Composite Veneers

Composite veneers – a viable (and cheaper) alternative to porcelain veneers? It would seem, watching TV these days, that any makeover would be incomplete without dental work to “straighten and brighten” the smile. Is just me, or are the SURGEONS themselves looking a tad made-over as well? Smile reconstruction is normally achieved by the use of porcelain veneers – fine, thin pieces of porcelain overlaid on top of dental enamel. Working with porcelain is expensive and it is not uncommon for treatment plans to exceed the $10,000 mark. Is there an alternative? Well, happily, there may be, in some cases.Composite, has been the restorative workhorse of dentistry for quite some time.

The word “composite” refers to the ingredients used to make this material – a combination or “composite” of resins and fillers to achieve life like tooth colours, strength and wear resistance. Many of you would already have composites in your mouth – it’s what your dentist would use for “white” or “tooth coloured” fillings. Newer generations of composite materials allow for very lifelike colours and translucencies making these fillings nearly invisible to the untrained (and occasionally, trained!) eyes. If the required modification to tooth colour and alignment is not extensive, then composite veneers – a thin layer of composite instead of porcelain – could be utilized to improve both alignment and colour of teeth. Costs are, in almost all cases, markedly less than what the same treatment would cost if carried out using porcelain.

Figure 1 and 1a – 8 composite veneers and 1 porcelain crown was placed here. The crown is the lateral incisor on the left. These took me 4 hours to complete, 3 hours to place and an hour a week later for final finishing.The hardest thing was to match the porcelain to the composite both in colour AND in surface contouring – teeth are NOT perfectly smooth and the contours have to look natural.

The teeth were bleached before starting.You can see that the shape of all the teeth were recontoured in composite, and the teeth further back were “built up” to show more tooth and to create a more “youthful” looking smile.

There is a catch though (isn’t there always). A huge advantage of porcelain restorations is that they are fabricated in a laboratory – the restorations can be tweaked and adjusted to a very high degree. Colour, shape, characterizations (e.g. white spots) can be easily introduced into these restorations, and modified till things look as you want them to. Composite veneers have to be done “on the fly” so to speak, with the veneers sculpted in the mouth. The procedure is very technique sensitive and moisture control is very important, as moisture from saliva (or your breath!) can affect the bonding of these veneers to the tooth. The downside from all this is that a set of eight composite veneers can sometimes take up to three hours to place, sculpt and finish; the upside is that it often costs a fraction of the cost of porcelain.

Aside from costs, there are a number of advantages to this procedure. There is little need to remove tooth structure so the procedure is nearly always reversible. Secondly, composites can often be repaired, so if a fragment breaks off, it can often be invisibly fixed, something that cannot be done with porcelain. There are also drawbacks. You nearly always end up with teeth that are slightly thicker than your natural ones as composite is “added” on the surface of your teeth. It is also often very difficult to mask discoloration on very dark teeth with composite, although opaqueing agents can help with this. Composite is not has hard wearing as porcelain so these restorations will need yearly polishing to maintain their luster and surface gloss.

How long will these veneers last? I would suggest that 7 years would be a decent amount of time before either replacement or refurbishing is needed. In refurbishment, a new layer of composite may be overlaid after thinning the original veneer.

If you are considering these, be sure to ask your dentist if he or she is experienced in doing these and if he or she is comfortable doing these – some dentists aren’t and they can be fiddly things to do. If you are considering either porcelain or composite and would like whiter teeth, you may have to consider having your teeth whitened before embarking on the placement of these restorations as composite/porcelain WILL NOT WHITEN!

These veneers are NOT suitable if you have issues with clenching and grinding your teeth, and there are other concerns that you would affect the suitability of these in your mouth. You should discuss this with your dentist.