Dentistry is one of those professions where many people think the actual "work" done by each dentist is similar. After all, a filling is a filling is a filling, right?
Not so. In reality, just like any other profession, all dental work is not created equal. To give an example, we have seen the bad veneer makeovers glowing in the dark ("chicklet teeth"), and the dental crowns with black lines showing thru the gums.
Besides the dentist's skill, a large part of poor-looking cosmetic dental work is determined by the ceramist that your dentist chooses to work with. Dentists can use a small "boutique" style ceramist that will custom create each tooth like a work of art; or they can opt for a machine-made veneer from a national chain type laboratory that spits them out "quickly and cheaply"... sometimes 90 percent less than the boutique will charge!
I have my own point of view here. Although some of them have been nice, overall, I've never been a fan of the machine made ceramics. So in 2002, along with world-renowned ceramist Yasu Kawabe from Japan, I founded Oral Design Boston, a ceramics laboratory on Newbury Street in Boston, MA. There, I was involved extensively in developing the technical and laboratory portion of high end porcelain veneer fabrication -- from importing rare porcelain vacuumed furnaces from Germany and Hawaii, to testing microscopes and elaborate porcelain combinations. I took this level of involvement because understanding and managing every step on the process is vital to ensure superb porcelain aesthetics when dealing with high-level cosmetic dentistry.
Now, I am not saying that you need to go to a dentist who's gone through the level of involvement that I have with the fabrication of ceramics. My patients like my work and are happy I go to the lengths I do, but thousands of people go a dentist who uses the machine-made route, and they are perfectly happy with the work they receive. And that's fine. It's up to you and what "look" you prefer, and also what you can afford.
Here are a few examples of people who have been helped by porcelain veneers.
Linda presented with multiple cosmetic complaints: severe wear that had shortened her teeth, discoloration and missing molars that showed in her smile. It took a combination of feldspathic porcelain veneers, porcelain to gold crowns and porcelain to gold bridgework to reconstruct Linda's entire mouth.
Howard presented with multiple cosmetic complaints: old mismatched crown work, an uneven gum-line and many dark areas framing his smile. Howard's gum line discrepancy was treated with laser gum surgery. We then used a combination of porcelain to gold crowns and all porcelain crowns to reconstruct Howard's entire mouth.
Sarah presented with six old, discolored and poorly made veneers. In addition, the teeth that surrounded Sarah's existing veneers were discolored and were not previously treated. We prepared Sarah's teeth and placed 20 feldspathic porcelain veneers to correct the cosmetic issues.
Pam presented with discolored natural teeth that were non-responsive to dental whitening. We prepared Pam's teeth and placed twenty feldspathic porcelain veneers to correct the cosmetic issues.
Dottie presented with a large space between her front teeth that she had always disliked. The teeth were also resistant to bleaching. Dottie received ten porcelain veneers to close her space and bring balance to her smile.
Fary presented with severely discolored natural teeth that were non-responsive to dental whitening, along with a severe open bite. We prepared Fary's teeth and used 20 Emax veneers to correct the cosmetic issues.
Brit presented with small teeth and a gummy smile. We performed an extensive laser gum reduction and placed 10 porcelain veneers to correct Brit's smile.
Follow Thomas P. Connelly, D.D.S. on Twitter: www.twitter.com/dr_connelly