When you see a specialist prosthodontist, like myself (Dr Sarkis Nalbandian), the decision as to whether you should get ultra thin porcelain veneers depends on a number of factors. Porcelain veneers are indicated for a range of dental circumstances:
Diagnostics is the first and most important part of the process to get the smile that you want, that lasts for a long time. The diagnostic process allows a specialist prosthodonist to help you design the perfect smile to suit your facial aesthetics and function (including speech and multi dimensional dynamics). In my practice, I sculpt your new smile directly in your mouth. This allows you to actually experience the teeth before we proceed with the next phase of the process.
When you are designing your smile I take into account ethnic facial variations. As a specialist prosthodontist with a keen interest in aesthetics, I noticed over the decades beauty standards vary according to ethnicity. Most importantly you need to understand that facial beauty is not static, but a dynamic multidimensional unity.
What we perceive as beauty also depends on trends and contemporary thinking. In many ways it is a fashion statement that changes with time. I am sure you do not walk around with the same hairstyle that we had in the 90’s today. Old beauty standards determined by anthropometric, photogrammetric, and cephalometric data, cannot correspond to the current public perceptions of facial beauty.
Ultra-thin porcelain veneers before and after
Correct diagnostics lead to minimal tooth intervention, preserving the precious enamel of your natural teeth. 99% of the time all porcelain veneers are about 0.2mm thick, that is all that is required, even in very difficult cases. This is the reason you need to see a specialist prosthodontist when considering porcelain veneers, or not. We are the smile specialists.
The most important thing when considering porcelain veneers is the diagnostic process. “Digital smile design” concepts only tell half the story. A specialist will develop a composite mock up directly in your mouth to insure that your bite, smile and speech dynamics are correct in all four dimensions and the treatment will not adversely affect the way you look, speak and feel with the new teeth. This means we look at the entire face and how the new treatment will compliment your facial aesthetics and whether you are happy with the change before the final treatment commences.
Naturally if you have severely crowded teeth, and because I practice conservative dentistry, accelerated orthodontics (PAOO) will be considered. Helping you achieve the best smile in the shortest possible time and preserve your natural teeth.
I invented the ultra thin porcelain veneers process and have over thirty years of experience in this treatment modality.
This is a very interesting question. "There is nothing permanent in dentistry. All restoration fail over time. There are too many intangibles over which one has little, or no control" (Pincus, 1967). Pincus was the progenitor of modern cosmetic dentistry. He was the dentist that placed the chicklets on Shirley Temple's teeth so that they would appear white on screen.
Although my personal data shows at ten years 95% are succesful. This is also due to the correct diagnostics process by a specialist prosthodonist in each case. Success is also on a case by case basis and depends on you as a patient and how well you maintain your porcelain veneers and continue with regular checkups. Night guards for people who grind (bruxism) their teeth and other requirements.
This depends on your health cover and insurer. You should inquire with them to find out if you are covered for porcelain veneers. The item number is 556.
The best cosmetic dentist is generally the one that can diagnose your case correctly and has a lot of experience in placing porcelain veneers. Most dentists dabbling in cosmetic dentistry don't have the volume of experience, and case histories required to effectively create a new natural looking smile, that is not only aesthetically pleasing, but also functional and comfortable.
You should always request to see the case histories of the dentist who you are considering, in order to see the level of expertise they have. Can they sculpt a new smile in your mouth in one visit to allow you to feel, see and experience the new smile you will be getting before you get them? To test drive the system and allow you assess how this new smile compliments your face before you commit to treatment. At this point the costing will be provided. Usually a 1 to 2 hour session and is the most important cosmetic dental appointment you will ever have.
Choosing the shape, size and colour of teeth
My role as a specialist involves correcting failed treatments, uncomfortable, unsuitable and unhappy patients with past cosmetic dentistry performed locally and internationally. The most important thing about cosmetic dentistry is to preserve your natural teeth and enamel at all costs. Anyone who wants to shave your teeth needs to explain the risks involved and the affect on your natural teeth and jaw structure.
The biggest problem I see today is patients who present with tooth sensitivity after porcelain veneers were placed elsewhere. This is largely due to incorrect diagnosis, unecessary tooth intervention (or cutting enamel). Unfortunately these patients had often not consented to having their teeth cut in the first place. This further compounds the loss of biological teeth and patient confidence.
As a specialist, my first priority is to conserve and maintain biology, while beautifying and rejuvenating your tooth/teeth, arch form, arch width to compliment your facial aesthetics.
You should consider the real cost in two ways: financial and biological. Financial cost is often the chief concern, but the biological impact of the incorrect treatment can often lead you to a much larger financial risk in the future. As a specialist, my aim is to preserve your natural teeth well into the future. Therefor, the risk of the future financial cost is really reduced in the correct diagnosis which leads to conserving your natural biology, lowering the risk of future complications and expense. Over thirty years of experience and placing over 30,000 veneers, means I understand the cost benefit to you of the correct diagnosis in the beginning.
We have worked with the same technical expert for over 20 years. This is real team work and the results are what you are paying for.
Unfortunately, when patients seek out cheap treatments elsewhere to save money, this often leads to expenses in the order of 3x more than what the original cost would have been. I know this because I have had to fix many of these cases. A simple porcelain veneer that would have been placed with minimal intervention, becomes a full crown, affecting the patient's biology and long term constant maintenance, root canal therapies, crowns, and eventually extraction. The restorative cycle ultimately leads to an implant. Not only do you lose teeth, you lose financially. Implants are significantly more costly and not as predictable as your natural tooth.
Being a specialist prosthodontist (board certified specialist cosmetic and reconstructive dentist) it is my duty of care to initially diagnose and plan your treatment accordingly.
Treatment planning in your case requires diagnostic (direct mock up) set up, which will tell us the following; the smile line, width, the level and degree of teeth display as it affects your speech and smile dynamics, which cannot be ascertained digitally.
Unfortunately, without diagnostic set up, I am in no position to assess above and cannot guess the effect of proposed treatment and your level of expectation. It is for your benefit that we proceed with the diagnostic set up, as it will save: time, money, and most importantly maintain biology (your teeth).
Your dentistry requires careful treatment planning and this I take very seriously.
It is better to spend less money on a consultation, than thousands on corrective treatments and loss of biology. After all it is your smile.
We don't know how much the treatment will cost you in Thailand, only how much it will cost to fix if something goes wrong. Please refer to one of our video case studies on a patient who opted for dental tourism overseas, who required considerable reconstruction at a considerable cost to fix a disasterous treatment.
The true cost of getting treatment overseas is in the long term repercussions that may occur if a treatment goes awry. Treatments of this nature require a long term commitment to maintenance and care under the supervision of the specialist performing the treatment. The legal obligations for foreign dentists, stops at the airport. Australia has one of the highest standards of dental care in the world and the dental community in Australia is beholden to those rules and regulations. Foreign practitioners are not.
While not all foreign treatments are horror stories, consider the speed at which these procedures are performed and how many patients a dentist will have to work on. As you are in and out very quickly, the level of care is naturally very low. Diagnostics take time. We are committed to your long term care here in Australia. Your smile is important to us.
This depends heavily on the state and condition of your natural teeth and enamel beneath the porcelain veneers that require replacing. We won't know what we will find when we remove your existing veneers, unless we placed them, in which case your tooth structure should still be sound.
When considering the cost of replacing veneers it is important that the correct diagnosis is performed so that you can experience your new smile before any new porcelain veneers are created or replaced.
It depends on you aesthetic needs and wants, while preserving biology, then yes. However, if you have severe crowding, a combination of orthodontics and porcelain veneers will improve the desired outcome and preserve biology.
My question is why? It is important to understand why you “need” porcelain veneers and whether this is the correct diagnosis for your case. Sometimes simple composite veneers can give you the desired outcome and at a reduced cost to you. In most cases it is better to have a specialist consultation before you proceed with any porcelain veneer treatment. A specialist diagnosis will help you understand exactly what you are getting and why you would be getting it.
Simply fill in the form on this page, or call us during office hours and we will make an appointment for you to come in to find out how we can help you with your specific circumstances.
We truly care about you your needs and we strive to be a welcoming, friendly practice where you will feel comfortable and safe. If you would like more information about the specifics of a treatment we are happy to show you the numerous case studies we have on file of patients we successfully treated who were in the same situation as you are now.
If you are suffering, please don't put off seeing someone.
Thank you for taking the time to explore this information about porcelain veneers. I hope this gives you an idea of what I can do for you if you are having difficulty and need help, because there is always hope.
Dr. Sarkis Nalbandian
Visiting Professor YSMU
Specialist Prosthodontist & Implant Surgeon
B.D.S. (Hons), Dip. Clin. Dent. (Oral Implants) Uni Syd, M. Clin. Dent (Prosth) King’s College, Uni London
D. Clin. Dent (Prosth) Uni Syd, FRACDS, MRACD (Prosth) FIADE, FPFA