Do Cosmetic Dentist Usually Make Their Own Teeth Design for Veneers or Rely on a Ceramist to Mock Up?

Teeth (smile) design is best "quarterbacked" by the ccosmetic dentist in conjunction with the aesthetic needs of the patient. This is communicated with the dental ceramist who can perform a diagnostic waxup with diagnostic photos, models, and drawings provided by the cosmetic dentist. The final smile design is often done when the temporary veneers or crowns are made and refined at the chair side to best meet the aesthetic expectations of the patient.

The ceramist/dental lab technician will often create the initial wax mock-up for a smile based on the dentist's specified criteria.  When it is done, the dentist and usually the patient will review it and make any changes desired.  That will form the model from which the final porcelain will be designed to.  It is a team effort between the dentist and ceramist, as well as the patient.

Mock ups, wax ups or smile designs are all part of the design phase in creating porcelain veneers.

Your question about who makes the mock up is especially insightful. At the level you are inquiring about, depends more on the actual duo of cosmetic dentist and lab technician. Many dentists do not do the design themselves. The majority are done by a lab technician.

The creative process really involves checks and balances at multiple different points in the creation of the veneers. An initial concept is created in the mind of the patient and the cosmetic dentist at the first meeting or consultation. After that a prescription is created by the dentist and sent to the lab. A good lab will add nuances to what the cosmetic dentist requested.

Then the veneers are prepared and the plastic temporaries are made. The plastic material has limitations in the level of finesse that can be created, so it is still an approximation of the original design and concept.

The original design is refined again as the patient gets used to the plastic temporaries. The patient may prefer certain changes and the cosmetic dentist may recommend some changes as well. All of these additional refinements are sent on to the lab.

When the ceramist makes the veneers he takes into account all of the refinements that have been made along the way. There are some final enhancements that really can only be created in the porcelain itself, so he builds them in then.

In the end, beautiful, fantastic veneers are created through great communication between the patient, the cosmetic dentist and the ceramist. ALL participants play irreplaceable roles. ALL must add their portion to the recipe in order to get amazing results.

The truth is most Cosmetic Dentists are to busy doing the "real thing" (actual veneers) to find time to sit down and do a complete mockup. It its a very tedious, time consuming and time intensive to do a complete Mockup (Ten teeth or more). A good cosmetic dentist will send a detailed prescription to the ceramist, including but not limited to length, width, portraits, closeup clinical pictures. The ceramist will do the wax mockup. The dentist may make some slight modification in the wax pattern. But the real customization is done in the mouth at the temporary phase. That is when final length, width, line angle and inclination are perfected.

A well educated and experienced cosmetic dentist (AACD) knows the same guidelines as a well qualified Ceramist. He will typically guide the Ceramist with the particulars for the patient and then leave it to the Ceramist to do the mock-up, which can then be modified by the dentist.