Monday, 23 October 2017

22 Things You Need to Know Before Getting Veneers

If you've ever considered getting veneers — a thin wafer of porcelain that is permanently bonded to a tooth to mask its color, shape, or positioning in the mouth — read this first to understand the full experience, courtesy of Michael Apa, DDS, a cosmetic dentist in NYC (aka the pioneer of porcelain). Because veneers are A) forever (well, kind of) and B) very pricey.

1. You need to go to someone incredible to get fantastic results. This is an aesthetic procedure but it’s also a serious dental procedure, so you’re going to want to see the cosmetic dentist's work to make sure they're good and that you like their style. Also, make sure you approve of their before and afters, and that you're able to see their work 10 years later and still like it.

2. Veneers aren't a must, but they are an option. Anyone can benefit from veneers if they don't like the looks of their teeth or overall smile, but Dr. Apa mainly sees people who want to correct an issue. For example, he has patients who don't want to undergo braces (again!) yet still have crooked teeth, others who don't like the color of their teeth and want to whiten them permanently, and some patients who have chipped front teeth or who've simply had thicker porcelain veneers done in the past and want a less noticeable look.


3. One smile does not fit everyone. "Patients comes in with an idea of what they don’t like about their teeth, and then my job is to take what they don’t like and actually make it work for them." FYI: Unlike hairstyles, you can't just take a picture of Gisele into his or someone else's office and say I want her exact smile, please!, because what works for her face won't work for yours.

"The cool thing about what I do revolves around customization," Dr. Apa notes. "First I discuss with the patient what is possible based off of their wants. I also take into account their personality, how they talk, the expressions they make, how high their actual smile goes verses a social smile, etc., and then I make sure they get the smile they want, while making sure their teeth also work functionally so they can still eat."

4. Imperfections = perfection. Dr. Apa doesn't believe in making teeth look perfect; instead, he wants to maintain the character of your smile, while enhancing it. He also doesn't want his dental work to be noticeable (aka no chiclet-looking teeth!); he wants people to look at his patients and think I feel like they didn't something, but I can't tell what it is.


5. You don't have to veneer all of your teeth. You can do one tooth (let's say you tripped and fell when you were little and now it has a gray cast to it) or your entire set of teeth (it just depends on your needs and budget). "If people ask me to do just their front teeth, there are parameters I have to respect though," he says. "For example, when I did Huda’s teeth, I only did four on the top front, because the rest of her smile was already in a good place, so I was able to fit those four veneers in perfectly like a puzzle piece."

6. If you're planning on getting lip injections (or any type of plastic surgery), tell your dentist about it before getting veneers. "Any other work done to the face throws off everything I take into account when I'm looking at my patients," he says. Side note: If you get lip injections, whether or not you have veneers, it can cast a shadow over your teeth, making them appear gray, he adds.

7. The color of a veneer is a really tricky thing. "People always want their teeth to look natural and white," he says. "But your teeth are either yellow-white or gray-white by nature, but everyone wants white-white. So, the trick is making their smile white without making their teeth appear dense, opaque, and fake." To find the perfect shade, he mainly looks at a person's skin tone to make a customized decision, which he relays to his team of ceramists. "But I always paint the temporary veneers the shade I'm thinking, so the patient can envision it beforehand, " he adds.


8. After you discuss your veneer wants and needs, temporary versions are made. To make sure you're going to like what you just discussed with your dentist, a mold of your teeth is taken and temporary veneers are then made out of a liquid composite. Think of it like a blueprint for your teeth. Dr. Apa specifically sculpts what your new smile will look like, so that he can take pictures of you for you to see and decide whether or not you'd like to move forward. They won't be as shiny as the porcelain veneer and are a little bulkier, but don't worry, they're only... temporary.

9. There is a fee for the consultation (in Dr. Apa's practice anyway). All of the above is discussed in the consultation, which, for Dr. Apa's patients, it's $500, but should you decide to move forward with the procedure, the fee goes toward the amount of your overall bill. Heads up: Veneers from him are $4,000 a tooth, but elsewhere in the country they can range from $1,000 to $4,000.

10. Once you commit to your veneer plan and figure out how many you need, more molds, X-rays, and photographs are taken. Then, you come back the next day for prep.

11. "Prep" doesn't mean your tooth is about to be shaved to a small nothing of a nub. "Ninety-nine percent of the time, I don’t need to shave away more than .5 millimeters to gain all of these before and afters you see [think: thinner than your fingernail], "Dr. Apa explains.


"The whole crux of what makes my teeth different than most is that I’m designing the final smile before I even start, so it allows me to be super minimal when it comes to what I have to do to prep the teeth," he adds.

For example, if you come in with large, grayish-looking, crooked teeth, that’s when he'd really have to shave the teeth down to get the look you might want. But if you have short teeth and gaps, he won’t have to do as much "prep" aka shaving.

12. You can either get partial (they don't cover your entire tooth) or full (they cover your entire tooth) veneers. Every case is different, you can either have the porcelain put right on top of your teeth, based on your needs, or, at the very most, you'll need .5 millimeters of reduction for a full-coverage veneer.

No prep:

Minimal prep:


13. After you get your temporary partial or full veneers fitted, you wear them for seven to 10 days. Dr. Apa refers to this as a "trial smile." This way you can see how you live with your new "smile." Then, after a week or so, you come back and discuss any changes you want to make. Once you and your dentist agree on what you want, more molds are taken, which are they sent to a ceramist for duplication. When the porcelain veneers are ready, they're fit to your teeth once more to make sure they're a perfect match.

14. Before the multi-hour application process begins, you'll be numbed with a localized anesthesia. Regardless of whether you choose partial of full veneers, you will be undergoing a medical procedure, so local anesthesia is required. Think of it as plastic surgery for your teeth. Oh, and depending on how many veneers you're getting, you could be in the chair for hours. For example, for 10 teeth it's about three hours.

15. Bonding cement is used to adhere the veneer onto each tooth. "Bonding cement is a substance that microscopically creates bridges from your real tooth to the porcelain so that it adheres to your tooth and becomes one," Dr. Apa explains. "Think of it as the glue for a press-on nail — only you can’t get this one off once it’s on." After the bonding cement is in place and the veneer is on your tooth, the bonding cement is cured with a tiny UV light to secure everything in place. This process takes about an hour for 10 teeth.

16. Bonding sensitivity is real and it can happen to you. Fifty percent of patients get bonding sensitivity, which is a reaction between your teeth and the bonding cement. The extreme pain it comes with can last six hours after the anesthesia wears off, followed by a dull pain that comes in waves. Consider Ibuprofen your BFF during that time period. Days after the procedure, there is often an adjustment period where your bite might feel off and you feel zings of pain. If either occurs, see your dentist so they can make slight changes to your teeth with a file (this sounds scarier than it is) and clear away any excess microscopic pieces of cement stuck between your teeth (this usually is the culprit for the pain). The follow-ups are all free, btw.


17. Your gums will be sore AF. In addition to possible bonding sensitivity, there's an overall healing process your gums go through, because they need to reform around the new teeth. Again, bust out the Ibuprofen because you're gonna need it.

18. The harder you are on your teeth, whether you grind or clench them, the longer the healing process will take. That said, this is all temporary pain. Dr. Apa assured me that every single one of his patients forgets they’ve had their teeth done because they *feel* like their natural set after a month or so.

19. Veneers are an investment that you have to take care of. At Dr. Apa's practice, each veneer, whether it's partial or full, costs $4,000 each, because he's hand-making the initial teeth that are they sent to the ceramist to copy. But at other practices, depending on where you live, they can cost from $1,000 to $4,000, so $10K to $80K for a full mouth. Can't swing that chunk of change? You're not alone. Dr. Apa recommends asking your dentist if he or she offers a payment plan, because not everyone can shell out that kind of cash at once.

20. Like fake books, veneers last for about 15 to 20 years, then they need replaced. However, if you don't take care of them (brushing and flossing regularly), you'll need to replace them sooner. Regardless, at some point you’ll have to trade them in for a fresh set.

21. To keep them looking amazing longer, you have to go to the dentist twice a year for cleanings and floss regularly. To help promote oral health, Dr. Apa created products to make sure his patients (and you — they're sold here!) have good hygiene. For example, his electric toothbrush offers 50 revolutions per minute, which is comparable to a real polishing that you’d get at your dentist, it’s also set on a 2-minute timer, so you know how long to brush.

Then, he whipped up a toothpaste that has hydroxy appetite (HA) instead of fluoride (your teeth are made of tiny cells of HA), which creates an invisible lattice across each tooth, strengthening it. His mouthwash also contains HA and has zero alcohol in it, which can make your gums recede. And lastly, he came out with his own gum gel that's packed with antioxidants, so it helps eliminate inflammation, swelling, and creates cellular regeneration (aka it keeps your gums pink and healthy).

22. To replace veneers, you gently and carefully drill off the old veneer, and start the new process over. Don't worry, more of your natural tooth does not get removed when they take the old ones off; your dentist will wear microscopic glasses to make sure he’s not drilling into the natural tooth.

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