August 24, 2016
Most porcelain veneer emergencies are related to:
So, if you’ve notice that something is different about your tooth the first thing to do is determine which of the two has occurred.
Carefully remove whatever parts of your restoration are in your mouth without damaging them further.
[See below for more information about both scenarios.]
To get an idea if it’s whole or not, take a look at your veneer’s overall shape.
You can also evaluate the tooth it came off. You may see broken segments still attached. (If you do, be careful. Shards of porcelain like these can be rough or sharp to your tongue and/or lips.)
If you do have the whole thing as one piece, and if you can get it to your dentist’s office safely, having it may save you the cost of a new one. So, wrap it up in some bathroom tissue and then place it in a hard protective container, like a medicine bottle.
If it’s broken, you can save the parts to show to your dentist, but most likely they’ll only be a curiosity to them.
You will, of course, need to contact your dentist’s office and report to them what has occurred. And they’ll need to arrange an appointment for you so they can evaluate exactly what has happened.
In most cases, when your veneer was originally placed only a minimal amount of your tooth’s front surface was trimmed away. If that’s the case, then it’s unlikely that your tooth will experience any significant problems between now and when you get in to see your dentist.
With many veneer cases, no temporaries are placed. The patient’s teeth are left uncovered (like your tooth that’s lost its veneer is now) for the entire one to two weeks while their laminates are being made.
Since your tooth has lost some or all of its front covering …
… So be careful.
If you do experience trouble with thermal sensitivity, or especially surface roughness, placing a protective layer of wax over your tooth can help to provide relief.
When you do get in to see your dentist, if there are any sharp or irritating parts of your veneer still remaining on your tooth, they can trim them off or buff them down. Doing so should be painless and just take a few moments.
If your laminate has debonded (has come off your tooth but is still in one piece), your dentist may be able to reattach it.
The success of the repair will be influenced by:
From a practical and cost standpoint, reattachment is worth a try. But it’s likely that perfectly ideal conditions won’t be met and the bond created will be subpar. (The more predictable, although more expensive and time consuming, solution is to make plans to have the veneer remade.)
If just a very small portion of your veneer has come off, it may be possible for your dentist to create a patch. However, this is not a first choice but simply one that’s used as a practical solution.
Generally, there are two main problems that tend to come into play with this type of plan.
That means that even if the repair looks satisfactory initially (which it very well may), over the long haul (months and years) the less durable bonding will deteriorate (pick up stain, fleck off at the junction with the porcelain) and a distinction between it and the veneer will become obvious.
If only a small bit of porcelain has flecked off, one solution is for your dentist to trim and buff your veneer until the chip’s divot has been polished out.
This makes a very lasting solution. However, neighboring teeth may need to be recontoured in a similar fashion so the symmetry of your smile is maintained.
You may have encountered the situation where you’ve discovered a crack or craze lines in your veneer but otherwise it remains whole and in place on your tooth.
In this type of situation, it’s impossible for your dentist to know how firmly the fractured parts are still bonded to your tooth. Additionally, over time the crack will tend to accumulate stain, ultimately spoiling the veneer’s appearance.
There really isn’t any type of repair that can be made in this type of situation. There’s no way for your dentist to fill in the crack or bond the two pieces of porcelain back together. You’ll simply need to make plans with your dentist to have your veneer remade.
Sometimes replacing a veneer either isn’t possible or doesn’t make a reasonable choice.
Proper case selection is a very important part of being able to create a successful veneering outcome. And it may be that now that problems have occurred (possibly more than once) that it’s obvious that your situation really wasn’t (or no longer is) a suitable application for this technique.
That scenario isn’t terribly uncommon. As we discuss here, a recent trend in dentistry has been one where dentists and manufacturers have pushed the use of veneers to remedy conditions that far exceed the original applications for this procedure. This includes: a) “Instant” orthodontics for severely misaligned teeth, b) Lightening very dark teeth.
If replacement isn’t possible or prudent, then having a dental crown made is the next step for your tooth.
For future reference, it makes sense to take note of what activity broke, or immediately preceded the breaking of, your veneer. And then, obviously, do your best to minimize or eliminate it (stop biting your finger nails, clenching your teeth, etc…).
Discuss your circumstances with your dentist. They may be able to suggest some solutions.
The type of veneer emergency that you’ve experienced can give your dentist a hint about what type of underlying problem lies at hand.
A porcelain veneer is a sandwiched affair, consisting of tooth, cement and ceramic. When one debonds (comes off its tooth, primarily in one piece), the separation may have taken place either at the ceramic/cement junction or else the tooth/cement one.
Dental materials will create a bond with dentin. But the strength of this bond is far weaker than the one possible with dental enamel (use the link above for more details).
If a high percentage of the tooth’s surface is exposed dentin, the strength of the tooth-to-cement interface will be comparatively weak.
As explained above, a dentist can attempt to re-bond the veneer. Unfortunately, the same underlying condition will still persist (not enough tooth enamel is present to create a secure bond) and therefore further episodes of debonding may be likely.
Especially in the case of repeated failure, making a dental crown for the tooth instead may be the only lasting solution.
Considering the thin, fragile nature of porcelain veneers, it may be surprising to most people that breakage or fracturing happens as seldom as it does.
These restorations work because when they’re bonded onto enamel, it’s the more rigid of the two and therefore tends to absorb most of the forces directed to the tooth.
When a veneer cracks, it suggests that the opposite is the case. The forces applied have been directed to it instead of tooth structure.
As an example, when a veneer is bonded to primarily tooth dentin (the problem discussed above) the laminate is the stiffer of the two. This tends to focus forces applied to the tooth to the veneer, thus leading to fracture.
RELATED Food You Can and Cannot Eat if You Have Dental Veneers
In some cases, just a small chip may have broken off a porcelain veneer (like off of its biting edge).
This would simply be testament to the fact that the tooth/veneer complex has been able to successfully withstand the pressures applied to it. However, the forces applied exceeded the internal strength of the ceramic itself.
The activity that caused the chipping might be a one-time event, like unexpectedly biting into something hard. But often it’s a parafunctional habit that is the problem and must be curtailed (clenching teeth, biting fingernails).
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