Dental veneers are thin, custom-made shells bonded to the front surface of teeth, offering a popular cosmetic solution for enhancing a smile. While durable, veneers are not permanent restorations and will eventually need replacement. Replacement is a routine procedure in cosmetic dentistry, allowing patients to maintain their desired aesthetic long after the original set has reached its functional or aesthetic limit.
Expected Lifespan and Causes for Replacement
The necessity for replacement is closely linked to the material chosen. Porcelain veneers typically offer the longest service life, often lasting between 10 and 15 years, sometimes up to 20 years. Composite resin veneers are a more affordable option but generally have a shorter lifespan, usually requiring replacement within five to seven years.
Several factors dictate the timing of replacement, even for well-maintained veneers. Physical damage is a common cause, such as chipping or cracking from biting hard objects or experiencing oral trauma. Over time, the bond between the veneer and the natural tooth can degrade, causing the restoration to loosen or detach, necessitating rebonding or full replacement.
The health of the underlying natural tooth structure is also a concern. If decay (recurrent caries) develops beneath the veneer, the shell must be removed so the dentist can treat the cavity.
Gum recession is another biological reason for replacement. As the gums pull back, they expose the dark margin where the veneer ends and the natural tooth begins, creating an aesthetic issue.
The Clinical Process of Replacing Worn or Damaged Veneers
The replacement process begins with the controlled removal of the existing shell. For porcelain, the old veneer is typically removed by carefully sectioning the material using specialized dental burs to break the cement bond. This step requires precision to minimize compromising the underlying tooth structure or removing additional natural enamel.
Once detached, the dentist performs a thorough assessment of the remaining natural tooth. This evaluation checks for signs of decay, microfractures, or structural damage that may have occurred underneath the restoration. Any decay must be removed and the tooth repaired before proceeding with the new veneer preparation.
Next, the tooth surface is re-prepared, often involving re-shaping or refining the existing enamel layer to create an ideal surface. An impression or digital scan is then taken and sent to a dental laboratory for the fabrication of the custom replacement veneers. The patient typically wears temporary veneers during the one to two weeks it takes for the permanent ones to be crafted.
In the final placement appointment, the temporary veneers are removed, and the tooth is cleaned and prepared for bonding. The interior surface of the new veneer is etched with an acid to promote a strong mechanical bond with the dental cement. The veneer is then precisely positioned, and a light-cured resin cement is used to chemically bond the restoration to the enamel. Final adjustments and polishing complete the procedure.
Long-Term Care and Future Considerations
Following replacement, patients may experience minor tooth sensitivity, particularly to hot or cold temperatures, as the tooth adjusts to the new bonding material. This sensitivity is usually temporary and resolves within a couple of weeks. It is prudent to avoid extremely hot or cold foods immediately after the appointment.
To maximize the longevity of the new restorations, a meticulous home care regimen is advised. Patients should use a soft-bristled toothbrush and non-abrasive toothpaste, as abrasive pastes can scratch the veneer surface and dull its polish. The use of a custom-fitted night guard is recommended if a patient grinds or clenches their teeth (bruxism), as repetitive stress can lead to chipping or fracture.
Regular six-month checkups are necessary for professional cleaning and monitoring the integrity of the veneer margins and surrounding gum tissue. If the underlying tooth structure becomes compromised after multiple replacements, a full dental crown may be considered. Crowns encase the entire tooth, providing greater reinforcement than a veneer, making them a better long-term solution for a tooth that has lost too much original tissue.