Dental veneers are thin, custom-made shells of porcelain or composite material designed to cover the front surface of an existing tooth to improve its appearance. Veneers are not replacements for missing teeth; they require the presence of a natural tooth structure to function correctly.
Veneers are bonded to the natural tooth using a strong dental adhesive. This process is highly dependent on the tooth’s outermost layer, the enamel. A small amount of enamel, often between 0.3 and 0.7 millimeters, is typically removed from the front surface to create space for the veneer and ensure it does not look bulky or unnatural.
The strength and longevity of a veneer depend on the quality of the bond achieved with the enamel. Adhesion to enamel is stronger and more predictable than bonding to the softer underlying layer, dentin. Specialized bonding agents penetrate the etched enamel surface, creating a powerful mechanical and chemical connection.
If a tooth lacks sufficient enamel, or if the structure is severely compromised, the bonding strength is drastically reduced. Veneers bonded primarily to dentin or other restorative materials are prone to detachment or failure over time. Therefore, an intact, healthy tooth structure is a prerequisite for successful veneer placement.
Preparing Compromised Teeth for Veneers
The presence of a tooth does not guarantee a veneer is the correct restoration, especially if the tooth is compromised. Veneers are cosmetic enhancements intended for structurally sound teeth with issues like discoloration, minor chips, or small gaps. They do not provide significant structural support to a damaged tooth.
If a tooth has severe decay, a large existing filling, or a significant fracture, it may require a different kind of restoration. If a tooth is severely damaged, dentists may perform a core build-up to replace lost structure before placing a covering. This rebuild restores the tooth’s shape but does not always make it a candidate for a veneer.
For extensive damage, a full dental crown is often the better solution, as it covers the entire tooth. A crown provides structural reinforcement to a weakened tooth, a function a thin veneer cannot perform. Preparing a tooth for a crown involves removing significantly more tooth structure—sometimes up to 60-72% of the coronal structure—compared to the minimal reduction for a veneer.
The decision between a veneer and a crown depends on the percentage of healthy tooth structure remaining. For example, if less than 30% of the tooth structure remains, or if the tooth has undergone root canal treatment, a full-coverage crown is generally the preferred choice. If the structural integrity is questionable, a veneer is avoided due to the high risk of failure.
Solutions When Teeth Are Missing Entirely
If a tooth is missing completely, a veneer is not an option because there is no natural structure to bond to. The focus shifts to replacing the entire missing tooth to restore function and appearance. Several reliable restorative options are available for replacing missing teeth.
Dental implants are the most effective and durable solution for single missing teeth. This involves surgically placing a titanium post into the jawbone, acting as an artificial tooth root. This implant then supports a custom-made dental crown, creating a replacement that looks, feels, and functions much like a natural tooth.
A fixed dental bridge is a non-removable device used to span the gap created by missing teeth. A traditional bridge requires crowns on the adjacent natural teeth, which serve as anchors for the prosthetic tooth. Unlike an implant, a bridge does not require surgery, but it does necessitate modifying the neighboring healthy teeth.
Removable partial dentures offer a less invasive and more cost-effective option for replacing multiple missing teeth. These appliances consist of replacement teeth attached to a gum-colored base, often with clasps that attach to the remaining natural teeth. While removable for cleaning and offering less stability than implants or bridges, they provide a viable way to restore appearance and chewing ability.