As we have mentioned previously, when Lumineers ® veneers are placed using a "no drilling" technique the teeth being veneered will end up being bulkier than they were originally, however minimally. This extra thickness can have an effect on considerations that range from cosmetic to functional to even biologic.
Listed on this page are some of the concerns that will run through a dentist's mind when they are evaluating a prospective dental patient so to see if they are a candidate for placement of Lumineers ® veneers using "no drilling" technique.
We've already alluded to some of these concerns but in general placing Lumineers ® veneers using a "no drilling" technique can result in an appearance that looks "toothier" than is normal. That's because if you take a tooth and place an additional layer on it (the Lumineers ® veneer) it will end up being larger.
Now from a standpoint of cosmetic appearance this might not be much of a concern. When people look at our smile they typically do so only from some distance and few of us give others an opportunity to inspect our smile up close for an extended period of time. Additionally, at a subconscious level when a person looks at our smile a large part of what they expect to see, and therefore a part of what makes us look "normal" to them, is uniformity. If all of the teeth that show when a person smiles have been veneered in a similar fashion, then this criterion of uniformity is easily met and therefore possibly making the increased overall size of the teeth a nonissue.
Another criticism dentists sometimes voice in regards to Lumineers ® veneers placement using "no drilling" protocol is that they feel that thicker porcelain veneers can provide a more lifelike and lustrous appearance than the ultra-thin Lumineers ® veneers that are utilized with "no drilling" protocol can. This is often simply a point of personal preference but in general the idea is that the dentist feels that a dental laboratory can impart more characterization and lifelike translucency into a thicker veneer (either a traditional porcelain veneer or a Lumineers ® veneer placed using traditional veneering technique) than they can in an ultra-thin "no drilling" protocol Lumineers ® veneer.
When Lumineers ® veneers are placed using "no drilling" protocol the veneers will add an extra thickness to the teeth on which they have been bonded, no matter how minimal. If "no drilling" protocol Lumineers ® veneers have been placed in a situation where the ideal initial conditions existed then it is expected that the dental patient will be able to adapt to this added thickness in just a few days, at most.
In those situations where the person's initial conditions were somewhat less than ideal for Lumineers ® "no drilling" protocol then the end result can be one where the veneered teeth have become oversized, possibly even grossly. This type of change can interfere with a person's biting motions, speech, or the way their lips glide or position themselves on their teeth. Over time a person may be able to adapt to these changes but if your dentist does not offer to place Lumineers ® veneers on your teeth using "no drilling" technique this may very well be one of the reasons why.
There are biological considerations associated with the overall shape of a tooth. Exaggerated and pronounced tooth contours typically make it harder to keep a tooth plaque free. These contours will disrupt the natural cleansing action generated by a person's lips and cheeks as they rub against the tooth's surface. They can also make it harder to remove dental plaque when brushing and flossing, especially in the region at and below the gum line. Anything that interferes with effective removal of dental plaque from a tooth can set the stage for tooth decay and gum disease. If caught early enough both of these conditions can usually be easily rectified, but many times the cosmetic appearance of the veneered tooth will have already been compromised.
Dental research has suggested that over bulking the contours of a tooth .2mm or less will typically not adversely effect the health of the gum tissue surrounding that tooth. .2mm is about the same thickness that a Lumineers ® veneer will add when the ideal initial conditions for "no drilling" technique are present. The potential for creating problems exists when a dentist chooses to place Lumineers ® veneers using "no drilling" protocol when the patient's initial situation is less than perfectly ideal. Some research has found that the health of gum tissue can be affected when a tooth's contours are over bulked as little as .5mm.
Traditional porcelain veneer technique can sometimes be used to change the apparent alignment of teeth. When this technique is utilized, the prominent portions of the crooked teeth are trimmed back so their front surfaces are somewhat even in alignment. The alignment discrepancies that remain are then perfected by minor variances in the thicknesses of the individual porcelain veneers that are subsequently placed. The net result is that the veneering process creates an even tooth appearance yet the veneered teeth remain relatively normal in size.
Attempting to create an even appearance for misaligned teeth using Lumineers ® "no drilling" technique creates the potential for producing a result where the veneered teeth can become oversized, possibly even grossly. When a "no drilling" technique is utilized the only way to even out the alignment of crooked teeth is by making each of the Lumineers ® veneers a different thickness. And while this approach can create a situation where to others the general appearance of the person's smile does seem to be even and regular it can come at the expense of having made some of the contours of the teeth quite oversized, thus placing the person at risk for the complications we have discussed.
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