Sunday, November 27, 2011

Are there Healthy Alternatives to Dental Veneers?

What are the main reasons for getting teeth veneers? 
In the world of dentistry, Veneers are mostly done for purely cosmetic reasons – they are an elective treatment. To most patients that ask me if they ‘need veneers, as a doctor, my answer is a simple “No.” However, as cosmetic dentist, I understand and oblige when a patients ‘wants’ veneers for personal reasons. I tell patients that porcelain veneers are a conservative dental procedure that restores the appearance of discolored, fractured or misshaped teeth. The procedure consists of bonding a thin piece of ceramic on to the surface of teeth. In many case the enamel surface (typically only 0.5mm) of the teeth is lightly prepared to eliminate the stain or fracture and accept the veneer. Veneers can drastically enhance the appearance of one’s smile.

Are there procedures that can improve natural teeth, eliminating the need for veneers? 
In dentistry, there is no ‘need’ for veneers, it is a matter of what the patient ‘wants’. Cosmetic enhancements that may substitute a veneer procedure may include; teeth whitening to eliminate stain; cosmetic bonding to enhance the shape of small, gapped or fractured teeth; and/or replacing old fillings with new, more cosmetic ones. 
There have been cases in my private practice - where after discussing options - the patient elected to have cosmetic bonding rather than veneers. Cosmetic bonding is a procedure where resin-composite material is sculpted over stained, fractured or misshaped parts of teeth. Bonding is more conservative than veneers. 

What procedures can result in veneer-perfect natural teeth?
An expertly crafted cosmetic bonding procedure, especially in combination with teeth whitening can create a very cosmetic result. Sharp or uneven edges can be shaped and smoothed by a conservative procedure called 'enamelplasty'. Air-abrasion procedure can removed tenacious surface stain to whiten the surface of teeth.  

What oral care products or habits would you recommend for gorgeous natural teeth?
Colgate Total or Crest Pro-Health toothpaste along with a soft-bristled toothbrush and floss used after meals will help reduce build-up of plaque and stain. Stain actually adheres more to teeth covered in plaque. Foods such as coffee, tea and red wine can stain, especially after prolonged use. Helpful hint: drink water after using coffee, tea or red wine. Water helps hydrate the gums and rinse away stain before it sets in.

What are the drawbacks to veneers?
Veneers are a non-reversible procedure. The cost can range from $900-$1500 per veneer. They require the same care that regular teeth do - flossing and brushing twice a day for 2 minutes. People with veneers must pay particular attention to biting into hard foods, such as sourdough breads and chocolate. Stress from hard foods, nail-biting, or clenching and bruxing of teeth can fracture porcelain veneers. I recommend all patients with veneers to wear a protective occlusal guard at night (also know as night-guard). Regular dental visits for professional cleanings and check-ups are highly recommended to ensure longevity and health of veneers.

Would you recommend veneers instead of braces or other teeth straightening methods? 
If a patient is happy with the natural shape, size, color and look of their teeth, I would not recommend veneers. However, veneers may be a good solution for a patient with peg-laterals (genetically small, peg-shaped teeth), discolored or fractured teeth (conditions that cannot be fixed by braces). To straighten gapped or crowded teeth with braces can take anywhere from 8 months to 2 years. Veneers can accomplish this in just two visits. The advantage of braces, is that the occlusion (bite) can be improved and the natural tooth structure is preserved. Conserving natural healthy tooth structure is the goal of dentists focused on oral health. The question of veneers or brace ultimately depends on the patients wishes.

For any questions about oral hygiene or healthy foods, feel free to ask!

Best Regards, 

Dr. Josh Berd, DDS
Dentist and Educator
San Francisco, California

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