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Porcelain Veneers Without the Drill

A new look at drill-free cosmetic dentistry

By Dr. Dennis J. Wells

(Continued)

Before prepless porcelain veneers.
Figure 5: Photograph showing disproportionate tooth size, tooth discoloration and the black triangle between the front teeth.
Prepless veneer prototype.
Figure 6: Photograph showing the “test drive” prototypes to evaluate proposed changes with the prepless porcelain veneer approach before finalizing them.
Final prepless veneers.
Figure 7: Photograph showing the final prepless porcelain veneers.
Photos provided by Dr. Dennis Wells

Test-Drive Your Smile: Another Benefit of Prepless Veneers

Committing to porcelain veneers can take a great deal of faith on the part of a patient because once the teeth are permanently reduced, there is no reversing the decision to have veneers designed. With no-prep veneers, the process is reversible (though removing them is not an easy task and best accomplished using a laser) and practically risk-free.

If a patient qualifies for prepless veneers, a highly-skilled dentist can artistically design hand-sculpted prototypes in order to allow both a preview and “test-drive” of a new smile. In this prototype phase, changes can easily be made to the tooth-colored materials and to capture them as a blueprint for the laboratory technician who fabricates the final veneers.

While this same approach can also be used for traditional veneers, the difference with no-prep veneers lies in the fact that the prototypes can be easily removed and the patient's original smile is unaltered.

A Preview of Coming Attractions

After a discussion about the goals and anticipated outcomes of the smile enhancement, detailed diagnostic records are gathered prior to beginning any dental restorations.

A comprehensive smile analysis is completed in order to compile information about the function and health of all the dental structures including the surrounding lips and facial features. Sometimes, a simple “mock up” can be made as a rough sketch in an effort to determine the feasibility of a prepless approach. The prototypes allow evaluation of the results in temporary materials before even making the final veneers. This is where an understanding of natural tooth shapes and contours allows an experienced cosmetic dentist to create the changes necessary for creating a natural looking smile.

The prototype stage allows individuals the exciting prospect of being involved in their smile design process. They can interact with their dentists providing feedback on shapes, sizes, and even colors of the new teeth. The prototypes can be test driven for several weeks while they are duplicated in the final porcelain veneers [Figures 5 and 6].

Once the laboratory technician has fabricated the custom porcelain restorations, the prototypes are removed and the final veneers are bonded directly to the enamel on the front surface of the teeth. The porcelain is then carefully contoured and polished to exactly mimic the natural teeth [Figure 7].

Questions to ask your dentist

  1. Am I a candidate for prepless or drill-free veneers?
  2. Can you create prototype veneers for me to test drive what my new smile will look like?
  3. How much will prepless or drill-free veneers cost?

Conclusion

All of the cases shown in this article were completed with absolutely no preparation of the teeth. Though additive-only techniques cannot be used in every case, prepless veneers should be considered for their benefits in cases where they may apply in whole or in part.

A prepless approach requires specific skills and training together with a keen sensitivity to natural tooth contours. Those who want to explore this as an option should consult with a dentist whose credentials and experience demonstrate an understanding of this technique-sensitive option.

More and more, dentistry, like medicine, is finding ways to be as conservative as possible while providing the best possible results. No-prep or prepless veneers are one way to improve and enhance smiles without the downside of drilling away healthy tooth enamel.



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