Will the veneers you're placing look natural? Here's how to tell.

In the second installment of this new Web series, Dr. Harvey Silverman provides tips on how to determine if the veneers you’re placing will look natural.

In the last edition of The 10 Minute Easy Smile Makeover, I discussed how your Smile Care Advocate (SCA) can help work-up patients who want to transform their smile but cannot afford it or do not want to have a conventional smile makeover. 

This week’s tip is how to accurately determine if your veneer will look natural.

We have all seen patients with artificial looking veneers. The teeth appear so prominent or opaque they stick out when the patient smiles. So, how can veneers look natural?

Coaching tip: Computer imaging is one technique many dentists use to share what a veneer might look like. However, with non-invasive in-office veneers I suggest doing a Smile Preview with a mock-up. This preview of the veneer is more accurate. By doing this you’ll also know if your skill set matches the patient’s expectations. 

After the mock-up is done, evaluate it for size, shape and color considerations.  Did you achieve the desired esthetic transformation (meeting your critical eye and the patient’s expectations)? Does the veneer look like it was born with that tooth? 

If it does you will have a natural looking veneer. If it doesn’t, take a pass.

Tip for docs who think out of the box: With the EasySmile® approach, there are clinical scenarios where you can actually first place the veneer and then do in-office whitening immediately after that. 

Indications: When trying to achieve 2 to 6 shades of color change with in-office whitening. It can also work with transformations of 6 shades or more but with less predictability. That’s because we know most patients (but not all) achieve up to 6 shades of brightness based on the Vident’s VITA Classical Shade Guide. But we cannot always count on 7 shades plus of improvement.

Let’s consider how this works for a patient whose teeth are C1 and wants to have teeth that are B1: A 5-shade change with the shade guide arranged in value order:             

B1, A1, B2, D2, A2, C1, C2, D4, A3, D3, B3, A3.5, B4, C3, A4, C4

Imagine this same patient had endo on a central incisor and is shade A3. 

The patient wants a veneer that also will be B1.

Here’s a tip for docs who think out of the box. Before bleaching do the Smile Preview (mock-up) without using opaquers. Is the mock-up color B1? If it isn’t take a pass. If it is B1, then consider doing the in-office veneer first as it will blend in with the bleached teeth.  I’m sure you’re thinking this is unconventional, right? 

In a few weeks I’ll explain more. It is really a cool system.

As a result of advances in technology and in material sciences I now do more in-office veneers than porcelain veneers. Using our Smile Preview system I coach docs to create in-office veneers that look gorgeous. It’s a simpler, more esthetic approach and patients routinely say, “Can I have this done today?” 

That is a refreshing change!