I am in the process of getting 8 Feldspathic Veneers and crowns. Initially the dentist took off .5 mm of tooth. He put on the temporary and my upper lip was puffed out. He told me he did not see the puffiness, but would take off more of the tooth structure. He took off an additional .3 mm and put on a new temporary. My upper lip is still puffed out. What is the maximum amount of tooth structure he can take off and is there anything else he can to to alleviate the protrusion of the upper lip!
What is the Maximum Tooth Structure That Can Be Removed for Preparing for 8 Feldspathic Veneers?
Doctor Answers 9
How much tooth to remove for Feldspathic Veneers
Love your question, because the best reduction is none if you can adjust to the slight additional bulk. If the teeth are dark and a lighter shade is desired, .5 mm reduction is very adequate to accomplish your goal with no additional bulk in the hands of a skilled cosmetic dentist and master ceramist.
Veneers and Lips
Was your lip puffed out before the veneers were prepared? Can he make the temporaries thinner?
If you lip was normal before then it is from the temporaries. Lots of patients complain about thickness of temporaries and permanent restorations. Sometimes it just takes a couple of weeks to get used to.
Tooth Structure removal
The amount of tooth structure than can be removed before possibly hitting the nerve when preparing a tooth for a crown or a partial coverage veneer varies from person to person. Esthetic issues and concerns prior to cutting teeth for veneers should typically be discussed with a diagnostic mock up and wax up, and all these factors should be evaluated before going forward with tooth preparation. You may need to have more tooth structure removed if your teeth are malpositioned in the first place. My recommendation is to discuss your concerns with your dentist and have him or her create a temporary that both of you are satisfied since that will closely mimic the size and shape of your permanent restorations.
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Feldspathic veneers require more tooth structure
Feldspathic porcelain veneers can be the most beautiful veneers. This porcelain type is free-hand stacked in many separate layers and then fired/fused in an oven. The resultant veneer can be customized with far greater detail than other dental porcelains. Veneers made from this porcelain are more costly to have fabricated and require much more expertise by the laboratory. This porcelain is very fragile on its own and requires a strong supporting structure to bond to for strength. When bonded to enamel, this porcelain is just as strong as the more commonly used porcelains such as E Max or Empress. The key is that the dentist cannot drill too much enamel away. When done properly, feldspathic veneers can represent the very finest in strength and esthetics possible. If too much tooth structure is missing, feldspathic veneers can break easily and are not a good choice.
Maximum Tooth Structure That Can Be Removed for Feldspathic Veneers
Removal of tooth structure for Veneers differs per person based on the existing condition of the teeth and the desired result. For example. If your teeth are well aligned and the colour is satisfactory, tooth preparation for Veneers could be kept to a minimum. SInce we get our best bonding between Veneer's and Enamel we want to keep the tooth removal as minimal as possible so we stay within enamel.
In cases where teeth need significant colour correction, have dark roots, are dark from root canal treatments, or are overcrowded etc, more tooth structure will have to be removed to reach an aesthetically pleasing end result.
Part of the process of creating a smile design with Veneers is preliminarily having a diagnostic wax up created. (Models that have been waxed up to an approximation of what your end result could be.) Thee diagnostic wax ups are used to create guides for making temporaries on your teeth once they have been prepared for veneers. If .5mm was removed from your teeth and temps .5mm thick were placed on your teeth your lip should not puff out anymore than it did prior to tooth removal. Unless, the end result is to bring your teeth "out" more. then the temps might be 1mm thick on .5mm prepared teeth. (gaining .5 mm and enhancing your lip profile.)
While some people love the idea of fuller lips it may not be for you but you bring up a great point. Lips are also a very important player in your smile design and have to be taken into account when having Veneers done. It sounds like, from your description, that the temps might be thicker than the amount of tooth removed. Im not sure how your temps were created but they MAY not represent the actual thickness of your final veneers. Something you need to discuss with your dentist.
Veneers are a rather conservative restoration that does not require alot of tooth removal. Reduction can range from person to person, however ,3mm-1.5 or 3mm is typical. If the lips feel puffy, it sounds like you need more redeuction on the buccal surface. Your doctor can safely remove .5mm from the buccal surface.
Two factors are envolved
It is hard to answer these types of questions as there is probably a lot more going on. But has your dentist tried to use a thinner veneer material? I would think it is better to adjust that than to continue to remove tooth structure. Did your dentist do a wax up and a mock-up (dress rehearsal) prior to beginning the work?
The rule of thumb is to remove the least amount of tooth structure to achieve the desired aesthetic and functional results
What is maxium tooth structure that can be removed for veneers?
Noramally you want to remove as little as possible nothing to .5mm. You can remove as much tooth structure as you like however after 2mm sometimes the nerve of the tooth can become exposed and you need to do a root canal good luck
Kevin Coughlin DMD, MBA, MAGD CEO Baystate Dental PC
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.