I had a patient come in the office a few weeks ago wanting veneers. This is a normal appointment and procedure at our office. But this patient didn’t want just porcelain veneers. He was very specific in that he wanted veneers where nothing is ground off of his natural teeth. In the dental world, we call these “prepless veneers” which really means no preparation, or grinding down, occurs. A more sophisticated, broader scope way to describe it would be “minimally invasive dentistry” which we will discuss in a subsequent blog. The end product of a prepless veneer is a thin layer of porcelain that can be bonded to the person’s tooth without drilling the tooth down in size.
Simple enough? Let’s examine this further.
Most people do not present with undersized teeth, but if your teeth do look like this, then you may be a candidate for prepless veneers.
We see people all the time who are interested in veneers. Most people request veneers as a service to make their teeth look different, better and more natural. However, my experience has been that most people do not understand what a veneer really is. A veneer is really an architectural term. It just means a covering over something else. In the same way, a dental veneer is a thin piece of handcrafted porcelain, which is a glass, made to go over and bond/fuse to a natural tooth. For the veneer creation process, think of it like a porcelain china doll. They are made from glass, shaped a particular way then painted however the artist wants the doll to look. Porcelain used for veneers is the same in that there is an artist making the veneer and like the dolls, there are multiple ways they can be painted and expressed by the artist. By themselves, they are fragile, but once they are bonded on the teeth, they become ultra-strong, almost like a new layer of enamel on your teeth. At our office, we will sometimes even say that the teeth need to be “re-enameled.” Dental veneers can be made as one solid form or they can be layered, little by little, to give the porcelain more detailed qualities and characteristics- just like the china doll. Veneers can be basic or detailed- like any piece of art. For this blog topic, we will focus on prepless veneers, which must be made ultra-thin and thus must be made by a master technician who really knows what he/she is doing.
Most patients are not candidates for prepless veneers, because the actual prepping, or grinding down, of the tooth allows the dental technician the required room to be able to create the veneer in the first place. Let me explain it like this: it is addition by subtraction. This means in order to make a tooth look normal or ideal, we subtract a small part of the tooth (prepping) so we can add back only what is ideal (the veneer). If you only add, and your teeth are a normal size, then all the sudden the veneers added on top just made your normal sized teeth look like very noticeable oversized, unnatural teeth. Some people call these horse teeth or Bugs bunny teeth- but either way, the new teeth are too big and don’t look right. Another way to think about it is this. Imagine biting down on a quarter with your front teeth. How many of the rest of your teeth will touch when you do this? If you said, none, you are right. So, taking this into consideration, the veneer has to be made so that the rest of the teeth can close properly. This is why in most situations, there has to be some subtraction of tooth structure not just for the veneer appearance to look normal but also so that the bite can function normally as well.
Let’s go back to the patient who came in asking for no preparation veneers. The one thing I haven’t mentioned yet is that his teeth were already smaller than normal. This means the “prepping” had already been done. He walked in to the office with teeth that were small- making him the ideal prepless veneer candidate. Most people do not present with undersized teeth, but if your teeth do look like this, then you may be a candidate for prepless veneers. So how did I accomplish such a great result with this case with ZERO drilling of the teeth? It’s all in the planning. My lab technician and I studied the patient’s bite on jaw simulator to determine what was possible. We then determined we could do this case completely prepless and the artist/lab technician began his work to make the veneers look like beautiful natural, God-given teeth. Again, keep in mind with these before and after photos, I never had to numb the patient.
I never had to grind one bit of his teeth down. Success? Yes. Life changing? Absolutely.