The whole truth about veneers: who should they be and how to avoid the “false mouth” effect

Veneers: disadvantages and advantages

Veneers are used to restore the outer surface of tooth enamel. They differ from artificial crowns:

• partial closure of the tooth surface (crowns are a “cap” that covers the tooth, including from the sides);
• To install veneers, the enamel is partially ground off (it is enough to remove a layer 0.5-1 mm thick)
• used only for the restoration of front teeth (incisors, canines, less often premolars), which are visible when smiling or talking.

The common advantage of all veneers is the achievement of a good aesthetic result with the least traumatic effect on the tooth. The main disadvantages include the fact that veneers cannot solve all aesthetic problems. Other pros and cons depend on the type of veneers and the materials from which they are made.

The main disadvantages and advantages of different types of veneers

What are veneers

Veneers are also called microprostheses. Their main goal is to restore the original appearance and shape of one or more teeth in a row. Most often, the products are used to correct elements located in the smile area.

Restored elements are difficult to distinguish from real ones, since the selection of material takes into account the natural color of the patient’s enamel. Plates are used in situations where other restoration methods do not produce results. This correction technique allows you to correct dental defects in the shortest possible time.

Removable veneers: pros and cons

Removable veneers are a structure that is applied to the entire dentition of the upper and lower jaw (you can purchase such an overlay only for the upper or lower teeth). These veneers are made of plastic and are placed on top of the teeth. Dental glue or silicone is used for fixation. The pads are worn as needed (at work, during a photo shoot), then removed. These products are not dental prostheses; they can be purchased (and used) independently, without consulting a doctor, for relatively little money: the price does not exceed 2000-3500 rubles. The most common among them:

• Perfect smile veneer . Made in the form of a continuous curved strip, imitating gums with teeth, which is superimposed on the front part of the jaw.
• Snap-On Smile . They resemble an orthopedic splint or mouthguard that covers both the outer and inner surfaces of the teeth (without gums), and is put on like a cover over the dentition. There are holes for the chewing surfaces of the lateral teeth. The design is made of thin plastic, so it creates minimal discomfort when wearing. This is a better model.

The advantages of removable veneers are much less than the disadvantages:

• they can be installed from above, without first removing the enamel layer - this is the main advantage of removable structures;
• unlike permanent microprostheses, a removable onlay masks the absence of individual teeth - another undeniable plus;
• low cost, affordable for many people.

Disadvantages of removable dental veneers:

• This design looks like natural teeth only from a distance (Perfect smile veneers also have an unnaturally bright color of the artificial “gum”);
• poor fixation - the false “jaw” can move or fly out at the most inopportune moment;
• fragility - it is better to remove the device while eating, otherwise the pad will quickly become unusable;
• can protrude lips due to additional volume;
• distort diction;
• create a feeling of discomfort;
• Wearing removable veneers for a long time during the day is harmful - the teeth in them are poorly washed with saliva, which over time leads to thinning of the enamel, and the accumulation of food under a poorly fitting veneer increases the risk of caries.

Before purchasing a removable structure, it is useful to study the comments on review sites - many models are rated by the authors as completely unsuitable for use. To avoid the progression of existing diseases of the teeth and other organs of the oral cavity, it is recommended to consult a doctor before purchasing.

Service life of veneers depending on type

Modern clinics offer a wide selection of veneers. Depending on the patient’s wishes and capabilities, the doctor will help you choose the most suitable option for overlays. Regardless of cost and material, products are always made individually.

The type of material from which the overlays are made affects the aesthetic result, as well as the service life. Expensive products have higher performance indicators.

There are three types of veneers: composite, ceramic and zirconium. There is another type of overlay, which is also called “Hollywood” - Lumineers.

Composite

Plates made of composite, which is a high-quality filling material, but at a cost, this is the most affordable option. In addition, dental patients are often attracted by the advantage of composite veneers - quick installation. But applying the material directly to the teeth in a thin layer is only suitable for minor adjustments. However, there is a drawback - the composite is stained to match the natural color of the patient’s teeth. If an impression is made, it will take more time, but this option is of better quality.

Since this is a budget option, you should understand that composite veneers have a service life and maintenance that are two interrelated concepts. When reconstructing using this method, you should carefully follow the recommendations of a specialist. On average, composite overlays will last 8 years.

Ceramic

The option of ceramic products is characterized as more durable and reliable. Their advantage is that the plates are not affected by dyes or food deposits. They continue to remain white throughout their entire service life. The manufacturing process is standard - based on an individual cast. Such plates have another significant advantage - they do not require the procedure of cutting down the enamel. How to care for ceramic veneers, you need to consult a doctor. Their service life can be up to 17 years.

Zirconium

Veneers made from zirconium dioxide are considered to be the most durable. The sketch for plates of this type is made using computer programs that create an individual model of the lining. Based on this sketch, the veneer is produced on a special automatic machine. To improve the quality of the product, an additional layer of porcelain material is applied to its surface. The overlays are characterized by a thin and transparent structure.

Zirconium veneers are distinguished by the following advantages: natural color, which does not change under any external influence, including smoking, the thinnest possible layer and biocompatibility.

The service life of zirconium dioxide veneers is the longest among all options - up to 20 years. However, these models of linings cost from 7,000 rubles per unit. The high price is justified by the method of manufacturing the product, the use of high-quality material and its service life.

Lumineers

The most expensive option is lumineers, which are used to create the “Hollywood smile” effect. Despite the fact that inexpensive material (ceramics) is used to create the plates, the service life of such veneers is the same as that of zirconium veneers - 20 years.

Lumineers differ from ceramic onlays in thickness; the “Hollywood” version is twice as thin and does not require tooth grinding. However, unlike zirconium dioxide products, they have a significant drawback - the natural color of the enamel shines through them; if it is dark, then the aesthetic appearance will no longer have the desired effect.

As a result, we can conclude that the service life of veneers depends mainly on the material from which they are made and the method of their creation. But product care and compliance with recommendations, which is based on the characteristic features of the material (for example, dye sensitivity, thin layer, etc.), can also have an impact on reducing the operating time. The condition of the teeth themselves also plays a certain role. If there are dental problems, you should get rid of them before reconstruction, and then visit a specialist at least twice a year for preventive purposes.

Clinic “A - Medic” is a dental center that has been providing implantology services for several years. We offer installation of high-quality veneers (ceramic, composite, lumineers, etc.) with a service life guarantee.

The clinic often holds promotions and discounts that allow you to get the “smile of your dreams” at an affordable price. On the website you can see prices for services, see photos of our patients before and after the procedure, and also read reviews about the work of specialists and the results of services provided in the clinic.

Composite veneers: pros and cons

Composite veneers (componeers) are a relatively new material for aesthetic restoration, which has appeared in dental practice since 2011. Ready-made half-crowns are produced en masse, of standard sizes (not according to individual impressions), from a semi-liquid polymer material, similar to modern fillings, which hardens under the influence of light and temperature. The doctor installs ready-made pads, grinding them to size directly during the appointment.

Componer advantages:

• compared to liquid composite veneers - greater strength (10 years or more - there is no exact data yet, since they began to be used recently) and a more natural appearance; due to the smoother surface, frequent polishing is not required;
• compared to ceramic half-crowns - quick installation and affordable price (from 15,000 rubles per tooth).
• suitable for restoring several teeth;
• Available in a wide range of colors and various shapes;
• easily repaired directly in the patient's mouth using liquid composite polymer.

Minuses:

• susceptibility to scratches and chips;
• the ability to quickly stain from food and drinks;
• less beautiful appearance than ceramic veneers.

Componeers are a good economical alternative to expensive ceramic veneers.

Alternative

In addition to mini-prosthetics, there are other ways to correct dental abnormalities. These include:

1. Direct restoration with polymer materials. The procedure is cheaper than installing veneers, but it has a number of disadvantages - weak light-transmitting characteristics, insufficient transparency. The materials used in the operation often become stained during food consumption and gradually lose their original appearance.
2. Crowns. The devices are used to correct large defects. Before fixing the crown, grinding of the problem area is necessary. When installing veneers, the elements undergo only light grinding.
3. Braces. Veneers create only a visual effect of correcting defective elements and bring visible results for minor malocclusions. Serious dental defects can only be corrected with braces.

Veneers are an expensive but effective way to correct anomalies of one or more units of the dentition. The technique has its advantages and disadvantages compared to alternative methods of dental correction - braces, crowns and direct prosthetics.

Ceramic veneers: pros and cons

Ceramic veneers are the best option for restoring the surface of the front teeth. They are made in a dental laboratory using individual impressions. It is best to restore not just one tooth with such crowns, but two to eight at once. Their advantages include:

• the most natural and beautiful appearance of teeth due to the fluorescent surface, the ability to give the material any shade that matches your own enamel;
• smoothness, ensuring easy care and good hygiene (there is less plaque accumulation on the ceramic surface);
• hypoallergenic;
• high resistance to staining;
• low abrasion;
• strength and durability – ceramic veneers last up to 20 years.

Disadvantages of ceramic veneers:

• the highest cost compared to onlays made from other materials (the price of one half-crown ranges from 30,000 rubles);
• long process of dental restoration;
• difficulty in repairing – it is very difficult to achieve a good effect when chipping such a veneer; They need to be removed for repairs.

Depending on the base material, ceramic veneers are divided into:

• Porcelain . They are made by hand from porcelain with various additives by casting or pressing. Porcelain plates can be slightly translucent, due to which the shade of the restored teeth does not differ from the color of neighboring healthy ones. The thinnest (and most expensive) type of porcelain veneers are laminiers, popular among Hollywood film actors.
• Zirconium dioxide . These veneers are made in an automated way (using robotic CAD/CAM equipment) - they are cut out from a single block. Most often, the base of a half-crown is made from zirconium dioxide, which is covered with another type of ceramic on top. These are the most durable and light-proof overlays, practically not susceptible to chipping. They are suitable for the most difficult cases, when the diseased tooth has darkened to such an extent that when viewed through the ceramic, it is very different in color from healthy ones. All-zirconium plates made using Prettau technology are successfully used in dental restoration in patients with bruxism.

Making veneers

The manufacturing process consists of several stages.

Manufacturing products using several technologies

Layer-by-layer application. Platinum foil is pressed around the plaster model. This is necessary to hold the ceramic composite during heat treatment.

The dentist applies the ceramic and fires it on the model itself. The advantage of this manufacturing method is that it reduces the cost of the product and minimizes the risk of material shrinkage.

Injection pressing technique

Modeling of wax overlays is carried out on models. After this, the material is packaged in fireproof materials. The frame of the product is formed under the influence of high temperatures and pressure. Finished models are painted in the desired shade upon completion of casting. The technique is characterized by ease of manufacture and compliance with all proportions of the design.

Computer modelling

The advantage of this method is that the product can be milled and fixed in the oral cavity in one visit to a specialist. Milling the lining takes on average no more than 10 minutes. After this, the structure is polished and glaze is applied to its surface.

The whole truth about ceramic onlays for teeth

The devices are attached to the teeth using self-hardening materials. The product can be pre-manufactured without the patient visiting the clinic. The doctor receives an impression of the tooth by email and sends this data to the laboratory. After production, the corrective product is sent from the milling shop to the clinic.

The characteristics of products produced in laboratory conditions and by direct method differ significantly. In the latter case, the thickness of the device depends on the color of the enamel - the lighter the tooth, the thinner the correction plate. The advantage of making veneers using the direct method is that they can be installed on the same day as visiting the doctor.

Liquid veneers: pros and cons

As in the manufacture of composites, a composite material is used for restoration with liquid veneers. The only difference is the prosthetic technology: the composition is applied directly to the prepared tooth, bypassing the stage of manufacturing the onlays. It is advisable to restore no more than one or two teeth with liquid veneers.

Advantages of liquid veneers:

• relatively low cost (from 15,000 rubles per tooth);
• quick installation;
• ease of repair;
• the ability to restore sufficiently large damage to the dental crown.

Flaws:

• poor resistance to mechanical stress - easily chipped, scratched, requires regular professional polishing;
• not very durable - service life is no more than 5 years (on average 2-3 years);
• easily stained when eating fruits, berries, strong tea, coffee, or smoking;
• Suitable for restoring teeth with minor enamel damage.

Types of veneers

For the manufacture of veneers, two types of materials are used, based on which the following types of products are distinguished:

• Ceramic. In turn, they are divided into porcelain and zirconium. The latter uses zirconium to make the frame, but the veneers themselves are also made of porcelain. They are more reliable than conventional pressed ones, but have less transparency due to the dense frame. The material for making veneers should be selected based on the color of the enamel of natural teeth. For transparent enamel, porcelain microprostheses are more suitable.
• Composite. Veneers, the manufacture of which can even be done by a general practitioner, since the entire process is carried out directly in the patient’s mouth. Therefore, they are often compared to conventional fillings. To produce high-quality composite veneers, you will need a well-equipped laboratory.

Benefits and harms of veneers

Installing veneers entails both benefits and certain harms. The benefits are:

• an impeccable smile is a guarantee of self-confidence and promotes success both in your career and on the personal front;
• in reliable protection of the closed surface from mechanical, temperature, chemical influences, caries.

Harmful points:

• the ground surface of a tooth without veneers is defenseless against adverse effects and has an unsightly appearance - after the first installation, they will have to be replaced with new ones (except ceramic ones) as they become unusable throughout life.

Before installing veneers, it is useful to weigh all the pros and cons, and ask yourself whether it is worth prosthetics for healthy, albeit not entirely ideal, teeth for the sake of the fashion for a snow-white smile.

Is it worth getting veneers?

The answer of a doctor who is faced with the question of whether it is worth putting veneers on teeth is always obvious. Increased sensitivity of teeth, significant damage to the enamel, a large number of fillings on the front teeth - all this is a good reason to carry out restoration using ceramic veneers. If we are talking only about aesthetics, then the final decision must be made by the patient himself. In our opinion, this method of restoration has enough advantages and we tried to describe them as fully as possible. The only and most significant disadvantage can be considered the irreversibility of the procedure, but beauty, as we know, requires sacrifice.

Making veneers and installing them is a jewelry and creative work. Do not forget that the thickness of the microprosthesis does not exceed 0.6 mm (for lumineers - up to 0.1 mm), so your ideal smile will be guaranteed not only by advanced technologies and high-quality materials, but also by the professionalism of orthopedists and therapists. You can count on all this at Amel Dental - the only dental clinic in our country that is accredited by the Global Clinic Rating and is among the 200 best clinics in the world providing dental services.

How to place veneers

The prosthetic process depends on which veneers are chosen - direct or indirect. The first includes liquid veneers made of composite material, the second includes all others.

Installation of direct veneers

Installation of liquid veneers consists of the following steps:

1. Initial appointment with the dentist (assessment of the condition of the oral cavity, identification of indications for a particular type of veneers and contraindications for their installation, agreement with the patient on the cost of the work).
2. Grinding off 0.3-0.5 mm of enamel from the outer surface of the tooth. Without this, its shape when the veneer is installed will be convex and the color unnatural. This procedure is usually not painful, but can be performed under local anesthesia if the patient wishes.
3. Layer-by-layer application of material to each prepared tooth, grinding, polishing.

The entire process can be completed in one session. Before installing veneers, failed fillings are removed and caries and its complications are treated. After dental restoration, the doctor gives recommendations on how to care for the veneers so that they last and remain in good condition for as long as possible.

Installation of indirect veneers

Stages of prosthetics with indirect veneers:

1. Determination of indications and contraindications, discussion of the pricing issue with the client.
2. Taking impressions for making veneers.
3. Grinding the tooth surface.
4. Protection of the prepared tooth. This stage is necessary to protect the damaged surface from adverse effects, normal food intake, preserve the gingival contour, and prevent displacement. For this purpose, the machined surface is sealed with a special compound - a desensitizer. A temporary filling is used to close a large defect.
5. Manufacturing of veneers. It takes from one day depending on the type.
6. Installation of veneers. The doctor fixes the microprostheses using special glue. Additional minor sanding may be required to ensure a better fit. After installation, the onlays are carefully ground and polished to maintain a normal bite and prevent soft tissue injury from sharp edges.

Indirect veneers are installed in 2-3 visits. The exception is compositors that do not require individual manufacturing - they can be installed in one visit.

Installation technology

As with any method of tooth restoration, the installation and production of veneers has its own technology. It will not differ much from the technology of restoration or replacement of dental crowns. It is possible to build veneers from a composite material directly in the dentist’s chair. The quality decreases, but you can gain time. There is no need to wait several weeks, the procedure will be carried out immediately.

The procedure for installing a veneer:

• Careful tooth preparation. If there are old fillings, they are replaced with new ones; if there is caries, it must be cured;
• Selection of veneer color. There is a special color scale for choosing the right shade;
• Grinding down part of the enamel for subsequent fixation of the veneer;
• Creating a dental impression (using it to make a veneer);
• Installation of a temporary plastic plate;
• Production of veneers in laboratory conditions;
• Installation of the finished veneer on a special composition.

From the first visit to the dentist to the final installation of the finished veneer it will take about 2 weeks. Creating a crown will take no less time. But straightening the curvature with braces takes much longer. Sometimes you have to wait more than a year. Modern technologies in the dental industry allow you to choose the best option for yourself. Whether to get veneers or not is up to you to decide.

Indications for installation of veneers

Situations when veneers give good results:

• discoloration of teeth that cannot be corrected by modern whitening methods (age-related changes, pigment spots, fluorosis)
• some changes in the shape of the teeth (chips, wedge-shaped or spiky teeth);
• disorders of the enamel - congenital underdevelopment, tendency to wear away, cracks;
• weakly expressed inclinations and rotations of teeth;
• presence of gaps between teeth;
• gummy smile (veneer allows you to make the dental crown higher);
• incomplete tooth eruption;
• the presence of small darkened fillings.

Lumineers: pros and cons, patient reviews

Not many people can afford to have lumineers installed, since the cost of such structures is 30,000-100,000 rubles per unit. But those who have decided to undergo the procedure willingly share their experience on social networks and on the websites of dental clinics.

Save up to 70% when installing lumineers!

Let's look at the main points that patients mention in their reviews:

• Reasons for installing lumineers. People write that they agreed to have lumineers installed because this method is gentle on natural teeth. In addition, patients are attracted by the possibility of long-term wearing of veneer overlays of this type (for 10-15 years) and the high aesthetics of the structures.
• Installation process. Most people say that in order to have lumineers installed, they had to undergo a correction procedure. In this case, the teeth underwent minimal physical treatment. There are also cases where the patient agreed to have the natural teeth reshaped and “trimmed” before installing lumineers because they were too long or asymmetrical. But such a procedure is not mandatory; it is used as a way to give a person’s smile impeccable aesthetics.
• Deadlines. Lumineers take longer to complete than other veneers. In some cases, people had to wait more than a month, but in the end they were all satisfied with the final result of the installation of veneers.
• Aesthetics. Opinions about the aesthetic properties of lumineers are extremely positive: patients are satisfied with their new snow-white “Hollywood smile”. Some of them noted a slight increase in the thickness and size of the teeth, but this did not become a reason for frustration for the person, and he still left a positive review.
• Strength. Almost every review here is positive, but it would be incorrect not to mention the troubles that happened to patients who had veneers installed. In a number of cases, the veneer structure chipped or collapsed, sometimes for no apparent reason. In dental clinics, people were replaced with new structures free of charge if the collapse occurred during the warranty period for the lumineers.
• Durability. Speaking about the period of wearing lumineer overlays, in 90% of cases people wear them for more than ten years. But there are also those lucky people who manage to wear Lumineers without replacement or correction for more than fifteen years.

After analyzing information and reviews from real patients about ultra-thin veneers, we came to the conclusion that lumineers in most cases are worth the investment in them and are a worthy way to correct defects in human teeth along the smile line.

And in cases where veneers chipped and collapsed, mistakes were made during their manufacture and installation. Therefore, you should take seriously the choice of a dental clinic and the attending physician who will perform the procedure of fixing lumineers on your teeth.

No matter how durable dental veneers are, you should not forget that the habit of biting your nails, cracking nuts with your teeth and opening bottles can lead to chipping of the veneer structure and its premature wear. And in this case the patient himself will be to blame.

There are also a number of contraindications to the installation of lumineers, which a person should not neglect. For example, lumineers cannot be installed on teeth that are heavily stained (fluorosis), since veneer overlays of this type are transparent and will not be able to completely hide the desired defect.

Contraindications for installing veneers

Prosthetics with veneers are not used in the following cases:

• absence of lateral teeth;
• malocclusion (except minor degrees), severe dentition disorders;
• caries, its complications (pulpitis, periodontitis), periodontitis, periodontal disease;
• acute diseases of other organs and tissues of the oral cavity;
• bruxism;
• bad habits that have a detrimental effect on the safety of microprostheses - gnawing on objects in moments of excitement or thoughtfulness, opening bottles with teeth, cracking nuts;
• destruction of most of the dental crown;
• allergies to the medications used and components in the veneers.

It is extremely harmful (and life-threatening) to install any dentures during an exacerbation of cardiovascular, renal, and pulmonary diseases. In case of a stroke or myocardial infarction, veneers can be installed only after six months.

offers patients a choice of high-quality veneers made using the most modern technologies - such onlays do not have to be changed frequently. Experienced doctors who regularly undergo training in Western clinics will provide qualified assistance in preparing for prosthetics and install the onlays as safely and painlessly as possible.

Contraindications

As with any medical procedure, there are contraindications. Every person wants to have beautiful and even teeth that will sparkle with whiteness. Having heard about such an easy restoration method, many turn to dental clinics. Unfortunately, this method is not suitable for everyone. To avoid wasting money, you should familiarize yourself with some contraindications for installing veneers.

Main contraindications:

• Absence of teeth performing a chewing function (6 onwards);
• Bite deformation;
• The presence of bad habits that contribute to tooth decay (bruxism, opening bottles with teeth, etc.);
• Engaging in any sports that can cause jaw deformities (boxing, martial arts, etc.);
• Large amount of tooth decay;
• It cannot be placed on a tooth that is more than 50% filled.

All these contraindications do not replace other methods of dental restoration. Veneers are rather unique plates; if treated incorrectly and roughly, they can be easily damaged. In addition, this is a rather expensive pleasure. If there are contraindications, you should consult your dentist for the best choice of dental treatment.

What is more expensive: veneers or lumineers?

A short table of price comparisons in Moscow.

Veneers, crowns, braces or restoration: patient reviews

The range of problems that veneers installed on human teeth help solve is quite wide. Judging by the reviews, many people had a choice regarding how to solve aesthetic problems with teeth included in the smile line. But for various reasons, in most cases they came to the conclusion that installing veneers was the most optimal option, but there were also opposite examples.

Problem of choice:

• Veneers or braces. People who naturally have defects associated with the curvature and incorrect direction of tooth growth often think about orthodontic treatment. Some of them even took it in childhood, but they were not able to completely correct their shortcomings. In this case, installing veneers helped solve the problem. An interesting review is from one of the patients who decided to install veneers on her teeth because she had complex problems (fluorosis plus “crooked teeth”). She was satisfied with the result of the installation, like most patients with wide interdental spaces.
• Veneers or restoration. There are cases when people who had their teeth restored several times eventually decided to install veneers and did not regret it. They report that the restoration does not give the desired effect, and the fillings darken over time, absorb dye from food and drinks, or begin to crumble. Installation of ceramic veneers solved dental problems in such patients for 7-10 years.
• Veneer or crown. In this situation, opinions were divided. There were people who had crowns installed, but then regretted it, because installing veneers would have been more gentle on natural teeth. But there were also people who first installed veneers, but their teeth became too sensitive or their destruction occurred. And then the person had to prepare the tooth and install a crown. But such opinions are in the minority; in most cases, the person was satisfied with the installation of veneers and wrote a positive review.

Lumineers and their features

Lumineers are thin plate-shaped plates 0.2 to 0.3 mm thick made of ceramic that are fixed to the front teeth. The wear life is more than twenty years.

Lumineers are used to correct minor dental defects. Such as: pigmentation, small chips, unattractive shade.

Any implants are installed only on healthy teeth. Therefore, if caries is present, it must be cured.

Lumineers can be installed in just two visits to the dentist.

1. At the first appointment, the doctor performs an examination, takes dental impressions and determines the shade of future implants. Sends the impression to an American laboratory, where lumineers are made using the patented Cerinate technology.
2. At the second appointment, the dentist performs a professional teeth cleaning. Then the finished lumineers are tried on and installed. The doctor applies etching and primer to the enamel. The inside of the lumineer is coated with a fluoride-enriched composition that strengthens dentin and makes the lumineer resistant to high acidity. The procedure is performed under multiple magnification using a dental microscope. This guarantees the highest precision of implantation. After placing the lumineers on the teeth, the composite solution is dried using a curing lamp. Then the excess cement is removed. The procedure for installing lumineers is complete.

Uncomfortable questions for a dentist: the whole truth about veneers

Veneers are a fashionable topic. And, like any fashionable topic, it is surrounded by myths, legends, rumors and fears. Dentist Gleb Pekli answers Yana Zubtsova which of this has to do with the truth. And Yana strictly monitors that he does not lie.

- Let's start with the fact that I myself have not installed veneers and do not intend to. I have nowhere to go: I have fewer teeth than there were sunny days last summer. Therefore, I will refer to the experiences of friends, which are not always positive. I wrote down all their complaints in a notebook here. And you, Gleb, will have to take the rap for the entire Russian dentistry.

-Oh-oh-oh, well, lucky, what can I say.

In order not to illustrate the entire text with the perfect face of Gleb Pekli, and not with the ideal “before” and ideal “after” smiles of his patients, we arranged a shoot with a slight accent of “Mr. and Mrs. Smith”.

-Yes. But no one promised that it would be easy. So, one of my friends, let's call her Masha, wanted to get veneers. But she changed her mind because she was afraid that they would cut down her own, healthy, although not very elegant teeth. After all, veneers are, in fact, such thin, pre-thin crowns that are placed on previously ground teeth?

-Yes and no. A veneer is a ceramic restoration that covers the front surface of the tooth and extends to the incisal edge...

-No, no, let's speak Russian. The words “ceramic restoration” - do you think they are understandable to people who have not completed dentistry? And in general, how can “restoration” cover anything? I would say that a veneer is a kind of “ceramic case”...

-Okay, I won’t say “restoration”, but “overlay”, and you call it what you want. So, veneers are not crowns. Previously, the following classification was adopted: a veneer is a ceramic overlay that covers the front surface of the tooth and extends slightly to the cutting edge. But it does not affect the intercontact spaces and the back surface of the tooth. Is it clear about “intercontact gaps”?

-Approximately. These are spaces between teeth, obviously?

-Yes. If the overlay touches these spaces, it is already a “half-crown”. And if both the front and back surfaces of the tooth are covered, it’s a crown. This definition was adopted by the WHO (World Health Organization). However, now a new type of veneer has appeared - “360 veneer”, when we prepare the tooth both from the front and from the back. For a number of reasons this may be justified. So, it turns out that the main difference between a veneer and a crown is the thickness of the ceramic overlay. The veneer is very, very thin.

But it should be noted that Gleb is much more like Brad Pitt than I am like Angelina Jolie :)

-Okay, but in any case this involves grinding healthy teeth, right? How justified is this?

-Provides. But this is a very superficial turning, 0.1-0.2 mm, and it does not affect the living tissue. Look here. Our teeth are 40% enamel and 60% dentin. Enamel is on top, dentin is underneath. Dentin is living tissue. Enamel is dead. Its only function is as a barrier. It provides dentin protection. To install veneers, we work only with enamel and only at a depth of 10-15% .

-But its protective functions still suffer?

-Yes, but we are replacing enamel with ceramics, which have higher protective functions.

-Does tooth sensitivity increase after grinding? Doesn't he start to react more sharply to cold or hot?

-Maybe a little, on the lower teeth. But this goes away in 1-2 weeks, and is not directly related to the grinding, but to the fact that the procedure for preparing for veneers requires applying a special solution to the teeth. This acid solution forms pores on the surface of the enamel, which are subsequently filled with a fixing material. And thanks to this, a dead bond is ensured between the tooth and the ceramic veneer. But yes, until we install the veneer, the tooth may react to cold and hot for a short time.

-But for my friend, let’s call her Glasha, this time lasted a long time...

-Glasha was probably unlucky with the doctor; he removed too much enamel and got into the dentin. There are no other reasons.

According to the latest data, size still matters. Including toothbrush size

-Okay, let's tell Glasha that she was unlucky. But you know what infuriates me about veneers advertising? This is the message that everyone needs veneers, that without them you can no longer claim the proud title of “a person with a beautiful smile.” Such a gentleman's set: on the wrist - Cartier or Rolex, in the hands - Bentley keys, in the mouth - veneers. Are there any medical indications for veneers? Or here, as in all aesthetic medicine, the only indication is the will of the patient?

-Great. Let's talk about testimony. They are aesthetic and functional. Aesthetics - the color and shape of teeth - are determined by the person himself. I can see a million flaws that can be corrected with veneers, but if the patient doesn't see them, I don't have to tell him about them. Functional - those that I, as a doctor, should tell him about. First: caries on the front surface of the enamel. The second is erosive changes in the enamel. Third, tooth wear. Fourth - trema and diastema, that is, too large gaps between the teeth. And fifth - malocclusion. And, by the way, “bad bite” is not only teeth sticking out forward, tilted back and gathered in a bunch, as is usually thought. There are many nuances there.

-As far as I know, malocclusion can be corrected with braces?

-Yes, but not everyone can wear braces. I had a patient, a young guy, a famous football player. He has good teeth, but they are all uneven. He said he couldn't wear braces for a year and a half. And we corrected the situation with veneers.

-Why are these veneers of yours such inhumane price tag?! My friend, let’s call her Dasha, got herself not ceramic, but some other veneers... like plastic? And they were 10 times cheaper! True, they were erased from her in just six months, and that’s all, hello. Although she was promised a long, happy life with them.

- It’s not surprising that your Dasha’s pseudo-veneers have worn off. What they gave her can correctly be called “direct restoration,” and these are not veneers, but completely different overlays. They are not made entirely of plastic, but of composite materials - the same ones from which light-curing fillings are made, but I would recommend that everyone think a hundred times before installing them. Yes, they are cheaper, and now these “composite veneers” are actively advertised everywhere, including the Internet and social networks, deliberately substituting concepts and playing on the fact that people see the difference in price, but do not understand the difference between composite material and ceramics: “Veneers in one an hour and one ruble, hurry up and run to us!” This is speculation on the topic of veneers, not veneers.

-What is the difference, besides the price? Only in the material?

-Well, how can I tell you? Almost in everything. And mainly - as a result. The composite material on the front surface of the tooth is extremely short-lived and will last a couple of years at most. But the worst thing is that in the vast majority of cases this leads to complications. And it does not meet the basic aesthetic requirements accepted in dentistry.

-What are these “requirements”? Are they registered somehow? It always seemed to me that it’s something like with hairdressers: “the main thing is that the patient likes it, and “beauty” is a subjective concept,” no?

-Registered. There are clear parameters. The work of a good dentist is not visible, and those around you are sure that you were lucky with genetics, and not with the doctor. What does a natural ideal tooth look like? Firstly, it is not a uniform white color: near the gum the shade of the enamel is deeper and denser, on the cutting edge it is almost transparent. Secondly, it always has a glossy, shiny front surface. Thirdly, this surface has micro- and macro-relief, natural depressions and elevations. And finally, morphology, that is, the size and shape of the teeth: the front incisors are dominant, the “twos” are slightly smaller, the canines are like the front incisors. If you follow all these points, you will get a perfect natural smile.

-And what from this list cannot be achieved if you use filling material rather than ceramics?

-Nothing. Filling material does not and cannot have color gradients. It is always monochromatic. Transparent cutting edge? Doubtful. Macro- and microrelief? Forget it. And the biggest problem: when hardening, the filling material loses from 3% to 7% of its volume (depending on the cost of the material itself). This is not visible to the naked eye, but after a while a gap appears between this pad and the tooth itself. A person drinks coffee and wine, eats berries - these intervals are painted over. The result is white teeth in a black frame. So-so aesthetics. But this is not the saddest thing. Bacteria accumulate in these gaps. The result is secondary caries. I have patients who have had these composite pseudo-veneers made somewhere, and then contacted me to replace them with ceramic ones. I removed the linings, and there was no case that there was no caries underneath them. He is always there.

-Why then does it even exist as an option, this “direct restoration with composites”?

-The correct use of these composite attachments is as a temporary measure before installing permanent crowns or veneers. Whatever the minimum grinding of the enamel, if ceramics are not immediately put on the tooth, it must be covered. In America and Europe they are used only this way. This is an excellent solution for a couple of months. But to sell composite tips as an independent service... If only in the most super-low-budget clinics? I don't know, I haven't heard. The second option for using composite attachments is to show the patient what his smile will look like and discuss all the details. Sometimes I make several composite samples with different nuances, and you choose which option you like best. And sometimes I use them to prove to a person that he does not need any veneers in principle.

-Oh, okay. Somehow I haven’t met dentists who tell the patient: “You don’t need my services, you’re already a star!”

-You may not believe it, but I literally had a patient today, a young man who was unhappy with the proportions of his teeth and wanted veneers. But I saw that in fact there was no evidence here, everything was fine with him. Using composite attachments, we made a simulation for him, he tried it on, looked at it, and agreed.

-And do such cases often happen in your practice?

- Once every one or two months. Often people are simply not satisfied with the color of their teeth. But this can be solved by bleaching. I do not have the task of “victimizing” all of humanity. I want patients who leave this office happy and feeling like their time and money were well spent. And not with the desire to sue another scoundrel doctor.

When the arguments ran out, they switched to arm wrestling. Place your bets on whose will win

—Are ceramic veneers all the same? Why then does the price vary?

-Veneers are made from two types of ceramics: Emax ceramics and feldspathic ceramics. The first is more popular, the second is more expensive. The advantage of the first is that it is stronger and less demanding on the doctor’s skill. That is, if everything is done perfectly, the occlusion - the joining of teeth to each other - is adjusted to the hundredth of a millimeter, then there is no difference. If the occlusion is slightly loose, emax will forgive this, but feldspathic veneer will not. The relative disadvantage of emax is that this ceramic comes from the factory in blocks and is then milled. But such a veneer cannot be made thinner than 0.3-0.4 mm. And in terms of its aesthetic characteristics, it will look a little simpler. The average person may not see this difference, but a professional will. It is also visible in the photo:

Emax ceramics Feldspar ceramics

Feldspathic ceramics are the queen. This is a material that is able to convey all the nuances of color and shape. Thickness - from 0.1 mm. And if Emax is milled mechanically, then the technician applies everything with a brush. This is naturally a work of art. The downside is that it is more fragile. But the minus is very relative. The strength of human tooth enamel is 80-100 megapascals. The strength of feldspathic ceramics is 260 megapascals, the strength of Emax is 480. That is, any ceramic veneers can chew the same thing that you chew with your own teeth. But not more. Neither emax veneers, nor feldspathic veneers, nor teeth should be nail biting. If a veneer chips, then never on its own, only together with the tooth.

-Can’t the veneer come off?

-Excluded. When we have done everything, tried it on and agreed on everything, we fix the attachments. We put it on the glue - and the glue penetrates both the veneer and the enamel. Remember when I said that before this, a special acid is applied to the tooth so that pores form in it? It is these pores that cement fills. Final fixation occurs in 4-6 hours. After this, the entire structure becomes one.

-And what, just a lifetime guarantee? Put it once - and for the remaining 50 years “in the house”?

-Here responsibility is divided equally between the patient and the doctor, 50/50. The doctor asks you to come for an examination once every 3 months. Who does this?

.And Gleb Pekli came up with these cool things - mouthwash in disposable packages, similar to the packages of sugar they give in cafes. You can take it with you anywhere. Helps me out a lot on the road.

-I suspect almost no one? But why do these regular examinations at all, what a headache, that is, a toothache!

-I’ll explain. Your teeth - they, you know, are not tightly sealed into the bone. They are supported by collagen cords and have a certain mobility, in the range of 0.1-0.3 mm. Something has moved somewhere - the occlusion has been broken. One tooth is overloaded, the other is underloaded. This simply wears away your natural teeth. Ceramics do not wear off. The only way it can relieve tension is to chip away. If a person regularly comes for examinations, this can be leveled out in time: by polishing the place where there is too much contact between the upper teeth and the lower ones. Just as if nature did it. This is regular oral maintenance. The same as with cars: when you buy an expensive car, you don’t have questions about why you need to do maintenance every 15,000 kilometers?

-You spoke so smartly about the patient’s responsibility. And what is included in the 50% that the dentist must bear on his tired shoulders?

- Come on, I’m not even trying to hide the fact that there are many more medical errors :) I did the examination incorrectly, made the wrong diagnosis, chose the wrong treatment regimen. I didn’t understand the causes of the problem and immediately started installing veneers. For example, a patient has no back teeth. And the doctor says: “Nonsense, we’ll put veneers!” Accordingly, these veneers will be a priori overloaded. And their shelf life will be shorter.

What should the doctor have done?

Restore the height of the bite, restore the back teeth through implantation or removable bridges. The treatment plan can be different, and this can be done in parallel with the installation of veneers.

You can grind a tooth incorrectly, you can resharpen it - as in the case of your friend Masha mentioned. Or was it Glasha? :)

You can place the veneer incorrectly, you can not completely remove the occlusion... And in the end the patient will say: “These veneers of yours are bullshit!” And it’s not the veneers’ fault, but the doctor’s.

-By the way, about girlfriends. My friend Natasha came to get veneers, and the doctor told her that her teeth were chipped, and charged her for implants, fillings, and something else “very necessary.” And he said that without this he would not install veneers. This doctor is a scoundrel, he wanted to cheat poor Natasha out of money?

-I think, on the contrary, he was a good doctor. The oral cavity before veneers must be put in order, otherwise it is the same as putting patches on decrepit matter. Is it washable? We need to figure out the reason. This is generally a very common story. Abrasion can be spot-on, one or two teeth. Or maybe generalized, when all the teeth are ground down. In the first case, there are probably problems with the bite, that is, the back chewing teeth do not perform their function, they become addicted, too much load falls on the front teeth, and they wear out. And this must be eliminated. And in the second case, perhaps the problem is the altered PH of saliva, which corrodes the enamel, and then you need to check the gastrointestinal tract and review the diet, otherwise any dental restoration will be nullified. And it is imperative to restore all the teeth in height, first the front ones, then the back ones. And if your Natasha insists only on veneers for her six front teeth and refuses everything else, she, of course, will find a less conscientious doctor who will follow her lead, but very soon her veneers will become unusable. And in fact she will pay more. The same can be said if a person has bruxism (the habit of clenching teeth) or hypertonicity of the masticatory muscle. Whatever the reason for their appearance, these things must be eliminated before veneers are installed. But they must be eliminated anyway! Did you know that people who suffer from bruxism sleep worse and are more tired because their brains don't rest at night? If the problem is that the height of the teeth is not aligned, we use a nighttime relaxing mouthguard, this helps. If the problem is neurological, we contact a neurologist.

—Lord, how many years can this story last?

-In fact, in most cases we do such work in 9-14 days. Here are the works done in 9 days.

Here - 12 days.

It’s been a month, but there it was necessary to first relieve the inflammatory process.

-But the doctor told my friend Stesha that if she wants “an even better smile,” then it would be nice to put veneers on the crowns that she already has on her front teeth... What do you say, doctor?

- Such a doctor would rip off his arms and legs. What exactly to install, a crown or a veneer, depends on the tooth. If it is destroyed or depulped, use a crown. If it is healthy - veneer. But recommending putting a veneer on a crown is the top... Or, more precisely, the bottom.

-And finally. The first time you successfully went off topic, but the second time this trick will not work. Why do these veneers of yours cost such, excuse me, a lot of money? All my friends cried about this - Masha, Glasha, Stesha, and Natasha. Well, 50,000 rubles for one tooth, and there are 6 front teeth, it’s terrible, doctor!

-Let's calculate what the price consists of. Do you think I’ll start telling you now how much the materials cost? No, first I will mention the doctor’s education and his constant advancement. This is up to 10,000 euros per year. Because medicine is developing very quickly. If the doctor does not go to congresses, he will treat you as he was taught at the institute 20 years ago. Then - the equipment of the clinic. Computers for the price of an E-Class Mercedes, microscopes for the price of a Bentley - without them, neither the installation of veneers nor modern dentistry in general is unthinkable. This is what you see in my office. And there is even more complex and equally expensive equipment that my technician works on, which you don’t see, but on which the final result largely depends. And the technician must also constantly improve his education and update his taxi fleet. Well, materials are just another expense item. Unfortunately, Russia does not produce anything that you would like to carry in your mouth. In total, the cost of one good unit of veneer is from 15 to 20,000 rubles. Therefore, in a Moscow clinic (taking into account our rental prices), equipped with the necessary equipment, where a good, competent doctor works, the installation of one ceramic veneer simply cannot cost less than 50,000 rubles. Everything else is a compromise. Yesterday's students - yes, they offer for 15-20. But these are yesterday's students who work with the same yesterday's technical students.

-Is there any good news? Otherwise, to end on this note - well, this...

-Yes, we have this price on a turnkey basis. That is, tooth repair, if there is caries, and all the preparatory work, including fittings, impressions, anesthesia and everything else, is included in it. And for “better equipment,” continuing the car analogy, I won’t ask you to pay extra.

Gleb Pekli conducts an appointment at the Insmile clinic . Instagram - @dr.pekli

Address: Tsvetnoy Boulevard 9.

Tel.:

The price of the initial consultation is 5,000 rubles. AND

And now - attention!

Promotions for our readers:

1. Consultation with Gleb Pekli on veneers with drawing up a comprehensive treatment plan and conducting a photo protocol - free of charge for a month from 11/05/2019

2. 10% discount on veneers – for a month from 11/05/2019.

3. Special price for teeth whitening Zoom 4 – RUB 20,300. (instead of RUB 29,000) about the promotional code “SMILE”.

If you have any questions of any level of inconvenience, ask them in the comments. Based on them, we will make a second material, where Gleb Pekli will answer for everything. He even promised a discount to the authors of the most furious ones :)