Replacing Facing composite
It is important to replace fading composite not only for the obvious esthetic reasons, but also to avoid cavities or malfunction. If composites are chipped or worn they may not function properly to chew food and may even cause food to get stuck between your teeth.
When a filling has a bad or defective margin adaptation the potential for increasing the risk of recurrent cavities escalates. This increase is due to the difficulty to adequately brush and floss around the composite filling and tooth. New fillings are recommended to replace existing defective fillings that are small and size and do not involve a lot of tooth structure.
When a large existing filling is present sometimes the dentist is incapable of placing a new one, as there is not enough tooth structure to form a proper margin. When this occurs it is then recommended that we place a porcelain veneer for its esthetic outcome, longevity and functionality.
In some cases there is not enough tooth structure remaining for a veneer. Under these circumstances, when a veneer is contraindicated a porcelain crown may be recommended.
Once the old fillings are removed, the selection of the type of porcelain material is essential. Not all porcelains look the same on natural teeth. If the tooth is discolored it will be necessary to choose specific porcelain for that specific tooth. In this case we used Emax porcelain because of its strength and ability to blend the discoloration of the natural tooth. Thanks to the ideal shape of the new teeth the gums are healthier and the teeth from the right side looks identical to the left. This gives an overall pleasant look.
Once the veneers are installed you will need to have a professional veneer cleaning every 6 months. With this cleaning we will focus on cleaning around the interface of the tooth and the porcelain as we want them to last for long time. In some cases a nightguard will be recommended to protect them from fracture especially in cases of grinding and clenching.
For your veneer makeover consultation first we will need to perform a clinical and radiographic examination. We perform this thorough exam to make sure there are no caries, nerve damage or periodontal issues associated with the teeth that will have a permanent restoration placed on. We want to repair or restore any pathologies first as we do not want to place a permanent restoration and need to make adjustments later on. Most of the esthetic problems can be resolved with more conservative procedures like teeth whitening, bonding or braces. If you are a candidate we will then perform a full esthetic computerized analysis. If you accept the treatment we will then take molds of your teeth to fabricate a prototype of what your veneers will resemble. The prototype of your future teeth will first be fabricated using wax. We can make changes and modify the wax up so that the final product is what you desire. The wax will be an exact replica of your final porcelain veneers and we will again copy it to transfer it to your front teeth. We will use a temporary material for the transfer that will resemble the end result in shape and color. We can play with the shades to determine how natural or white you would like your permanent veneers. The prototype will not damage your teeth in any way. It is just a way for us to show you what you will look like before we modify your teeth. Once you are completely satisfied with the prototype and are 100% committed we will take the necessary steps to modify your teeth for the final veneers. Afterwards, we will take molds of your teeth and then temporarily cement the prototype for you to wear until our scheduled delivery date. You will typically wear the prototype for approximately 2 weeks. When your final restoration arrives we will remove the prototype, again try on the veneers and get your approval and if all is well permanently bond them to your front teeth. We highly recommended that you then schedule routine six months maintenance, cleaning and exam to ensure the longevity of the veneers. We also recommend that you wear a night guard to protect your investment and ensure they are not damaged from grinding and clinching during sleep.