The value of the veneer

22 January 2024

Luke Hutchings explains how to overcome the challenges of composite veneers.

One of the most requested cosmetic dental procedures is veneers. Since the pandemic activated the ‘Zoom boom’, patient appetite for such enhancing ‘tweakments’ has grown. Combined with the omnipresent social media of celebrities and influencers sharing their latest Hollywood smiles, the public’s dental aspirations for brighter, whiter smiles have come into their own.

However, it’s not all plain sailing.

When Lily Lindsay splashed out £1,000 on her dream smile last summer, little did she realise that she would suffer an allergic reaction to her composite veneers. Two weeks after what appeared to be a successful treatment, she started suffering unpleasant symptoms, including an unsightly and uncomfortable skin rash.

Lily’s reaction was rare, but there are other challenges that patients need to be made aware of when it comes to this popular option for enhancing dentition. One of the main challenges of composite veneers is their susceptibility to staining. Unlike porcelain veneers, which have a smooth and non-porous surface, composite veneers are more porous, making them more prone to discolouration over time.

Common staining agents, such as coffee, tea, red wine, and tobacco, can penetrate the porous surface, leading to a dull and discoloured appearance. It is, therefore, important for patients with composite veneers to be cautious of their dietary and lifestyle choices to minimise the risk of staining. Dental professionals should encourage regular, professional cleanings and whitening toothpaste to help maintain the brightness of composite veneers.

Wear and tear

Another consideration when it comes to composite veneers is their durability. While they are generally strong and resilient, composite veneers are not as strong or long-lasting as porcelain veneers. Composite material is more susceptible to wear and tear, making it more prone to chipping or cracking, especially in individuals who grind or clench their teeth. Additionally, composite veneers may need to be replaced more frequently compared to porcelain veneers, which can ultimately increase the overall cost of treatment.

Maintenance and care are additional issues associated with composite veneers. While they are less invasive and reversible compared to other dental treatments, they still require regular maintenance. Good oral hygiene practices, such as brushing and interdental cleaning, are essential to prevent plaque build-up and gingivitis. Another downside of some dental composites is that they accumulate more biofilms and plaque than other restorative materials and pose the problem of recurrent caries along the tooth-composite interfaces over time.

Patients with composite veneers should be advised to avoid biting on hard or sticky foods that can cause damage to their veneers. If a composite veneer chips or becomes dislodged, it will need to be repaired, contributing to additional time and cost.

A fine art

Composite veneers also require a high level of skill and artistry. Achieving a natural and aesthetically pleasing result with composite veneers is a complex process that demands meticulous attention to detail. The dental professionals must carefully match the colour of the composite resin to the natural shade of the patient’s teeth, ensuring a seamless blend and an overall natural appearance – bearing in mind that the patient’s level of satisfaction may not be the same as that of the dentist. A good understanding of colour and shade determination is essential. Human dentition shades differ significantly, and electronic devices can identify approximately 100,000 dental shades, while the human eye can identify only one per cent of these shades.

It requires expertise in sculpting and shaping the material to create a harmonious smile, too. The success of composite veneers relies heavily on the skill and experience of the dentist, making it vital they choose a qualified professional for the procedure. Having your skills validated by a respected industry association is a stamp of approval that boosts personal confidence and enhances your professional reputation.

Membership of the British Academy of Cosmetic Dentistry (BACD) gives dental professionals access to an accreditation programme that requires them to hone and demonstrate their skills in functional aesthetic dentistry. Suitable for both clinicians and laboratory technicians, the process involves the submission of clinical cases in categories that include smile makeover, indirect shade matching, tooth replacement, posterior restoration, complex composite bonding, periodontal plastic surgery, minimally invasive techniques and complex whitening. BACD accredited status sets members apart and validates the extent of their competence to patients.

Composite veneers offer a convenient and affordable option for patients seeking to improve their smile. However, there are challenges associated with this treatment: the vulnerability to staining, the need for regular maintenance and replacement and the skill required for a natural result. Carefully assessing a patient’s needs and expectations can help dental professionals determine the best treatment option for achieving that longed-for, beautiful and lasting smile.