I had porcelain veneers placed on my upper 6 teeth in the early 90's. I had them replaced last year as some were chipped and I wanted whiter teeth. The replacements didn't have the proper backing and you could see my teeth through them. My dentist removed them and put another set on. Now my veneers keep popping off. A different dentist said he doesn't recommend placing veneers a 2nd time because there isn't enough enamel left for them to stick to. He recommends crowns. What do you suggest?
How Many Times Can You Replace Porcelain Veneers?
Doctor Answers 14
How Many Times Can You Replace Porcelain Veneers
Porcelain Veneers can be replaced multiple times provided there is enough healthy tooth structure under the existing veneers. If the cosmetic dentist you are seeing did not place the original veneers, it is impossible to gauge what your underlying tooth looks like until the old veneers are removed completely. Over the years, we have successfully replaced many veneers that had just been replaced by another dentist or even several dentists (i.e., multiple times). Usually, these cases involved an improper bite situation or a poor bond by a practitioner who lacked the cosmetic expertise necessary for a successful esthetic and functional outcome. Perhaps your teeth have shifted which would affect your bite patterns and thus cause the veneers to fail. Grinding or clenching can also affect your bite and cause failure as well. Check your current bite with your newest veneers. If the bite is off, the extra stress on these teeth could be causing the veneers to pop off. If you have a choice, veneers are a more favorable option, as it is more conservative than crowns. As you know, teeth do not grow back, so do your research and consult with multiple qualified cosmetic dentists to make an educated decision before initiating any further treatment.
Replacement of Porcelain Veneers Multiple Times
You have a genuine concern and have had some very frank and thoughtful answers by some capable cosmetic dentists. The fact remains, if you want the veneers replaced again, they CAN be carefully removed and new veneers can be fabricated and bonded to dentin in a manner that WILL last. Best of luck.
Veneers, re-doing veneers, crowns
You can re-do veneers as many times as you want or need, however it is the judgement of the dentist to determine if you have enough tooth structre left to beable to support a veneer. If not, you would need to do all porcelain, metal free full coverage crowns for proper longevity and aesthetics.
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Veneers should not fall off
For cosmetic dentistry to be successful a number of things must be taken into account. These include:
1) An understanding of where we want the tooth position, size, and shape to be before the case even begins.
2) Restorations placed in harmony with the muscles of the face, other teeth, lips, and joints.
3) An understanding of the benefits and limits of the materials used.
The definition of the word "veneer" has now blurred as we place "3/4 veneers", 3/4 crowns, and "no-prep veneers". A knowlegable dentist knows the circumstances when each of these options are most appropriate. There is no need for a blanket decision to only do veneers once or twice or three times on a tooth. If done correctly, hopefully once or twice in a lifetime will be fine. If not, a transition to a crown or "3/4 veneer" is not a huge one and will not feel or look any different. Whichever choice is made, they should not "keep popping off!"
Check the bite and the technique
The strongest and longest bonds are to dental enamel. That means that when a veneer is bonded to the tooth enamel it can last a very long time. Some preparations take away more enamel and in this case the veneer is bonded to dentin, or dentin and enamel. As a rule the more dentin that we bond to the less likely the bond is to last a very long time.
However, it is possible to bond to dentin, and I have veneer cases that have been done on dentin predominantly, and they last for many years before debonding. When veneers are bonded to dentin especially, it is important that the dentist use very precise technique and correct protocols to ensure the best result. Any contamination of the tooth surface during bonding such as saliva, even mouth humidity, can compromise the final result.
When the "bite" is unbalanced, the result can be that excess stresses are applied to the teeth by grinding/clenching habits or even normal everyday function. These excess forces are usually what cause the veneers to crack or chip. Be sure that your dentist designs your bite to minimize the destructive forces, or wear a nightguard or some type of protective appliance at night.
If you do some of these things you will likely be able to redo your veneers or rebond the existing ones.
Replacing Veneers Multiple Times
Veneers need to be bonded properly to enamel to ensure longevity. Also your bite needs to be properly adjust so that you do not grind or bite on the veneers with excessive bite pressure.
If there is limited amounts of enamel then I agree that crowns might be a better option.
It sounds like the veneers are "popping" off due to issues with the bonding process or potential occlusion (bite) problems. Veneers should be able to be replaced without an issue unless there is not an adequate amount of enamel left to bond to. For these cases you will be bonding to dentin and it would be wise to transition to all porcelain crowns. These crowns can look just as good as veneers as they are made of the same material. If your bite is "off" or you are grinding then you should consider getting a nightguard to protect the new porcelain crowns.
Your Original Veneer Experience is Typical
Your original veneer experience is what you should expect. The most common cause of veneer failure is chipping or breaking. Having the restorations coming off should be very rare with proper preparation of the tooth, proper bite adjustment, and excellent adhesive techniques. To me it is more semantics between veneer or crown. I use the same porcelain material for both and conserve as much tooth structure as possible without compromising the final result.
It really depends. Most veneers last 20 years or more. If they are prepared and delivered correctly. They need to be taking care of. If you following your regular cleanings and routine exams you should get a very long life out of them. As a patient you must be careful and remember they are porcelain. If you put veneers on at 20 years of age, I would say you should have to replace them once. When you prep tooth structure for a veneers it is very conservative, so you can do it more than once. I would recommend that it not be done more than three times in a life time, and it is likely that will not happen.
Veneers pop off for many reason. One reason may be about bad bite. The fact you said your old veneers chipped off and you had to replace them , makes me wonder whether your teeth have been shortened due to time, aging, or grinding and ultmtaley changed your bite where you are not a candidate for veneers, or full crwons for that matter.
Now suppose you do not have bite issue, if in the process of the placement of your original veneers there were not too structure removed, you should be able to get veneers again without them popping. If the tooth structure is not enough, you will get better logivity wiith corwns.