Porcelain Veneers in Rancho Santa Margarita
In my 37 years as a dentist (UCSF 1977), an upper front tooth has always been the most difficult of all the teeth to match to the surrounding teeth, mainly because it’s almost the first thing anyone sees when a person smiles. Teeth take on different qualities of color or appearance in different lights or angles of light. The dental laboratories that make porcelain crown labs use terms like “opalescence”, ”luminescence”, “translucence”, and “fluorescence” (none of which I can keep straight) to describe these light-reflecting or light-refracting properties of porcelain or tooth enamel.
Modern materials and tools are responsible for the dramatically improved ability to match front crowns to the surrounding teeth. The porcelains used today have the same reflective or refractive qualities as tooth enamel, so front crowns look like teeth. Also, the front-tooth crowns used in the past had porcelain baked on to a metal base, called a coping. This created the ugly black line commonly seen at the gum line. It also took away the natural translucence of tooth enamel making it look like the kitchen sink and made the tooth’s roots look dark through the gums. Today’s front crowns have no metal, and the porcelain used very closely duplicates the natural light-transmitting characteristics of tooth enamel.
Dramatic improvements have also been realized in the technology of front-tooth veneers. These laboratory-fabricated very thin (as thin as 0.3mm) custom-made sheets of porcelain bond on to the fronts of the teeth. This means we can give the patient beautiful, clean, white, straight-appearing teeth with an absolute minimum of grinding away of tooth-structure.
Sometimes, we use a laser to recontour the gum tissue around the teeth to make them look longer and aesthetically more pleasing. In other cases, in individuals with small-looking teeth, maybe with spaces between them, we don’t remove away any tooth-structure at all (one brand-name you may have heard of is Lumineers)- the veneer bonds directly to the tooth enamel.
One other great advantage of being in the Saddleback Valley is that the best dental laboratories in the world are right here. Teeth are not all one color. There are shadings and differences in opacity or translucencies. When the lab guy, either when we send the patient to the laboratory, or when he comes to the office, can look at the adjacent teeth directly, he can do a phenomenal job of matching the new piece to them, even the dreaded single front tooth crown can become non-apparent.
A patient asked me once while discussing her case what will she do during the two weeks that the permanents are being made. I told her that one of the great lab techniques we can take advantage of today are the temporary restorations we place while permanent front teeth crowns or veneers are being made in the lab. After we get all the teeth prepared, sometimes as many as ten at a time, and the final impressions (from which models are made on which the restorations themselves are fabricated) are taken, we place a one-piece plastic “provisional” that will look very close to as good as the permanents. When we pull away and let the patient see the temporaries, almost without fail, the patient is amazed at how they look.*
It’s still true, though, that restoring the two front teeth with porcelain crowns or veneers is easier, cosmetically, than doing just one, and doing the four incisors or even six (I-tooth to I-tooth) front teeth dramatically improves cosmetic results. Some peoples otherwise narrow tooth arch can be broadened. Crooked teeth can be made to look straight with crowns or veneers, rather than braces. And the gum height can be altered with the laser, allowing the teeth to look longer, if necessary, or at least even.
In this era of the “extreme make-over”, the possibilities continue to widen.
Nobody needs to be shy about their smile. Call me at my Rancho Santa Margarita office- 949-459-7212- to make a complimentary consultation appointment if you are concerned about yours.