitrat@ctaz.com) Subject: Re: Advice on veneers Date: 2001-03-28 21:26:01 PST Nice hidden advert, doc. There is not much evidence for this statement. Cerec is good, but not there yet in fit. just my opinion. From: Dr. Steve (drsteve@mancusodds.com) Subject: Re: Advice on veneers Date: 2001-03-29 07:25:50 PST Frank, The full coverage Cerec crowns look great on premolars and molars right out of the machine. There is enough translucency and enough richness to the color that they generally look better than PFM's. To do cuspid to cuspid really requires custom staining and glazing. The variation of color in a natural tooth is much greater here. I am quite amazed at how good these things can look as full crowns! Stephen Mancuso,D.D.S. drsteve@mancusodds.com Troy, Michigan USA From: Dr. Steve (drsteve@mancusodds.com) Subject: Re: Advice on veneers Date: 2001-03-29 07:28:32 PST Frank, The fit is comparable to a laboratory porcelain margin. You can still get a better marginal adaptation with a gold margin. But,,,,,,,,,,,,,,,, is it significant?? Stephen Mancuso,D.D.S. drsteve@mancusodds.com Troy, Michigan USA
