Dental veneers are thin, custom-made shells, typically porcelain or composite resin, bonded to the front surface of teeth to improve appearance. They are a popular cosmetic solution for addressing issues like discoloration, minor misalignment, chips, and gaps. While veneers themselves do not inherently harm the teeth, the necessary preparation process involves a permanent alteration to the natural tooth structure.
The Tooth Preparation Process
The application of traditional veneers requires removing a small amount of the tooth’s outer layer, the enamel. This preparatory step prevents the final restoration from appearing bulky or unnatural on the tooth surface. If the veneer were simply bonded on top of the existing enamel, the tooth would look noticeably thicker and protrude.
The amount of enamel reduction is usually minimal, typically ranging from 0.3 to 0.7 millimeters. This precise removal creates the necessary space for the veneer to sit flush with adjacent teeth, ensuring a seamless aesthetic result. Dentists aim to be as conservative as possible, preserving the maximum amount of natural tooth structure. Since enamel does not regenerate, this removal is the primary reason the procedure is considered a permanent alteration.
Potential Long-Term Complications
One immediate concern after the procedure is increased tooth sensitivity, which occurs because enamel removal exposes the underlying dentin layer. Enamel acts as a natural insulator, and its reduction makes the tooth more reactive to hot or cold temperatures. This sensitivity is often temporary, but a dentist should be consulted if it is severe or persists.
A more serious long-term risk is the development of tooth decay on the underlying tooth. Although the veneer covers the front surface, the natural tooth remains susceptible to decay, particularly at the margins where the veneer meets the tooth structure. Poor oral hygiene allows bacteria to accumulate at these edges and potentially seep underneath the restoration, compromising the tooth’s health.
Gum inflammation or recession can also occur if the veneer margins are not perfectly smooth and properly positioned. An improperly fitted veneer can irritate the surrounding gum tissue, leading to redness, swelling, or the gums pulling back. This recession exposes the tooth structure beneath the veneer, creating an aesthetic issue and increasing the risk of decay. In rare instances, preparation or deep decay underneath the veneer can irritate the tooth’s pulp, potentially necessitating root canal therapy.
The Irreversible Nature of Veneers
The process of getting traditional veneers is considered irreversible because enamel is removed during the preparation phase. Since enamel cannot grow back, the prepared tooth surface must always be protected by a restorative material, such as a veneer or a crown. Removing the veneers without replacement would leave the tooth exposed, sensitive, and highly vulnerable to decay.
This decision requires a lifelong commitment to maintaining the restorations. Veneers do not last forever; porcelain veneers typically require replacement every 10 to 15 years, while composite veneers may need replacement every five to seven years. The replacement process involves removing the old veneer and bonding a new one, establishing an ongoing maintenance cycle. This cycle ensures the modified tooth structure remains protected.