Dental veneers are custom-made, thin shells designed to cover the front surfaces of teeth, improving their appearance by changing their color, shape, or size. They are a common cosmetic dentistry treatment used to address various aesthetic concerns like chips, cracks, gaps, or discoloration. This article explores what happens to the natural tooth structure underneath these cosmetic enhancements.
Tooth Preparation
The process of placing dental veneers involves an irreversible alteration to the natural tooth. To create space and ensure a natural appearance, a small amount of enamel is removed from the front surface of the tooth. This typically involves shaving off approximately 0.3 to 0.7 millimeters of enamel, an amount comparable to the thickness of the veneer itself. This preparation prevents the veneered tooth from appearing bulky and allows the veneer to bond flush with the natural tooth surface. Because enamel does not regenerate, this permanently changes the tooth’s original structure, requiring a covering.
Protection and Long-Term Health
Once bonded, veneers provide a protective layer over the prepared tooth. The strong adhesive bond forms a seal, safeguarding the underlying enamel or dentin from bacteria and acids. This protective barrier shields the tooth from decay and wear. Properly bonded veneers contribute to the tooth’s integrity, maintaining its health. The non-porous materials used for veneers, such as porcelain or composite resin, resist decay on their surface.
Potential Concerns Underneath
Despite the protective qualities, issues can arise if the bond is compromised or the tooth was not initially healthy. If tiny gaps form in the adhesive seal, micro-leakage can occur, allowing bacteria to penetrate beneath the veneer. This bacterial ingress can lead to secondary caries, or decay, developing on the natural tooth structure.
Sensitivity to hot or cold temperatures may develop if enamel removal exposes the dentin, the layer beneath the enamel containing nerve endings. Aggressive tooth preparation or deep decay can irritate the tooth’s nerve, potentially leading to significant discomfort or the need for a root canal. These problems often progress silently because the decay is hidden beneath the opaque veneer material.
Maintaining Health
To ensure the continued health of the tooth beneath the veneer, consistent and diligent oral hygiene is important. This includes brushing at least twice daily with a non-abrasive toothpaste and flossing once a day to remove plaque and food particles from around the veneer margins and between teeth. Regular dental check-ups and professional cleanings are also necessary for monitoring the integrity of the veneers and the health of the underlying teeth. Avoiding habits that could compromise veneer integrity, such as biting hard objects or using teeth as tools, protects the bond and natural tooth. Wearing a nightguard can protect against damage from teeth grinding.
When Veneers Need Attention
Dental veneers are not permanent and may need replacement over time, with porcelain veneers typically lasting 10 to 15 years and composite veneers lasting 4 to 8 years. If a veneer becomes chipped, cracked, or debonded, the underlying prepared tooth can become exposed, increasing its vulnerability to sensitivity or decay. Replacing an old veneer involves carefully removing it and any remaining bonding material. The underlying tooth remains prepared, and may require minor re-shaping or cleaning before a new veneer can be bonded. The condition of the tooth at this stage largely depends on its health prior to the veneer’s removal.