Once the dentist has concluded that the porcelain veneer's fit and appearance are satisfactory they can then make preparation to bond it to its tooth. Even though you will be unaware of if a part of this preparation process will include removing the remains of the trial paste from the inside of the veneer. The veneer's internal surface will then need to be treated so that the cement will bond to it properly.
Porcelain veneer technique is an extension of standard tooth bonding methodology. The science of this technique is based on using an acidic tooth conditioner to create an etched enamel surface. At a microscopic level an etched enamel surface is coarse and rough.
A liquid "bonding agent" is applied to the etched enamel surface. Because it is a liquid it can seep into the nooks and crannies that have been created by the etching process. Once the liquid bonding agent hardens it becomes physically locked into place on the surface of the enamel (a mechanical bond has been created). The cement being used to attach the porcelain veneer to the tooth then in turn creates a chemical bond with this initial bonded layer formed by the bonding agent.
The dentist will place an acidic etching gel on the tooth's surface and allow it to work for about 15 to 30 seconds. They will then wash and dry the tooth so to remove all traces of the etching gel. An appropriate etched tooth surface has now been created.
At this point the dentist will apply bonding agent to the etched tooth surface. The set of this bonding agent is initiated by way of shining a curing light on it for 10 to 20 seconds. A curing light's output (light) activates a catalyst contained in the bonding agent which in turn triggers its setting process. (The cement that will be used later on to bond the porcelain veneer in place contains this same type of light activated catalyst too.)
Cement (the same shade that was deemed appropriate when testing with the trial pastes) is then put inside the porcelain veneer. The dentist will gently press the veneer into place so to express excess cement from underneath the veneer.
The dentist will want to remove much of the excess cement before it is set (while it is still pliable and easily removed). Toward this goal the dentist will shine the curing light on just a portion of the veneer, so only a part of the cement becomes set. This way the veneer will be firmly tacked in place but the greatest portion of the cement will still be uncured and easy to remove.
The dentist will remove that portion of the uncured excess cement that they think is indicated with a hand tool or brush. Once this has been completed they will again expose the porcelain veneer to the curing light, this time for about 60 seconds. This will cure the remainder of the cement.
At this point the attachment of the porcelain veneer to the tooth has been completed (in the sense that the veneer is now firmly fixed in place on the tooth). The dentist will need to complete the removal of any excess cement that still exists around the edges of the veneer. Since the cement is now set the dentist will need to use some combination of hand tools, their dental drill, and abrasive strips in order to remove it.
If there are any veneer outline or shape issues that have yet to be addressed the dentist can deal with them at this point. The dentist will also evaluate the patient's bite as it relates to the new porcelain veneer. A porcelain veneer must not interfere with a person's bite, either when the person simply closes their teeth together or when they slide their teeth to the left, to the right, or forward.
As a means of evaluating these actions the dentist will have the patient perform jaw movements while a piece of carbon paper lies between their teeth. The paper will leave marks that identify those locations where contact is made between the teeth and the porcelain veneer. The dentist will evaluate these marks and then with their dental drill make adjustments to the porcelain veneer as is needed.
It would be expected that the amount of time needed to place a porcelain veneer would be on the same order as the length of time needed when the tooth was first prepared, or a little bit longer. If only one porcelain veneer is being seated then this appointment might be on the order of 30 to 40 minutes or so. Of course the amount of appointment time set aside would need to be longer if more than one porcelain veneer was being placed, possibly as much as an hour or two. This question is one that your dentist should be able to answer easily when you discuss things during your initial porcelain veneer consultation appointment.
At the completion of the insertion appointment a porcelain veneer is, in general, in place and ready to go. Your dentist may ask you to avoid placing heavy chewing forces on the teeth with the new veneers for the first day or so. In those cases where a dental anesthetic has been used it might be prudent to limit your oral activities until that point in time when the numbness has worn off, so you don't inadvertently bite your lip.
In those situations where a shape change, especially one involving several teeth, has been one of the main accomplishments of the treatment you may notice that you have some initial awkwardness with eating or speaking. You should feel free to contact your dentist and discuss the difficulties you are experiencing. Hopefully a person will find that they quickly adapt to the changes their porcelain veneers have provided.
It can be within normal limits that the teeth that have received porcelain veneers might experience some sensitivity to thermal stimuli such as hot and cold foods and beverages. In most cases this sensitivity can be expected to dissipate within a week or two, but in all cases you should feel free to contact your dentist so to get their input and advice regarding the specific nature of the sensitivity you have noticed.
Your dentist may request that you return for a follow-up appointment one to two weeks after the porcelain veneers have been placed. This will provide them with an opportunity to see how you are doing and also inspect the porcelain veneers. At times a dentist may identify excess cement that was previously overlooked and take this opportunity to remove it. If you have any concerns about the outline shape or contours of your porcelain veneers your dentist can make adjustments during this visit also.
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