I’m writing in today to discuss something that’s been bothering me quite a bit as a dentist. Lately, I’ve had many patients come into my practice who have had chairside work done, but the direct composite veneers technique was way off, resulting in a very unnatural look for the patient. It seems like most dentists today have a fairly good understanding of opaquers. They do a fair job of masking surface irregularities, stains, and whatnot. However, their efforts seem to stop there. They aren’t focused on creating something that looks natural. Unfortunately, the patients don’t seem to know any better and they accept these bright white chicklet teeth because they’re happy to be free of the cosmetic blemishes and they don’t realize they could have teeth that look natural. I’m talking about translucency here—and the various shades which make up the appearance of a tooth’s color. I feel like this is something that is barely touched on in dental school—perhaps they’re more focused on the mechanics versus aesthetics. When I show patients before and after photos of how a direct composite veneers technique with layers looks compared to their solid white mass, I get the same response every time. It’s immediate excitement about how their teeth could look, followed by a wave of sadness that they’ve invested so much already to get sub-par aesthetics. Look—if you’re going to do cosmetic work, you should study cosmetic dentistry. Don’t just slap a layer or two of material on a tooth and call it a day. You owe your patients this much. Natural teeth are not one color. They’re made up of layers of various colors, with multiple levels of translucency.
I could go on about this all day and even provide some tips for dentists who want to improve their direct composite veneers technique, but I know there are many ways to produce beautiful results. What works for me may not work for someone else and I don’t want someone trying to copy my technique based on words on a screen thinking it’s the end-all. That said, if we could at least open their eyes some to the possibilities, so they seek out a solution that works for them, that would make my day.
Dear Dr. Jones,
Thanks so much for sharing your experience. This is one thing addressed in the Uveneer FAQ and on some of the instructional videos as well; that various layers and materials can be used even with a dental matrix system to achieve the desired aesthetics.
As you can see in the photo below (which is a before and after photo provided by a Uveneer dentist) opaque white teeth would not have worked at all here. It wouldn’t just have been a matter of translucency at the incisal edge; the coloring of the tooth would have been all wrong if the dentist had not used shading and layering to match the neighboring teeth.
This blog is sponsored by Uveneer, maker of an innovative dental matrix that helps dentists create more beautiful chairside veneers in less time.