April 30, 2016

Replacing Veneers after 15 Years

Author

Dr. Charles Payet

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Date

April 30, 2016

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There are a number of important questions to ask when considering cosmetic dentistry, including porcelain veneers:

  • How many veneers do I need?
  • What can (and can’t) you change about my smile with veneers?
  • When are veneers better than braces?
  • How much do veneers cost?
  • How long do veneers last and what happens when they need replacing?

Recently, we saw a patient for whom I did 8 porcelain veneers in 2001, and his case illustrates all of these questions, so without further ado, let me introduce Steve’s teeth.  (He’s a rather private person and prefers not having his portrait used, and this is something that we always respect.)

Please forgive the varying levels of photography you see through this article; the first photos were originally slide film that were scanned from negatives, then they move through a series of progressively better cameras and a progressively improving photographer (me). 🙂  I’ve tried to even them out with Photoshop, but rest assured, absolutely nothing else has been done to the photos.

8 Porcelain Veneers in 2001

Steve originally came to us because he was getting ready to attend a big high school reunion, if I recall correctly.  It was on kind of short notice, too, as in he was catching a flight the next day.  Yikes!  But we arranged to see him later that day and started him on 8 veneers to lengthen his worn-down teeth.  He looked pretty good with the temporary veneers for the reunion, and we saw him a few weeks later to bond in the real porcelain veneers.  So back in 2001, the first set of 8 veneers took Steve’s smile from here:

Comparison of teeth before and after veneer procedures in 2001 and 2016.

Fast Forward to August 2015 & 2 Cracked Veneers

Close-up of a person's smile with a chipped front tooth. The teeth are white, and the mouth is slightly open.

Given that Steve has a very demanding job that requires a lot of travel, we didn’t see a lot of him after the first veneers were done.  Then he moved out-of-state and we obviously didn’t see him at all for many years.  Imagine my surprise, when I got a text message on a Friday evening in August that 1 front veneer had broken and another had a crack in it!  Fortunately, Steve still did business in Charlotte and was on his way here when it occurred.  The tricky part?  He was leaving for a big vacation in just a week.  So the only thing to do was to see him on a Saturday morning to fix him up.  As it happened, a 3rd veneer had a crack, too.  After some discussion, we decided to re-do those 3 veneers for now, and we’d consider whether or not to redo the 4th front tooth if it didn’t match just right.

So why did Steve have 3 cracked veneers?  A simple but powerful reason:  bruxism associated with sleep apnea.   Steve was diagnosed with sleep apnea a few years ago and had started wearing a snore guard that doubled as a nightguard.  But once porcelain is stressed, it can’t ever be unstressed, so the years of bruxism before the snore guard took their toll and eventually the porcelain cracked.  Also, his lower front teeth were already worn and uneven, which also put stress on the porcelain.  Veneers on the lower teeth would be an option to reduce that risk, but they’re not enough of an issue for Steve to do.

This is why we  always recommend a nightguard to protect your investment in cosmetic dentistry!

A Commitment To Patient Satisfaction, Even Under Pressure

Close-up of four bright, white teeth with smooth surfaces; the center two teeth are slightly larger.

While we typically work with an boutique dental lab for our big cosmetic cases, there was no time for that in Steve’s situation.  Our local lab worked super hard to get the 3 veneers done as fast as possible, and we saw Steve the next Thursday at lunch to bond them in.  However, the first set honestly did not look too good.  In fact, they were kinda  bad.  Like this:

Close-up of a person's upper front teeth, appearing white and healthy. Pink gums visible.

With a lot of photos and notes, we returned the case to the lab for a rush fix, and they did a far better job this time!  We saw Steve back the very next morning, Friday at 8am, to bond the improved veneers in before he left for the airport.  Seriously.  We bonded them in, checked his bite, and he drove to the airport for his flight.  No pressure!  He looked a heck of a lot better like this at that point:

But while the 3 new porcelain veneers did look much better, Steve and I ultimately agreed that we should have done the 4th front tooth for the best match, so early in 2016, we started redoing the 2nd right front tooth look like the other 3 front teeth.  Even then, though, Steve had a few small gripes about the other 3, and to be honest – he was right.  So after more discussion by text and phone about his ultimate cosmetic goals, we agreed that the right thing to do was to redo all of his veneers and even add the first molar on each side.  This time, we would work with our top lab, because Steve wanted only the best.  The new goals included:

  • Brighter white veneers
  • More natural texture, not so flat-looking
  • Maintain the masculine, squared-off look that Steve preferred
  • Make the smile broader by adding the molars and giving them more bulk to fill out the smile

Side-by-side comparison: Man's smile with veneers in 2001 and 2016. Different angles show tooth and lip changes.

Veneers Can Last for Decades and Rarely Fail All at Once

Steve’s case is fairly typical in a number of ways and illustrates a number of things about the durability of veneers, as well as the reasons they fail:

  • Properly bonded porcelain veneers can last 15-20 years and longer
  • Just as with most things, they rarely fail all at the same time. It’s usually 1-2 at a time.  This means you can replace them as needed.
    • Steve chose to redo all of his veneers because he wanted all of them even brighter than the first set.
    • If the rest of the veneers are ok, there is no need to redo all of them.
  • Don’t forget: as long as you have teeth, you can get cavities.  Brush, floss, and see your dentistry regularly!
  • If you’re investing $15-40,000 in your smile, wear a nightguard.  It’s the cheapest and most effective insurance available.

Hopefully this article has provided answers to many or all of your questions about porcelain veneers, their durability, what happens when they need replacing, why they often need replacement, and how to care for them so they’ll last as long as possible.  I do have other patients with veneers that we did 15-16 years ago that are still going strong and not in need or replacement yet; I’m looking forward to seeing how much longer they last!

To make an appointment for a Complimentary Smile Consultation:

Call us 704-364-7069 or contact us

We’ll look forward to meeting you soon!

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