What are the downsides of veneers?

The answer in full

A veneer is a thin shell bonded to the front face of a tooth to change its colour or shape, or to close a small chip or gap. It comes in two materials: porcelain, made in a lab to fit your tooth and bonded at a second visit, or composite, built directly onto the tooth in one sitting.

“What are the downsides?” is one of the most honest questions you can ask before any cosmetic work, because in most cases a veneer is a decision that does not reverse. So here you get the downsides first, one by one, with no scare tactics and no gloss. Not to put you off. So that you decide with your eyes open.

And for the right tooth, in the mouth of someone who looks after it, a veneer has its place: it changes the colour and shape of a tooth and closes a chip or a gap in a way whitening alone cannot. This article is not against veneers. It is here so that the decision is yours, and not a photo’s.

The seven, in short

• A thin layer of the tooth is trimmed, in most cases, and it does not grow back.
• Sensitivity to cold for a while afterwards.
• It chips, wears and stains over time, and composite does all of it sooner.
• An edge at the gum that needs cleaning every day, or the gum can get inflamed and recede.
• Your bite and your grinding often decide its fate more than the material does.
• Its colour does not change later, so whitening comes before it, not after.
• Years on, it is replaced, and that responsibility stays with you.

Each of them in detail below. And if you do decide to go ahead, what makes a veneer last and what shortens its life is in What makes veneers last, and what shortens their life.

The downsides, one by one

These are the seven, in the order that matters for your decision. The first matters more than all the others, because it is the only one that cannot be undone.

One: part of the tooth is trimmed, and it does not grow back

So the shell sits flush instead of looking bulky, in most cases a thin layer of enamel is trimmed from the tooth, and that layer never returns. A tooth that has been trimmed will need a veneer or a crown for the rest of its life. In a limited number of cases it can be done with little or no trimming, and the examination decides.

To see where a veneer sits on the ladder: whitening trims nothing. Composite often needs less trimming, or none. Porcelain veneers, in most cases, need a thin layer taken from the face of the tooth. A crown trims the tooth on every side. So the first question to ask any clinic, in any country: roughly how much of my tooth will be trimmed?

Two: sensitivity afterwards

When the enamel is thinner, the tooth can feel the cold for a while. It usually settles, sometimes it lingers, and if it does not settle you call. The more teeth are done, the higher the chance that one of them stays sensitive.

Three: it chips, it stains, and composite does both sooner

A veneer stands up to normal eating, not to seed shells, ice, opening packets with your teeth, or a jaw that grinds through the night. Composite chips and discolours sooner than porcelain, especially with coffee, tea and smoking, though when a piece breaks off it can often be repaired on the tooth. Porcelain resists stains more and keeps its gloss longer, but if it breaks, it is usually replaced. Neither is wrong. You just need to know which one you are getting.

Four: the gums at the edges

Every shell has an edge next to the gum. If that edge is not fitted well, or is not cleaned every day, tartar collects on it, the gum can get inflamed and recede, and the edge or a dark line can begin to show. The shell itself cannot decay, but the tooth under it can, especially along the edge next to the gum, and then the veneer has to come off so the tooth can be treated. So a veneer is not fit-and-forget. It is daily cleaning along a line that was not there before.

Five: the bite and grinding

If your teeth close together wrongly, the pressure lands on one veneer more than the others. So the bite is checked first, and sometimes there is small work on it before the veneer or alongside it. And grinding and clenching are among the biggest enemies of a veneer: a whole night of pressure on a thin shell. Many people do not know they grind until they wake with a tired jaw or a veneer breaks. If you grind, we decide at the examination how to protect your teeth from it, and that becomes part of the plan from day one.

Six: its colour does not change later

Whitening changes the colour of your natural teeth and does nothing to the shell. Whiten afterwards and the veneer ends up one shade and the rest another. That is why whitening comes before the veneer, not after, and the shade of the veneer is chosen to match the new colour. You are choosing a colour that will stay with you for years, so do not choose it in a hurry.

Seven: replacement, years on, is a responsibility

A shell has a lifespan: longer with care, shorter with grinding, biting on hard things and neglected gums, and then it is replaced. Any veneer or crown on a tooth that has been trimmed does not go back to how it was; if it chips or stains, it is replaced with another, not simply taken off. So a veneer is not a one-time decision. It is a commitment that comes back to you years later, in time and in cost. And if you move between countries, the veneer moves with you but the dentist who fitted it does not, so the follow-up has to be found wherever you are. The more teeth, the more commitments.

Not for everyone: when a veneer is not the answer at all

A veneer is an answer for a particular tooth in a particular state, not for everyone who asks for one. These are the cases where it waits, is not done, or where something else suits:

• Decay, tartar or gum inflammation. A veneer is bonded to a clean, sound tooth and a healthy gum. Decay, tartar or gum inflammation are treated first, because a veneer over a problem stays over a problem, and hides it until it grows. Here the veneer waits; it is not ruled out.
• Grinding that is not under control. A jaw that grinds through the night is liable to break one shell after another. If you grind, protecting your teeth from it becomes part of the plan from day one, and if we cannot get that protection settled, a veneer is not the right choice for now.
• Crowded or protruding teeth. Hiding them under shells takes more trimming, and braces straighten them with no trimming from the face of the tooth, or far less, and the examination decides. Age is not the barrier: Braces as an adult: age is not the barrier.
• A tooth that needs a crown, not a shell. A tooth with a large filling, a heavy break, or a root canal, if it has left the tooth much weaker, usually needs a crown that covers all of it, not a shell on its face. A veneer where a crown belonged usually breaks early.
• Enamel that is thin or weak. If the enamel is thin or weak to begin with, the bond to it is weaker, and the examination decides whether a veneer suits or something else does.
• Children, usually. A veneer waits until the tooth has fully come through and the gum around it has settled, so it is usually not for children. In special cases such as enamel defects, and in teenagers, the examination decides.

And when the simpler answer suits

Many people ask for veneers when what they want is something simpler. Ask yourself: what exactly do you want to change?

• Only the colour? Whitening changes the colour of your teeth with no trimming, and the colour fades over time and is repeated. Whitening is not the same as a cleaning: a cleaning removes tartar and stains, whitening changes the colour of the tooth itself.
• One chipped tooth, or a small gap? Tooth-coloured bonding (a composite restoration) on one tooth, built on the tooth in the same sitting, often with less trimming or none, and can often be repaired if a piece breaks off. And if a veneer is needed at all, it is one veneer for that tooth, not a whole smile.
• A rough or uneven edge? Sometimes a light smoothing of the edge is all it takes, with no shell.
• Teeth that are not straight? Braces, not shells to hide them.

And if what you have in mind is a whole smile, on every tooth that shows, read Hollywood smile or veneers: what is actually the difference first, because every one of the seven downsides above multiplies with the number of teeth.

What to do now

If you are still thinking about veneers, these are the steps in order:

1. 1

   Ask yourself: what do you want to change?The colour? A small chip? A gap between two teeth? The shape? Not every one of those needs a veneer, and the simpler answers are listed above.

2. 2

   Mention grinding at the first visitDo you wake with a tired jaw? Has anyone told you that you grind in your sleep? Are the edges of your teeth going flat? That is the most useful thing you can bring with you, because it changes the whole plan, and protecting your teeth from grinding becomes part of it from day one.

3. 3

   Health before cosmeticsTartar, decay, gums that bleed: all of it is treated before the veneer, not after. That is not a delay. It is what lets the veneer stay.

4. 4

   Whitening first, not afterIf you want your teeth lighter, whitening comes first, and then the shade of the veneer is chosen to match the new colour. Whitening changes the colour of your natural teeth and does nothing to the shell.

5. 5

   Ask about the trimming, specificallyHow much will be trimmed from each tooth? Can any tooth be done without trimming? What happens to the tooth if I change my mind later? Ask these of any clinic, in any country, and we are one of them. If the answers are not clear, take your time. Teeth that are trimmed do not come back. And how do you tell good veneer work from bad? In What makes veneers last, and what shortens their life.

6. 6

   See the look before you commitWith smile design you see the expected shape on your own teeth before anything is done that cannot be undone. That is the moment you can still say “not like this”, before anything is trimmed.

7. 7

   If you are only in Amman for a stretchSay so before anything starts. Porcelain needs a second visit for bonding, and every veneer needs follow-up afterwards, so the visits are planned around your dates before you commit, as far as the work allows. What cannot be planned away is the follow-up. And a departure date is a poor reason to trim a tooth: if the dates do not allow the work to be done properly, waiting is wiser than hurrying something that does not reverse. If you already have veneers from another clinic or another country, bring what you know about them, the material and roughly when they were done. They can be examined here.

8. 8

   Book an examinationAt the examination your teeth, gums and bite are looked at. You hear whether a veneer is for you or not, which material, how much would be trimmed, and what the doctor expects for your own case, and why. Then you decide, in your own time.

When to call

A veneer itself does not usually hurt, so most calls about one are not emergencies. But if you have veneers, wherever they were done, some signs should not wait for the next check-up:

• Call this week: a veneer has chipped, a piece has broken off, it feels loose, or there is an edge you can feel with your tongue.
• Call this week: sensitivity to cold in a veneered tooth that is not settling.
• Call this week: a gum that is red or bleeds when you brush around the veneer, an edge of the shell that has started to show, or a dark line along its edge.
• Call today: a veneer has come off whole. Keep it somewhere clean and bring it with you, because in some cases the same shell goes back on. And do not try to glue it back yourself with any adhesive.
• Call today: a swelling in the gum around the veneer, especially if it is growing or comes with pain, pus or fever, or strong pain in the tooth under it.
• Call today: sensitivity to heat that is getting worse, pain that stays after the cold or heat is gone, or pain that wakes you at night.

Call and we will find you the earliest slot, and tell you what to do until you arrive. Before any painkiller, ask the doctor first, so it suits your case. If the swelling has reached your eye, or it has become hard to swallow or breathe, that is a hospital emergency, not an appointment. And if the clinic is closed and the swelling is growing or you have a high fever, go to the nearest hospital emergency department, and let us know as soon as we open. And if the pain is in another tooth with no veneer: Toothache: what to do right now.

Questions people ask