The placement of dental veneers involves bonding thin, custom-made shells to the front surface of teeth to improve cosmetic appearance. The direct answer to whether veneers can be placed on “rotten” teeth, or teeth with active decay, is no. However, a tooth with previous decay that has been fully treated and restored may still be a candidate. The decision depends entirely on the current health and structural integrity of the tooth, which must be evaluated by a dental professional.
Why Active Decay Makes Veneers Impossible
The primary function of a dental veneer is cosmetic, relying on a strong, clean tooth structure for successful placement. Active decay is a major contraindication because veneers require a healthy surface, usually enamel, for the bonding agent to create a durable seal. Decay destroys this hard tissue, leaving a compromised surface that cannot properly adhere to the shell. Without strong adhesion, the veneer is likely to fail prematurely, potentially leading to chipping, loosening, or falling off.
Placing a veneer over an active cavity traps decay-causing bacteria inside the tooth structure. This sealed environment allows the decay to progress rapidly and aggressively, often undetected because the veneer hides the visual signs. The accelerating decay can quickly reach the tooth’s inner pulp, leading to nerve damage, pain, infection, and potentially requiring a root canal or extraction.
Decayed teeth also lack the necessary structural stability to withstand the bonding process and the normal forces of chewing. The tooth structure must be sound to support the thin, rigid veneer. A decayed tooth is inherently weaker and cannot reliably withstand the pressure applied during bonding or the daily stress of biting.
Required Dental Repairs Before Considering Veneers
Before a veneer can be considered, active decay must be eliminated to create a healthy foundation. For minor decay, the infected material is removed and the space is filled with a simple restoration, often a tooth-colored composite resin. This filling stabilizes the tooth and ensures the surface is clean before the veneer process begins.
If the decay is deep and has progressed close to the pulp, the tooth may require root canal therapy to remove the infected nerve tissue. Following a successful root canal, the tooth must be asymptomatic and free of infection. If significant tooth material has been lost, a core build-up is often necessary to replace the missing structure and create a stable base for the veneer preparation.
The goal of these preparatory treatments is to restore the tooth to a state of health that can support the veneer long-term. A thorough dental examination, including X-rays, confirms the absence of decay and ensures the tooth has sufficient healthy enamel for secure bonding. If the tooth remains too compromised after restoration, a veneer may not be the appropriate solution.
When Veneers Are No Longer an Option
When decay is severely extensive, the tooth may be too compromised for reliable restoration with a veneer, even after all active decay is removed. A general guideline for exclusion is when a tooth has lost a large amount of its natural structure, such as over 50% damage, or if decay extends significantly below the gum line. Veneers are intended for fundamentally healthy teeth needing cosmetic enhancement, not for those requiring comprehensive structural reinforcement.
When the tooth cannot support a veneer, a full-coverage crown is often the next step. A crown fully encases the entire visible portion of the tooth, providing complete structural reinforcement and protection. This is a much stronger solution than a partial-coverage veneer for a heavily repaired tooth, addressing both structural weakness and cosmetic appearance simultaneously.
In the most severe scenarios, where damage renders the tooth non-restorable, extraction may be the only option. Following removal, replacement solutions are necessary to restore function and appearance. These options typically include a dental implant, which replaces the root and tooth structure, or a fixed bridge, which uses adjacent teeth for support. Determining the extent of the damage and the best path forward always requires a professional assessment using clinical examination and diagnostic imaging.