Porcelain Veneers Without the Drill

A new look at drill-free cosmetic dentistry

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Figures 3 and 4: Notice after treatment the increased length of the upper anterior (front) teeth along with space closure and how it makes a significant difference to the smile.

Photos provided by Dr. Dennis Wells

Potential Cases for No-Prep Veneers

• There are a significant number of patients who have relatively small teeth for a variety of reasons:, e.g. external causes such as acid erosion; genetic factors resulting in naturally small teeth and in spacing between the teeth; discrepancies between jaw size and teeth size — to name a few. These instances all provide potential candidates for “prep-less” restorations [Figures 3 and 4].
• Orthodontic cases that involved the extraction of teeth to solve a crowding problem typically result in narrow arch forms with the teeth that sometimes tilt inwards.
• Short, worn teeth — creating a smile with more visible tooth length can sometimes “turn back the clock” for someone who has worn their teeth down by grinding.
• Narrow smiles — Many times, the teeth in the sides of the smile are positioned inward and do not show from a frontal view.
• Teeth that need to be more visually present, e.g. when big lips may overpower them, or the teeth are too small in relation to the overall smile.
• Teeth that are genetically misshapen; “Peg laterals” is a fairly common condition in which one or both of the teeth directly next to the two upper front teeth are very small and peg-shaped.

When No-Prep Veneers Won't Work — While no-prep veneers can make many positive changes, there are some situations that no-prep veneers can't correct. In cases that involve improper tooth position, large discrepancies in root position, poor bite relations or a poor facial profile, some form of orthodontic treatment will be required to mechanically move the teeth. If orthodontic treatment is declined, some amount of tooth preparation may be required to create the illusion of proper alignment. When veneers are used to “camouflage” improper tooth positions, it must be with an understanding of the degree of limitations and risks.

Not every smile can be enhanced with prepless veneers. Teeth that are already relatively large or positioned forward in the smile do not typically lend themselves to adding another layer of thickness. In these situations, careful decision-making in partnership with your dentist will be necessary to explore other options that might involve tooth preparation or orthodontics.

There is no substitute for an expert dentist's talent and expertise in the various cosmetic techniques. These skills — combined with a clear understanding of an individual's goals and determination of the clinical needs obtained by a thorough diagnostic evaluation — are critical to ensuring a successful and beautiful smile.