Porcelain veneers have been considered the flagship of cosmetic dentistry. While it is one of the most sought procedures used by cosmetic dentists to rejuvenate one’s appearance in San Francisco, it has also been stereotyped. Some consider porcelain veneers as overrated, invasive, and not natural looking, comparing them with the “Hollywood” smile of the fifties.
The main reason for this idea are examples of really poor aesthetic outcomes provided by general dentists who lack a thorough understanding of the principles of smile design. Cosmetic dentistry is a time-intensive process that cannot be shortcut by a two-visit smile makover.
This is why comprehensive cosmetic dentistry has to be redefined. It is not just a cosmetic procedure makes one look like a movie star. It is actually a science that understands how to truly enhance one’s natural smile without adding artificiality.
When looking at our human appearance, we often appraise it’s aesthetics without considering nature’s purpose and the results of its funtional design. There is a reason why our bodies look the way they look. Nature does not care about aesthetic appraisal, which is the product of the human mind.
There we are, looking at the stars and enjoying the concepts of space, future, and beauty. However, nature is much more pragmatic: either things work or they don’t in a given environment. Their visual appearance becomes only apparent with a set of eyes that is connected to a human mind.
So, what is beauty?
It is the aesthetic appraisal of either light or sound, the cardinal signals of our planet Earth.
What is aesthetic?
It is the consideration of something that creates approval, hope, and excitement. It is something that gets us in touch with the essential purpose of the human mind: survival. A human mind becomes elated when encountering something that indicates health, beauty, and transcendence.
So, what do porcelain veneers have to do with this?
They create a visual experience that indicates health, beauty, and a spirit of play to the observer. Is this desirable? You bet.
Human beings are “social animals.” They communicate. They have rules of engagement. And they are masters in this. Sublime to obvious messaging is used to create an effect to the observer, another human mind.
So, how do we communicate?
It is certainly not just words. It is also the image that we create about ourselves: tattoos of soccer players, the beautiful face of a Cindy Crawford, the athletic body of an Arnold Schwarzenegger. Have they created an effect on you? Well, this is a normal condition of human existence: to create effects and to perceive them.
This can be verbal. Language is probably the most important asset of human action. But one should not underestimate the effect of aesthetic appraisal. The emphasis is on “effect.” The canvas is less impressed than the observer, but a human canvas knows exactly what effect it wants to create. An, being a sentient being, it often succeeds in creating the effect it intends. We understand each other.
Teeth?
Yes, teeth have an effect on the recipient. It gives him/her an idea about the sanity and health of the originator of an idea. Hence, an idea becomes much more important, when given by someone who displays assets that indicate sanity and health. These are visual indicators, but human beings are tuned into the visual appraisal of their environment and their fellows. A quick understanding of a situation is necessary for one’s level of survival.
So, what would be the best means of creating the effect of aesthetic appraisal?
It might be a body or face that looks clean, healthy, and sane, indicating a successful future ahead.
And this is where teeth come into place.
They are stable.
They do not change.
Hence, they can be created and inserted as a stable messenger of future.
What are the parameters of teeth that represent a successful future?
White = Clean
Pink = Healthy
Translucency = Youthful (long future)
Natural = Not fake, BUT REAL.
How do they make YOU feel? = Confident.
And all this will radiate to your companion.
Look at two people. They have the same values for society. They have the same degree of intellect and creativity. They have the same urge to help others. But one of them has stained teeth, such as teeth that were exposed to tetracycline during childhood.
How do those teeth look like? Dark. Wooden.
How do they make the owner feel?
How do they make the observer feel?
Is the solution simple?
Yes, if the above attributes are realized.
Porcelain veneers are the best, and sometimes the only, solution for deeply stained teeth. Dental porcelain is available in a wide spectrum of opacities and translucencies, which allow the cosmetic dentist to match the individual requirements for compensating varying degress of dental discolorations.
Why dental bleaching might not work.
Yellow teeth might bleach well. However, brown, and even worse, gray teeth, may not lighten with hydrogen peroxide at all. The reasons for this are not well understood, but it appears that non-dental pigments that are incorporated during odontogenesis are more stable and locked into the tooth structure than stains that adhered to teeth after their completion.
Condition of tetracycline-stained teeth (quality of enamel, thickness of enamel layer, quality of adhesion of enamel to dentin)
Conservative treatment that preserved tooth structure. (depending on the need to block color of underlying dentin and the desired new value – (see YouTube lecture below)
So much more conservative than porcelain crowns (The invasiveness of dental crowns.)
How little is enough (YouTube Lecture)
References:
Maxillary rehabilitation of tetracycline-stained teeth with diastemas by using ceramic veneers and a digital workflow.
Turkyilmaz I et al. J Dental Sci 2023; 18(3): 1425-1426.
A review on natural teeth whitening.
Benahmed AG et al. J Oral Bioscience 2022; 64(1): 49-58.
Conservative approach to treating severe tetracycline staining: a 12-month follow-up.
Santos Rocha R et al. Gen Dentistry 2021; 69(4): 41-44.
Effect of ceramic materials on the optical properties of porcelain veneers for tetracycline-stained teeth.
Chen J et al. Hua Xi Kou Qiang Yi Xue Za Zhi 2021; 39(3): 341-346.
Severe tetracycline dental discoloration: Restoration with conventional feldspathic ceramic veneers. A clinical report
Faus-Matoses V et al. Clin Exp Dentistry 2017; 9(11): e1379-e1382.
A Restorative Challenge: Tetracycline-Stained Teeth
Cutbirth ST. Dentistry Today 2015; 34(7): 126, 128-30.
A case report of a 20-year clinical follow-up of porcelain laminate veneer restorations
Katoh Y et al. Operative Dentistry 2009; 34(5): 626-30.
Clinical considerations in managing severe tooth discoloration with porcelain veneers
Chu FCS. J Am Dental Assoc 2009; 140(4): 442-6.
Restoring tetracycline-stained teeth with a conservative preparation for porcelain veneers: case presentation
Bassett J et al. Pract Proced Aesthetic Dentistry 2004; 16(7): 481-486.
Severe tetracycline dental discoloration: Restoration with conventional feldspathic ceramic veneers. A clinical report
Faus-Llacer V et al. Journal of Clinical and Experimental Dentistry 2017; 9(11).
Nonvital tooth bleaching: a review of the literature and clinical procedures.
Plotino G et al. J Endod 2008; 34(4): 394-407.
Restoring the Tetracycline Stained Dentition -Blocking out discolored dentin while mimicking the natural tooth structure.
Wynne T. Inside Dentistry October 2016; 56-61.