In some ways placing porcelain veneers is a fairly difficult juggling act for the dentist performing the treatment. By this we mean that there are a number of factors that can each have a relatively significant impact on the final cosmetic appearance of a porcelain veneer but the dentist will have only some degree of control over many of them, and even less control over others.
As we've discussed on previous pages the degree of translucency that a porcelain veneer has will affect its cosmetic appearance but this translucency is a function of the way the veneer has been fabricated. The dentist will communicate their needs to the dental laboratory technician but porcelain veneers are handcrafted items, not items that are stamped out on an assembly line. Although the dentist has selected a dental laboratory in part based on their ability to communicate with them they only have input, not direct oversight, over the veneer fabrication process.
The dentist must also juggle factors associated with the cement being used to attach the porcelain veneer to the tooth. In those cases where it is possible to tweak the color of the veneer the dentist may find that two different colors of cement may each provide a close color match whereas neither is perfect. Additionally, try-in pastes aren't always perfect matches for the cements they are intended to represent. To compound things even further some cements can undergo a slight color shift when they are cured.
These are only some of the easier to explain obstacles that your dentist faces. So please understand that your dentist won't be able to guarantee results when they place porcelain veneers they can only promise to perform the treatment in a fashion where they have tipped the scales in their favor as much as possible, so the outcome is as predictable as it can be.
There can be instances where a patient's porcelain veneers have been bonded into place yet later on the patient concludes that they really were hoping for an end result that was slightly lighter in shade. Once a porcelain veneer has been bonded onto a tooth its color cannot be changed. If there is something about a veneer that is not pleasing then the only option is to grind it off and repeat the veneering process, which clearly can be a pretty expensive proposition.
This scenario clearly demonstrates the importance of the patient's active participation during the porcelain veneer try-in stage. During this step the color changes that are possible when using different shades of cement can be evaluated. If you have an opinion it must be voiced. After a porcelain veneer has been cemented it is too late to make a predictable change.
We have just told you the bad news associated with color concerns and cemented porcelain veneers, there is however potential that there might be some good news in this type of situation. It is conceivable that the apparent color of a porcelain veneer might be changed by way of using teeth whitening treatments.
As we explained previously the actual color of a veneered tooth is greatly influenced by the shade of the opaque layer lying underneath the veneer. If both the porcelain veneer and the cement it has been bonded on with (together as a unit) have some degree of translucency then a portion of the veneered tooth's color is a function of the color of the tooth structure that lies underneath the veneer and cement. If the color of this tooth structure can be changed it can have an affect on the overall color of the tooth.
You will need to ask your dentist about the prudence of this approach and its potential for producing results in your situation. It seems likely that a tray-based teeth whitening system would be the most effective form of the at-home teeth whitening. To be effective the bleaching agent needs to be applied to the backside of the tooth. This will be the entry point for the whitener. It seems that the characteristics of a tray-based whitening system would meet this requirement most effectively.
Some people seeking a relatively large color change for their teeth might be best served if they use teeth whitening treatments before the process of placing porcelain veneers is begun. It might be possible that after completing the bleaching treatments they discover that the color they have achieved is pleasing and therefore porcelain veneers are not needed. That would be nice. Even if the teeth whitening treatments don't provide an acceptable end result there can still be a benefit from having had them.
A porcelain veneer is very thin and in order to mask over very dark tooth structure it may have to be fabricated so it is relatively more opaque, as opposed to relatively more translucent. Veneer translucency is one characteristic that is typically associated with the ability of a veneer to mimic tooth enamel and create a very natural and life-like appearance. By using teeth whitening treatments first and achieving at least some degree of color change then the relative translucency of the porcelain veneer being made can be greater. The veneer won't have to be as opaque as it would have been because it doesn't have to hide tooth structure that is quite as dark.
In all cases you should ask your dentist about the prudence of this approach, the various methods of teeth whitening that might be used, and how choosing to include a whitening process will affect the timing of the other steps of your treatment plan.
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