Veneers

A laminate, a veneer, and a laminate veneer are really the same thing. They are a thin, fingernail-like covering that is cemented over the face side (front) of the natural tooth to improve aesthetics, tooth position, and also to address possible decay or a fracture.

Laminate veneers may cost anywhere in the range of $800 to $3500 per tooth, depending on a dentist’s expertise and training. Any additional treatments such as soft tissue procedures (crown lengthening or gingivectomy) or bonding on adjacent teeth in conjunction with the laminate veneers are not included.

Laminate veneers are usually made with a biocompatible ceramic material like porcelain or e.max. Porcelain looks quite natural with its translucent properties, but it is weak and may be prone to fracture in patients with excessive biting forces. E.max, on the other hand, is a lithium disilicate, which is aesthetic, translucent, and has four times the strength of porcelain. In most cases, dentists and patients will prefer e.max as the material of choice for laminate veneers.

The complete laminate veneer treatment for 10 teeth usually requires two longer appointments (3 hours each) and one shorter follow up visit (15–20 minutes). The first visit will include the preparation, impression making, and temporization of the 10 teeth. The second visit, which is usually shorter than the first visit, involves the removal of the provisionals and cementation of the final laminate veneers. A short post-insertion appointment to evaluate the gingival tissues is usually recommended two weeks after cementation.

Yes, but rarely. Laminate veneers are typically stronger than your own teeth and exhibit excellent bond strength to the enamel. If they do break or fracture, it is usually attributed to teeth grinding (bruxism), thin or weak ceramic material, or misalignment of the bite. When the laminate comes off (termed debonding), is usually due to contamination during the cementation process or not enough bonding surface on the prepared tooth.

Usually every 12–15 years, depending on the amount of gingival recession that has occurred over time. Laminate veneers can last 30 years or more if little to no gingival recession has occurred. Patients usually replace the laminate veneers due to recession which exposes dark, unsightly root surfaces near the gumline.

We often recommend bleaching their teeth prior to laminate veneer treatment, if a patient’s natural teeth are darker than the desired shade. We advise bleaching the teeth because: first, the patient may be content with their tooth shade after the bleaching process and not require the laminate veneers after all; second, it will lighten the underlying tooth structure prior to placing the new veneers. Since the most aesthetic laminates are translucent like natural teeth, we recommend starting out with a lighter underlying tooth shade instead of a darker one for the best possible results.

A crown is a covering or replacement tooth when a restoration is placed over the entire natural tooth to protect it from decay or fracture. This usually requires the removal of the entire enamel layer of the natural tooth. In most cases, a laminate veneer only requires 0.5mm removal of the enamel layer on the facial and incisal (face and biting) surfaces. A laminate preparation is more conservative compared to a crown preparation, because the integrity of the underlying tooth structure preserved. After cementation, laminate veneers are usually stronger and more esthetic than their crown counterpart. Nonetheless, if a tooth is severely broken down due to decay or fracture, a crown is the prudent choice.

Laminate veneers are expensive due to the extensive dentist's time needed to satisfy the patient's esthetic demands and also due to the high laboratory cost. Patients should select a restorative dentist, preferably a prosthodontist, with extensive training in esthetics and smile design in order to achieve natural and functional results. Finding a dentist with expertise in laminate veneers is often difficult. Many restorative dentists offer laminates in their practices, however these often achieve unsightly results which appear too bulky, monochromatic, and white. In order to make strong natural looking restorations, a skilled dentist will always contract the services of a master dental technician. As a result of the precision, artistry and back-and-forth communication required between the technician, dentist and patient to produce esthetic results, the highest quality laminate veneers are the most expensive.