One of the fundamental advantages of using porcelain veneers to create changes for teeth, as opposed to other types of porcelain dental restorations, is that very little tooth reduction is needed. In general (and depending upon the specifics of the case) the dentist only needs to trim the tooth the same amount as the thickness of the veneer being placed.
In most cases this means that the tooth reduction will be as little as .4 to .8 of a millimeter. That's on the same order of thickness as the plastic credit card carried in a person's wallet. That's not much. In comparison dental crowns require up to 2 millimeters of trimming, and this amount of reduction is needed on all aspects of the tooth, not just the front side as is the case with porcelain veneers.
There can be differing circumstances or philosophies regarding the need to trim the biting edge of a tooth when it is prepared for a porcelain veneer. In some cases the veneer might feather out and end right at the tip of the tooth whereas in other cases the veneer will need to wrap over and encase the biting edge. When the biting edge of the tooth is reduced it is usually on the order of about 1.5 millimeters, which is enough that if only a single tooth has been trimmed you would notice it.
All of these tooth reduction considerations are obviously something that is a concern for the dentist and not so much you. A dentist will base their tooth trimming decisions on their knowledge and previous experiences. As a dental patient you simply need to know that some tooth reduction will need to take place.
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You may have seen information on TV, in magazines, or on various websites that describes the placement of porcelain veneers where "no tooth reduction is needed". One such brand name associated with this veneering technique is Lumineers ® by Cerinate ®. We don't have a lot to say about this phenomenon. Without question we think that the precise fashion in which a porcelain veneer is made is best left up to the dentist. We would say however that a Lumineers ® "no tooth reduction" veneering technique might have some obstacles to overcome.
With traditional porcelain veneer technique the front side of a tooth is reduced the same thickness as the veneer that will be placed (typically .4 to .8 mm). This insures that once the veneer has been cemented the tooth will not be bulky or over contoured. If a tooth's shape is exaggerated as a result of the veneering process there can be concerns about how the tooth feels to the patient, conceivably some problems associated with oral functions, and considerations related to the dental patient being able to maintain the health of their gums around the tooth over the long term.
"No tooth reduction" veneering technique relies on the porcelain veneer being ultra thin, usually measuring on the order of .3 to .5 mm (Lumineers ®). And while yes this is a very minimal thickness it is not nonexistent and it can be associated with the any of the difficulties we have just mentioned.
Another obstacle associated with "no tooth reduction" technique is, if a porcelain veneer is ultra thin then how will it be able to adequately mask the discolored tooth structure that lies beneath it? A hallmark characteristic of porcelain veneers is that they can mimic the appearance of tooth enamel because they are translucent, just like tooth enamel is. One would expect that in order to boost an ultra thin porcelain veneer's masking capabilities it would need to be comparatively more opaque and therefore relatively less translucent. In general, the more opaque a veneer is the less life-like and natural its appearance will be.
Only a dentist (and only after having examined you) can make the decision regarding the appropriateness of placing a porcelain veneer without performing any tooth reduction. Clearly "no tooth reduction" porcelain veneers are not the right solution for every situation. And it might be expected that relatively fewer rather than relatively more dental patients will present with the initial conditions that make this technique the preferred method for creating porcelain veneers.
More than likely the dentist will need to "numb up" your tooth and its surrounding gums with a local anesthetic ("Novocaine") before they begin the process of trimming it for a porcelain veneer. Doing so will insure that you will be comfortable throughout the entire procedure.
In theory the amount of tooth reduction that a dentist needs to perform will be confined to just the enamel layer that covers the tooth. And if this is the case it might be possible that a dentist could trim a tooth without the dental patient experiencing discomfort or sensitivity.
In reality however sometimes the edge of the veneer needs to lie on a tooth's root surface and this part of the tooth (tooth dentin) certainly can be sensitive when drilled upon. Additionally the thickness of the tooth's enamel can be so thin, or become so thin during the drilling process, that sensitivity is experienced during the preparation procedure.
Another consideration relates to the gum tissue that surrounds the tooth. The tooth trimming required for a porcelain veneer will need to end either right at the gum line or just slightly below it. The dentist may need to push your gums back a little bit so they can work in this region without the drill touching them. Retracting gums in this manner can pinch somewhat.
The amount of time that is required for a dentist to create the preparations for porcelain veneers (and take the
dental impression and also if needed
place temporary dental veneers) will be a function of how many teeth are being treated. One tooth might take as little as 30 minutes or so. In those cases where multiple porcelain veneers will be made the dentist might set aside one or two hours of appointment time. This question should be an easy one for your dentist to answer during your initial consultation appointment.