COSMETIC TOWN JOURNAL



Expert Doctor

Prep and No-Prep Veneers

A dental veneer is a thin shell of restorative material which is placed over the front surface of the tooth to improve its appearance and protect it from further damage. The veneer is made of either composite or porcelain and it is classified as a prep or no-prep veneer. The classification is based on whether removal of any tooth structure is required or not. A prep veneer, AKA a traditional veneer, involves the removal of some enamel to accommodate the restoration on the tooth surface. The amount of enamel removed from the tooth is equal to the thickness of the composite or porcelain that will replace it. The reduction which is required for porcelain veneers is greater compared to that in composite veneers. In a no-prep veneer, the removal of tooth structure is not required and the restoration is just bonded into place. Dental veneers are ideal for restoring fractured or discolored teeth and to get rid of small noticeable spaces in-between the teeth. Dental veneers can also improve the color, symmetry, size and shape of a tooth.

Am I a Good Candidate for Prep and No-Prep Veneers?

A GOOD CANDIDATE for prep and no-prep veneers includes:

  • A patient who requires very minor changes to the teeth is better suited for a no-prep veneer
  • No-prep veneers are very thin so they are best used on someone who needs very little improvement in their smile
  • Patients who need bigger changes or improvements are better off with prep veneers because they can be made thinner or thicker according to the needs of the patient
  • No-prep veneers are for patients who want to brighten their teeth a bit or have close or small spaces in the teeth
  • Prep veneers are better suited for more extensive problems like darker discoloration, fractures, minor misalignment and slightly larger spaces

Patients who are NOT GOOD CANDIDATES for prep and no-prep veneers include;

  • Someone with teeth that are severely crooked
  • A person with teeth that are very crowded
  • People without sufficient healthy enamel to remove a thin enamel layer before placing the veneers
  • A person without healthy teeth and gums
  • A person with broken teeth will need dental crowns or implants

How are Prep and No-Prep Veneers Performed?

When placing prep veneers, the dentist removes a thin layer of enamel from a patient's teeth. On the other hand, no-prep veneers require little to no enamel removal. Between a prep and no-prep veneer, the prep veneer is on the high end of strength and expected longevity. Porcelain veneers are always sent off to be made in a dental lab and composite veneers can be made in the office of the dentist.

When patients select prep veneers, the dentist removes a layer of enamel from the front of the teeth that are being treated. The total amount of enamel depends on the desired results of the patient. In most cases, the dentist removes about .5 mm to .7 mm of dental material from the front of the teeth. The dentist then takes an impression of the teeth in order to make the veneers in the dental office or at an off-site dental lab. A cosmetic dentist often has patients whiten their teeth prior to the veneer procedure and then match the color of the veneers with the new white color of the rest of the teeth. Temporary veneers are always placed to protect the underlying dentin and prevent sensitivity while eating or drinking and to preserve appearance. Once the veneers are complete, the dentist checks their shape and appearance to make sure the veneer does not affect the bite of the patient or have any alignment issues. The dentist also checks the color of the veneers against the natural shade of the teeth. The veneers are then bonded to the teeth and a curing light is used to harden the cement used to attach the veneer to the teeth.

The main difference in placing no-prep veneers is that the removal of tooth structure is not required. Otherwise, the veneers are created and placed as described above.

Composite restorations can be completed in a single appointment while veneers require multiple appointments since they are made in a dental lab. The most important difference between dental bonding and veneers is strength, durability and staining. The downfall of composites is that they are not as dense and strong as porcelain, may need to be replaced more often and can be stained by food, drink and smoking.

Alternative Treatment

Dental bonding, AKA composite restoration, is used to restore missing parts of a tooth. Although dental bonding can be used to restore problems on the front surface of the teeth, it is not in a thin shell form like veneers. As a result, the junction between the tooth and the restoration might be more noticeable. With a veneer, the entire front surface of the tooth is covered so no obvious edges, margins or junctions can be seen by others.

What are the Costs of Prep and No-Prep Veneers?

The cost of prep and no-prep veneers depends on the type of veneers used by the dentist, the amount of work that needs to be done to prepare the tooth, the geographic location of the procedure and any fees charged by the dentist or the facility. In general, the cost ranges from $900-$3500.

Recovery and Downtime

There is little to no RECOVERY or DOWNTIME required with prep and no-prep veneers. Patients should be careful with temporary veneers since they are not as strong as permanent veneers and there might be a bit of sensitivity with the temporary veneers. Otherwise, patients can return to work the same day and resume immediate use of their teeth.  Some dentists recommend night guards after the veneers are placed to help patients that clench or grind their teeth at night.

Results

The results after having veneers placed are seen immediately. Proper oral hygiene is critical to maintaining the results of both prep and no-prep veneers.  Patients should not practice any oral habits that are destructive to the teeth. Dental veneers might need to be replaced or repaired as time passes due to wear and tear, cracking and chipping or gum recession. If properly maintained, dental veneers last between 7 to 20 years.

Limitations of Prep and No-Prep Veneers

Limitations of prep and no-prep veneers include:

  • Veneers only provide a partial restoration of the front teeth
  • Patients with dental issues, such as cavities, will need to treat them before having veneers placed
  • Porcelain veneers are not suitable for teeth that are badly broken or worn down with little remaining enamel
  • Teeth that are excessively crooked are not ideal for veneers
  • No-prep veneers cannot produce dramatic improvements on the appearance of the tooth
  • Prep veneers require enough sound tooth structure to support the veneer

Risks of Dental Veneers

Some risks of prep and no-prep veneers are:

  • No-prep veneers cannot be bonded to the teeth as strongly as prep veneers, and having no-prep veneers pop off the teeth is common, so additional trips to the dentist may be required
  • No-prep veneers can change the shape of the mouth and face as the extra thickness added to the teeth pushes out the lips and cheeks
  • Cracking or chipping of the veneers
  • Tenderness
  • Soreness
  • Tooth sensitivity
  • Changes in the bite of the patient

Research and Experience is Key for a Patient

Patients looking to have prep or no-prep veneers should always ask for “before and after” pictures of procedures the dentist has performed. The more cases the dentist has performed, the better they should be at performing the procedure. It would be wise for the patient to ask how long a dentist has been doing veneer work. Patients should do proper research and make sure their dentist of choice has experience in providing the kind of results the patient desires.

 

Written by Cosmetic Town Editorial Team - MA

Based on an exclusive interview with Mary Swift, DDS, in Dallas, TX