Dental veneers are thin, custom-made shells, typically fabricated from porcelain or composite resin, which are permanently bonded to the front surface of teeth to improve their aesthetic appearance. Veneers are designed to mask issues like discoloration, minor chips, or slight misalignment. A cavity is a hole in the tooth structure caused by dental decay, where bacteria produce acid that erodes the enamel and underlying dentin. Many people seeking a smile transformation wonder if they can cover existing decay with a veneer, but dental health requirements must be addressed first.
Why Cavities Must Be Treated First
Veneers cannot be placed directly over active dental decay because the underlying cavity is a progressive infection that requires elimination. Placing a veneer over a carious lesion seals the decay, trapping acid-producing bacteria and accelerating the destructive process. This hidden decay continues to spread rapidly, often going unnoticed until the problem becomes severe, leading to significant structural weakening of the tooth.
The trapped infection can quickly advance deeper into the tooth, potentially reaching the pulp—the nerve and blood vessel center. If the decay progresses to this stage, it can cause severe pain, abscess formation, or necessitate a root canal treatment or tooth extraction.
Successful veneer placement relies on a robust and stable foundation for a strong chemical bond. Decayed enamel and dentin are structurally compromised and cannot provide the healthy, clean surface needed for the specialized dental adhesive to work correctly. Attempting to bond a veneer to a decaying tooth results in compromised adhesion, making the veneer prone to premature failure or falling off.
Restoring Teeth Before Veneer Placement
Once active decay is identified, the first step is the meticulous removal of all infected tooth material. The dentist excavates the decayed tissue, ensuring only healthy tooth structure remains. This process halts bacterial spread and creates a clean environment for the subsequent restoration.
For smaller areas of decay, the tooth structure is rebuilt using a dental filling, most often a tooth-colored composite resin. The filling must be placed conservatively, optimizing the remaining natural enamel to maximize bond strength for the future veneer. This restores the tooth to a sound condition that can reliably support the cosmetic shell.
If the cavity is extensive and has compromised a large portion of the tooth, a simple filling may not ensure long-term stability. In cases of significant damage, a full-coverage restoration, such as a dental crown, may be necessary instead of a veneer. A crown encases the entire tooth, offering structural reinforcement when the remaining tooth material is too weak to support only a veneer.
Long-Term Care and Preventing New Decay
A veneered tooth remains susceptible to new dental decay, particularly at the margin where the veneer meets the natural tooth structure. This margin is the most vulnerable point, as plaque can accumulate and initiate decay just as it would on any other part of a tooth.
Maintaining meticulous daily oral hygiene is crucial for the longevity of the cosmetic work. Patients should brush twice daily using a soft-bristled brush and non-abrasive toothpaste, focusing on the gumline and the edges of the veneers. Flossing daily is important to remove plaque and food debris from between the teeth and around the margins.
Using an alcohol-free mouthwash is often recommended, as alcohol can potentially weaken the bonding agent over time. Regular professional checkups and cleanings are necessary for monitoring the integrity of the veneers and the health of the underlying tooth. The dentist can detect early signs of decay or issues with the bonding material that are not visible to the patient.
If decay forms under an existing veneer, the veneer typically needs to be carefully removed to treat the new cavity. This process often requires the fabrication of a replacement veneer.