Composite veneers: 10 things to know before deciding

Before deciding on composite veneers, there are ten things worth knowing: who they are indicated for, the difference between thin veneers, conventional veneers and porcelain, how much the professional matters compared with the brand of composite, how the color is chosen, how many teeth are involved, what changes and what does not, how long they last, the care they need, reversibility, and what to ask at the assessment. With those answers, the decision stops being a guess.

A thin composite veneer, known in Brazil as a 'dental contact lens', is a fine layer of composite resin applied to the front of the tooth, with little or no filing down of the tooth, to adjust color, shape, size or small gaps. It is a conservative procedure, done directly in the mouth, usually in a single visit. Precisely because it is quick, it is often decided on too quickly, and that is where many frustrations come from.

In this article, Dr. Cléo Salustiano (CRO-SP 170844), who sees patients in English at her office in Mooca, brings together the ten points she considers before recommending dental veneers and explains how the assessment, not haste, should guide the choice.

This article comes from Dr. Cléo Salustiano's dental office in Mooca, São Paulo (care in English, Portuguese and Spanish). See the composite veneers page to learn how the treatment is done here and book your assessment.

Step by step

1. Indication: who composite veneers make sense for. Composite veneers are indicated for healthy teeth that need small changes in color, shape, size or gaps. Inflamed gums, cavities and bruxism are not obstacles but prior steps in the plan, dealt with first. Large changes in tooth position call for orthodontics, not veneers.
2. Thin veneer, conventional veneer and porcelain: what is the difference. The thin veneer, known in Brazil as a 'dental contact lens', is the finest version, with little or no tooth reduction; the conventional veneer is thicker and may require more preparation of the tooth. Both exist in composite, made in the mouth, or in porcelain, made in a laboratory. Porcelain stains less and lasts longer, but requires more tooth reduction and is more complex to repair; composite is reversible and repairable.
3. The result depends more on the professional than on the brand of composite. The composite brands used in esthetic dentistry are similar in quality. What separates a natural smile from an artificial one is the hand of the person doing the work: choice of colors, layering, anatomy, finishing and polishing. It is worth more to see the professional's cases in natural-light photos than to ask which composite they use.
4. Color: natural white is not the same as artificial white. The color is chosen in relation to the skin, the lips and the teeth that will not receive veneers. The BL shades, from BL1 to BL4, are tones of bleached white: BL1 is the lightest and BL4 the closest to a light natural tooth. An overly intense white on every tooth gives the veneer away.
5. How many teeth are involved. It depends on how much of the smile shows when talking and smiling, and on which teeth stand out. There are cases of one or two teeth, to close a gap or even out a smaller lateral incisor, and wide smiles where the veneers go from the canines to the premolars, six to ten teeth. There is no standard number.
6. What changes and what does not. A veneer changes color, shape, length, texture and small gaps. It does not change the position of the root, does not correct a crossbite, crowding or very crooked teeth, and does not treat the cause of wear. In those cases, orthodontics comes first; compensating for position with composite produces large, bulky teeth.
7. Lifespan: 5 to 8 years, with maintenance. With periodic polishing and suitable habits, composite veneers usually last 5 to 8 years, sometimes longer. The time depends on the technique, the bite, the use of a night guard when there is bruxism, and hygiene; without maintenance, the composite loses its shine and stains much sooner.
8. Maintenance and habits. The routine includes a soft toothbrush, a toothpaste without strong abrasives, daily flossing and a visit every six months for polishing and checking the margins. Coffee, red wine, dark tea and cigarettes stain composite; they do not need to be cut out, but they call for rinsing soon afterwards. Nail biting, chewing on pens and opening packages with the teeth chip the edge.
9. Reversibility and minimal tooth reduction. In most cases, a composite veneer is made without filing down the tooth, or with very slight reduction to adjust the contour. The tooth stays intact, and the veneer can be removed or redone without major consequences. This reversibility weighs on the decision, especially for those who are still unsure.
10. What to ask at the assessment, and why the plan comes before the price. Ask who will do the work, how many teeth are involved, whether there will be any tooth reduction, how the color will be chosen and what happens if something chips. The price only makes sense after the plan, because it depends on the number of teeth, the prior steps and the complexity of the case. A price given before the assessment is a guess.

How are composite veneers made at the dental office?

The process starts with the assessment, which takes about 30 minutes: an examination of the teeth and gums, photos of the smile, analysis of the bite and a conversation about what bothers the person. With that, the dentist decides whether a veneer is the answer, how many teeth are involved, whether there will be any preparation and what needs to be treated first. Any simulation used at this stage is a preview of the work, not a promise of the result.

At the treatment visit, the first step is cleaning the teeth and making the final choice of color, before the tooth dries out. Then come isolation, which keeps the field free of saliva, and conditioning of the enamel, which prepares it for adhesion. The composite goes on in thin layers, each with a role: masking, giving color, giving translucency to the edge.

The part that most defines the result comes at the end. Finishing shapes each tooth, respects the small differences between them and creates the surface texture. Polishing seals the composite, gives it shine and reduces the tendency to stain. Lastly, the bite is checked and adjusted.

At the clinic, the person who does the assessment is the person who does the work, which avoids having the plan made by one person and the treatment by another. The follow-up visit takes place one to two weeks later, to check adaptation and the gums, and then every six months. More details on the composite veneers page.

What should you look at before making the decision?

A good decision is not made in a hurry. A promotion with a deadline, a quote sent by message without an assessment and a promised result based on someone else's photo are reasons to be wary. A serious plan comes after the examination, in writing, with the number of teeth, the prior steps and the expected maintenance.

The first few days call for some adjustment: mild sensitivity to cold, which tends to pass within a few days, and the feeling that the teeth are slightly bigger, which goes away as the lips and tongue get used to them. If something feels off in the bite, the adjustment is simple and should be done at the office, never at home.

Some signs show that a veneer needs attention: gums that bleed near the margin, a rough edge that catches floss, a dark line between the veneer and the tooth, a stain that does not come off with brushing, or a chip. Almost always, a maintenance visit solves it with polishing, finishing of the margin or a spot repair.

Finally, compare the alternatives. For those looking for greater durability and fewer stains, and willing to accept more removal of tooth structure, porcelain veneers may be the way to go. For those who want reversibility, a single visit and simple repairs, composite usually does the job well. It is also worth understanding how long composite veneers last.

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