They say veneers don’t work!

Veneers don’t last!

Over the years, I’ve encountered colleagues that claim veneers are doomed to fail…. Or, that they are less predictable than crowns.  “Veneers pop off.”  “Veneers break,” they say.

 

Baloney!

I’ve been fortunate to have practiced for almost 33 years (so far), 27 years in one place.  I’ve also been fortunate enough to have a number of patients who have been in my practice for a long time.  As such, I’ve had the opportunity to observe the longevity of my own work… for better or worse! 

When patients move away, we can at least claim “geographic success!”  If your cases move away, they haven’t failed… as far as you know.  Some of mine have stuck around.

How long do veneers last?

My first 2 veneer cases, done 22 years ago, are still in recall in my practice.  Both cases are intact.  Another of my early cases, done 17 years ago, was in hygiene recall today, and I finally remembered to grab my camera for some follow-up photos!  When the others return, I’ll try to remember to take photos and add them here.

Today’s 17 year old recall case was just four units… #7 – 10.  The laterals are veneers, and the centrals are crowns.  But, before we show the follow-up photos, let’s look at where we started and what we did 17 years ago.

The patient didn’t like his smile.  He didn’t like the single crown on #8.  He didn’t like the rotations of the “bucky” teeth.  Orthodontic treatment was rejected.  We agreed to treat the four upper anterior teeth restoratively.

Before:

Before – retracted view.

After:

After – retracted close-up view.  17 years ago.

Before & after:

Before & after – smile. 17 years ago.

Today:

Retracted view – 17 year follow up (today).

Sure… the porcelain has lost some of its sheen / glaze. 

The patient and I chatted about the case, and I advised him we did this 17 years ago.  He was astounded and told me how happy he is with the result.  He said, “Outstanding!  The roofs on some houses don’t last that long!”

Occlusal view – 17 years later.

There is no sign at all of microleakage.  None of these restorations has debonded in 17 years.  No fractures, either. 

The key to longevity?  Meticulous attention to detail in every step of the process.

Retracted close-up view.  17 years later.

Building a reputation for quality work takes MANY years.  It’s a marathon, not a sprint.  But, it’s gratifying to see these cases holding up.  I told this patient we’d be taking photos again in another 17 years!

Post your thoughts and experiences in the comment section below!

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7 Responses to They say veneers don’t work!

  1. Brian K. Van Netta, DDS says:

    Hi Mike. Nice work on those veneers. And it’s obvious that patient takes good care of his mouth and hopefully presents regularly for re-care. Just as important as great technique by the operator is proper patient selection. This seems to be a lost concept today. In a struggle to make bank, docs are slapping in any kind of work on any kind of patient. Massive bruxers, heavy smokers, those with horrendous oral hygiene and poor diets – all are being treated without regard to these important factors.

    Then in just a few short years or less, the work looks like shit, perhaps not so much due to poor technique, but rather to poor patient selection. It takes more guts to tell a patient honestly that they are not a candidate for treatment because it may not last in their mouths. Simply arguing that “you informed them prior to treatment” may technically be accurate, but in my opinion in a flimsy dodge.

    It seems I’m the odd man out discussing these cases with specialists. Oral surgeons sinking implants on heavy smokers, orthodontists reluctant to de-band mid-treatment for horrible hygiene, and periodontists performing exotic surgeries on the most questionable patients. Their argument? “We won’t make a living”. The worst thing is that the patient usually always blames the doc when things fall apart. And that contributes to the perception of the entire profession.

  2. Mark Portnoy says:

    in my experience, veneers are less reliable than crowns. also the esthetic issue with zirconia veneers produces a mono-chromal result that is more opaque than desired. by the time you compare the amount of prep needed to adequately produce a veneer, why not just prep for a full crown and have the assurance of good retention design.

    • The Dental Warrior says:

      I’ve never done zirconia veneers…. and wouldn’t. Can’t bond them like etched porcelain.

      As for retention of veneers vs crowns… in my experience…. Either no difference at all, or possibly veneers have BETTER retention. In my opinion, prepping for a full crown for “assurance of good retention” is unsupportable. In all the cases I’ve done, I’ve simply not seen ANY issue with veneers debonding. Literally zero. I’ve seen a few break, just like crowns and even natural teeth. But, just pop off? None. No lie.

  3. My earliest veneers were feldspathic porcelain done in the early 1990’s. Failures are very rare and those I still see look great!

    • The Dental Warrior says:

      Thanks for chiming in, Jim (I see it’s your first comment on the blog)!

      Feldspathic are tough to beat esthetically. I’d say the only drawback is fit. It takes a really good lab to make those fit well (if you can even find a lab that does them these days). Pressed porcelain has outstanding fit and very good esthetics. Of course, you can cut back pressed porcelain and do stacked on top of it for esthetics.

      But, I agree… failures are extremely rare. I honestly cannot think of any veneer restoration I’ve done that has simply debonded “en toto.”

  4. DentalSave says:

    Excellent writing!
    You are completely right, Veneers generally don’t need as much molding as crowns do, yet they are more grounded and look better.

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