Dental veneers are thin, custom-made shells, typically fabricated from porcelain or composite resin, designed to cover the front surface of a tooth to improve its aesthetic appearance. They are a cosmetic solution used to address issues like discoloration, minor misalignment, or chips. The core requirement for successful veneer placement is a healthy tooth. Therefore, you cannot get veneers with active cavities; any existing tooth decay must be completely treated and the tooth restored before a veneer can be considered.
Why Untreated Decay Jeopardizes Veneers
Placing a veneer over tooth decay creates a sealed environment that accelerates the progression of the existing cavity. The decay-causing bacteria become trapped, and the veneer prevents saliva and brushing from reaching the area to neutralize acid or remove plaque. This rapid decay can quickly spread inward through the dentin toward the tooth’s pulp chamber, which contains the nerves and blood vessels.
If the decay reaches the pulp, it causes pain and necessitates a root canal procedure or, in severe cases, tooth extraction. Both treatments require the immediate removal of the veneer, undermining the cosmetic investment. The long-term success of a veneer relies on a strong, airtight bond to the tooth’s enamel. Bonding agents adhere poorly to soft, decayed dentin, resulting in a weak attachment that risks the veneer falling off prematurely. A compromised bond also allows oral fluids and bacteria to seep into the margin, leading to new decay around the edge of the restoration.
The Required Steps Before Veneer Placement
Preparing a tooth with decay for a veneer begins with a dental examination, including diagnostic X-rays to assess the depth and extent of the cavity. Once identified, the first mandatory step is the complete removal of all compromised tooth structure. This is accomplished by drilling out the softened, infected material, ensuring the underlying tooth is entirely clean and healthy before any cosmetic work proceeds.
After the decay is removed, the resulting space must be restored and stabilized, typically using a composite resin filling. This restorative material rebuilds the original tooth contour and provides a solid foundation for the veneer. The restored tooth must be structurally sound and infection-free before the cosmetic phase can begin.
Only after the tooth is completely stabilized does the dentist proceed with the traditional veneer preparation. This involves removing a thin layer of enamel, usually between 0.5 and 0.7 millimeters, to create space for the veneer shell. This preparation step is followed by taking an impression of the newly contoured tooth, which a lab uses to custom-fabricate the final porcelain veneer.
When Extensive Decay Requires Other Options
When tooth decay is extensive, a simple filling and veneer may no longer be a viable treatment option. If the decay has compromised more than half of the tooth’s structure, extends significantly below the gum line, or involves a substantial portion of the biting surface, the remaining tooth is too weak to support a veneer. A veneer only covers the front surface for aesthetic improvement and offers minimal structural reinforcement to a severely damaged tooth.
For teeth with large-scale damage, a full dental crown becomes the preferred alternative. A crown is a cap that completely encases the entire visible portion of the tooth, restoring its original shape, size, and strength. By covering all surfaces, the crown provides structural support and protects the weakened tooth from fracturing under chewing pressure. While a crown requires the removal of more original tooth material than a veneer, it is the only way to save and stabilize a tooth that has lost significant structure due to extensive decay.