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Dental veneers can improve embarrassing teeth

By Kelsea Gursk

Copley News Service


Amy Aumann has something to smile about. The 41-year-old schoolteacher from Decatur, Ill., recently transformed her not-so-pearly whites into a dazzling, perfect smile, all in just about a month's time.

To get the look she desired, Aumann had 20 of her teeth covered with dental veneers - thin, porcelain facings that are permanently bonded to the front surface of a tooth to create a more attractive smile.

"I can't believe what a difference it makes," she said. "I'm so happy to have teeth that I can smile with and have no staining show."
Aumann's teeth had been permanently discolored by the antibiotic tetracycline when she was a young girl. She had consulted with her dentist about possibly fixing the problem with a whitening agent but was told that it would be only a temporary fix.

Then earlier this year, her mother noticed an advertisement for veneers in an AARP catalog and brought it to Aumann's attention. The ad led Aumann to dentist Dr. Tanya DeSanto, who has been helping patients change their smiles with the use of porcelain veneers for about 11 years.

Veneers are "a really easy way to change your smile," DeSanto said.

The procedure is commonly used to fix slight alignment problems, close gaps between teeth, adjust mild overbites and permanently lighten teeth.

Although relatively unheard of until lately, veneers are nothing new. Porcelain veneers have been available to dentists for more than 20 years, but only recently have entered the public spotlight. Reality television programs such as ABC's "Extreme Makeover" and Fox's "The Swan" typically recommend veneers to makeover candidates as a quick way to improve their smiles.

"It's such the hype because 'Extreme Makeover' made it that way," DeSanto said. "But we've been doing it for a long time.

"I think people are realizing your smile is everything," she said.
Veneers can't help everyone, however.

"Basically, they have to have good oral hygiene and a good, healthy mouth to be a candidate," DeSanto said. Veneers cannot be placed on teeth with existing crowns or if decay or periodontal disease exists.

An initial consultation helps determine candidacy. After a thorough oral exam, DeSanto creates a diagnostic wax model of the patient's mouth to study, and to show what their teeth would look like with veneers. She makes sure the patient approves of the projected result.

"I can assume what I think would look good, but since this is cosmetic, you better know what they want. You have to communicate," she said.

Once candidacy is determined, a patient plans for two additional visits.

The first appointment involves prepping the tooth enamel. During this procedure, a minimal amount of enamel is shaved from the front of each tooth that will be fit with a veneer. Local anesthesia is available but usually isn't needed, DeSanto said.

After the enamel work, DeSanto takes an impression of the teeth and makes sure she can achieve the proper bite alignment. The impression will be sent to a laboratory with specific shading and sizing instructions. DeSanto also photographs the patient's mouth and e-mails the image to the lab, which in turn sends back a projected digital image of the patient's new smile.

She then puts temporary veneers on the patient to wear while the permanent ones are created. The typical waiting period is about 10 days.

Temporary veneers are made of composite resin, a plastic-like material much less durable than the porcelain used in permanent veneers.

Bruce Monroe, a 42-year-old researcher at the Southern Illinois University School of Medicine, received six veneers from DeSanto. He said his temporary veneers "were pretty much a pain."

Monroe had the veneers placed on his top row of teeth to create a whiter, straighter smile and to prevent further wear on his two front teeth. A habit of grinding his teeth and a slight bite misalignment eventually resulted in the two front teeth becoming thin and chipped.

That grinding habit likely was the reason for his troubles with the temporaries, he said.

"I knocked them out a few times," said Monroe, who has had his permanent veneers for about a year. "I sneezed, and I looked down and my teeth were on the table."

He revisited DeSanto to have the veneers glued back on.
"Other people I've talked to haven't had near the difficulty," Monroe said.

DeSanto said despite the extra caution required when wearing composite veneers, they do have some advantages. Most importantly, they are great for helping patients prepare for their new, permanent smile.

"It gives them a really good chance to get used to what that look is like," she said.

The composite material, however, can't compare to the sleek, lifelike appearance of porcelain. Porcelain, which is translucent, has a light-handling characteristic that mimics enamel and provides a realistic sense of depth.

"Porcelain looks so much more refined and perfected," DeSanto said.

A patient picks out the shade for her porcelain veneers at the end of the first visit. A variety of shades are available, from natural yellow-brown tones to the not-so-natural "Hollywood white" shades.

Finding the perfect veneer shade is a flexible process. Because the veneer is translucent, a patient's overall look can be lightened or darkened by changing the shade of the cement that will bond the veneer to the tooth.

"You can change the shade of a veneer two or three shades just with the cement," DeSanto said. "In a matter of seconds, you can make it lighter of darker."

Once the permanent veneers return from the lab, the patient returns to DeSanto's office to complete the procedure.

"I remove the composite material, and we permanently bond each veneer individually, and then we shape, sculpt and take our 'after' pictures," DeSanto said.

"The best part is when I hand them the mirror," she said. "Almost everyone cries. They're just so happy.

"It's one of the best parts of my job."

Aumann said she was thrilled with the results.

"I yelled and screamed," she said of the moment when she first saw her new smile. "It was a pretty exciting feeling.

"I asked, 'How long are these going to last?' and (DeSanto) said, 'As long as you last,'" Aumann said.

DeSanto said porcelain veneers require no extra care and are meant to withstand normal, everyday wear and tear, although they are susceptible to trauma, just like normal teeth.

"They're on there, they're forever," she said. "They don't stain; they don't discolor."

Aumann says the best part of her new teeth is how much better they make her feel about herself.

"It's made me more confident," she said. "I used to smile, but not as much as I do now."

Monroe said he's just as pleased with his new smile.

Although his main motivation for getting veneers was to prevent additional wear on his front teeth, he does admit he's happy with his new look.

"They definitely look a lot nicer," he said.

Happiness has a price, though. Most insurance companies won't cover the price of dental veneers because they're considered a cosmetic procedure. Average prices for a veneer are $800 to $2,500 per tooth, depending on location.

Aumann, who received help paying for the veneers as a birthday present from her mother, said it was time and money well spent.
"I would recommend them to anybody," she said. "They're so easy to take care of, and they look really good.

"I really love them."

For more information, go to The American Academy of Cosmetic Dentistry's online brochure on dental veneers at www.aacd.com

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