POSTOPERATIVE CARE OF NEWLY CEMENTED PORCELAIN VENEERS
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You’ve finally made the decision to revamp your smile with porcelain veneers- congratulations! Now you can venture out into the world with a beautiful, confident smile. However, your work isn’t done after you’ve had your veneers put into place, and there are several steps you’ll need to take to keep them safe. By taking a proactive approach to caring for your veneers, you can get the most out of your stunning new smile.
Because veneer treatment is an investment into your smile, there is a good reason to want to maximize your results. This means prolonging the life of your veneers with proper care.
As this is an investment in your mouth, please take the following steps to ensure that your veneers will last you for many years to come.
Tips for Caring for Your Porcelain Dental Veneers
- Brush twice a day for at least 2-3 minutes. Ideally, straight away after eating anything.
- It is possible to get a cavity under your veneer. Pay special attention to your gumline. Plaque and bacteria at your gum line will lead to decay that can cause your veneer to fail.
- A mechanical or ultrasonic brush will help you to adequately remove plaque and bacteria. In addition, most electric brushes have a timer that assists you in brushing for a full 2-3 minutes.
- Pay special attention to the area where your veneer meets your gums. This area can trap bacteria and plaque which can lead to a cavity under your veneer.
Use the right toothpaste
- Some toothpaste brands may contain ingredients that are too abrasive for both your teeth and your veneers.
- When choosing your toothpaste, make sure to check the ingredients for substances like hydrogen peroxide and sodium bicarbonate or baking soda. The former will eat away at your veneers’ surface while the latter’s gritty nature can lead to the veneers losing their colour and sheen.
- In general, it may be wiser to choose gel products over those in paste form as they tend to contain none of the ingredients mentioned.
- Do not feel compelled to buy whitening toothpaste either, as they are not necessary and may even be detrimental to your veneers.
Avoid substances that may cause stains
Porcelain veneers are designed to be stain-resistant, but that fact isn’t the same for your natural tooth structure. In order to keep your smile looking at its whitest, you should be wary of substances that might stain your veneers, including heavy cigarettes, coffee, soda, red wine, tea, berries, and beets. If you do enjoy one of these items, be sure to brush and floss your teeth immediately afterwards to minimize the likelihood that stains will develop.
Avoid Too much Alcohol
- Consuming lots of alcoholic drinks will soften the bonding composites holding the veneers to your teeth. While this doesn’t mean the veneers will come loose, it will make the bonding line more prone to damage, deterioration, and stains.
- Alcohol is not found just in beverages though. When buying mouthwash or toothpaste, check the ingredient list to see if they contain alcohol as these can be just as damaging as liquor.
Avoid frequent snacking, which is the single greatest factor in promoting tooth decay.
- Floss all of your teeth at least once a day. Ideally straight away after eating anything
- Make sure that you insert your floss in between each tooth.
- Wrap the floss around each tooth and move it up and down to loosen and remove food and bacteria.
- Use a new section of floss for each tooth.
- You should visit our office at least twice a year for professional dental cleanings or more often if directed.
- At least once per year x-rays will be taken and each tooth will be checked for cavities, cracks, and infection. Please call our office at any time if you are experiencing any tooth problem. We are here to help.
- Proper brushing, flossing, and regular 6-month cleanings are necessary to the long-term stability and appearance of your veneers. Small problems that develop with veneers can usually be found at an early stage and easily corrected, but postponing proper care can result in the need to replace an entire restoration.
TAKE NOTE: NON-ATTENDANCE OF 6 MONTHLY CHECK-UP AND HYGIENE APPOINTMENT IN OUR OFFICE WILL MAKE OUR LIMITED WARRANTY VOID (See Implied 3 years warranty terms and conditions below)
Other Tips for Professional Care of your Newly Cemented Porcelain Veneers
- If you’re seeing a new dentist or hygienist, make sure to mention your existing work, and ask them to look particularly on the cervical and gumline margin of your restorations.
- If you have cosmetic dental work, ultrasonic scalers must be used with great caution. The ultrasonic scaler can chip the margins of porcelain veneers. It’s not the water that is the cause for concern, but the metal tip that vibrates at an ultrasonic frequency. If used improperly around the margins of dental crowns, veneers, or composite bonding, they can damage the appearance and leave the restored teeth vulnerable to decay. These ultrasonic scalers are powerful and they not only have the potential to nick the margins of porcelain restorations, but they can nick the cementum of teeth, causing a roughness that will attract plaque and calculus.
- Regular pumice polish should not be used on composite bonding as it can leave scratches and cause erosion. An aluminium oxide polishing agent should be used instead.
- Polishing devices that use a powerful spray of sodium bicarbonate, prophy jet or other power polishing equipment should never be used on porcelain and composite restorations. They can break the glaze and roughen the surface, which can lead to easier staining. Although your restorations will look great immediately after the appointment, their appearance will rapidly deteriorate if these devices are used.
- Some maintenance procedures that work well for natural teeth or metal restorations can ruin ceramic or composite materials. If you’re seeing a new dentist and you’ve had cosmetic dental work done in the past, make sure to mention your existing work to them.
- The hydrofluoric acid contained in some fluoride treatments can etch porcelain dentist crowns and veneers and break the surface glaze. Any treatments used on cosmetic dental restorations should contain neutral fluoride only.
Whitening (if Applicable)
- In order to keep your natural teeth the same colour as your new veneers, periodic whitening is recommended.
- The most economical way to keep your smile white is to use custom whitening trays with a strong whitening solution. Most patients find that the best time to whiten is after a professional dental cleaning. Your teeth are plaque and tartar free thus allowing your teeth to respond positively to the whitening gel. Let your teeth be your guide on how often you should whiten.
Occlusal Night Guard
*Clenching and grinding exert pressure that can be generated across the teeth that can range from 100 to 600 psi (pounds per square inch). That incredible amount of force can cause many different problems related to your gums, jaw, and teeth.
- Clinching and grinding when you have multiple porcelain restorations can cause cracks and fractures to your natural teeth. Porcelain by nature is a harder material than natural enamel.
- An occlusal guard is an appliance designed from dental models of your teeth and made of rigid plastic. It covers either your upper or lower teeth and prevents the teeth from coming together while sleeping at night. It also provides a guide for your jaw so that muscles can relax and bite problems will not trigger the bruxing action.
Do you have a bad habit of chewing on pens, or are you a nail biter? Not only are these habits gross and a social faux pas, but they can also actually lead to damage of your porcelain veneers over time. To protect your cosmetic dental work, make an effort to keep inedible items out of your mouth.
Do not bite into very hard objects. Everybody knows the teeth are not just used for eating, but they can also be used as tools for, say, opening bottles. Unfortunately, such activity is harmful not just for your teeth, but also for your veneers. Very hard objects, such as metal caps and glass bottles can chip the porcelain. If you have the habit of biting into random things, such as pencils, pens, or even ice, it would be helpful if you can take steps to end the mannerism.
- As with natural teeth, avoid chewing excessively hard foods on the veneered teeth (hard candy, ice, nuts, ice, raw carrots, bones, raw apples, hard chips, and meat cuts that contain bone) because the porcelain material can break under extreme constant pressure.
- The gums may eventually recede from the veneers, allowing discoloured tooth structure underneath to show. This generally takes place after many years and at that time veneer replacement is necessary.
What should I expect after my permanent veneer is cemented in place?
Once your permanent veneer has been cemented in place, you will need to allow the cement to completely harden in the first 24 hours. Because of this, you must avoid chewing hard or sticky foods, as well as avoid using a rotary toothbrush or flossing around your permanent veneer for the first 24 hours. In addition, you may also notice small pieces of excess bonding material around your new veneer. Most of these pieces will eventually fall off while brushing, however, if you feel anything sharp, come into our office and we can remove it.
When can I eat?
You can eat as soon as your mouth regains feeling. During your procedure, a local anaesthetic will be used to numb your mouth and keep you comfortable. This will cause your lips, teeth, and tongue to remain numb for up to five hours after your procedure. The amount of time you will remain numb depends upon how much anaesthetic was used, where it was used, and how fast your body metabolizes it. Because you can do damage to your mouth trying to eat when numb, we recommend waiting to eat until you have feeling in your mouth. Also, be sure to avoid eating chewing or hard foods in the first 24 hours following your veneer placement.
How can I manage my pain?
Before your anaesthetic wears off completely, we recommend taking analgesics as needed. This will help manage your pain when the anaesthetic wears off. Once the anaesthetic wears off, you can continue this routine to manage your pain.
In addition to general tooth pain, you may also experience some tooth sensitivity to temperature, sweets, or biting. This is completely normal and will usually dissipate within a few days following your procedure. If it continues beyond a few days, you will want to call our office for further instruction.
Finally, your gums may also be sore or irritated following your tooth preparation procedure. To help alleviate this discomfort, we recommend a warm salt water rinse. A warm salt water rinse is composed of one teaspoon of salt in a cup of warm water. You will want to swish this mixture around inside your mouth, over your gums, then spit.
Adjustment period right after cementation
After the cementation of your porcelain veneers, it may take a few days -a few weeks to get used to the new veneers. This adjustment includes biting, speaking and the changes in your new look and a new smile. Your bite and the way your teeth come together may feel different, especially if we changed the length, shape and/or thickness of your teeth. If your bite feels unbalanced or some or one side or one tooth is hitting first before the others, please be sure to call our office for an appointment to make an adjustment.
While you are adjusting to the new cemented restoration, we strongly recommend being on a soft diet until you get used to eating with your new restorations.
Most porcelain veneer emergencies are related to
Fracture – Breaking, cracking, crazing, chipping
Can a broken porcelain veneer be repaired?
If just a very small portion of your veneer has come off, it may be possible for us to create a patch. However, this is not a first choice but simply one that’s used as a practical solution.
Generally, there are two main problems that tend to come into play with this type of plan.
Your laminate is made out of porcelain but the only material for us to make a repair with is plastic (dental bonding/dental composite). These materials have different optical qualities and properties. Depending on the location of the patch and the size, they may not be durable or be unsightly visible.
That means that even if the repair looks satisfactory initially (which it very well may), over the long haul (months and years) the less durable bonding will deteriorate (pick up the stain, fleck off at the junction with the porcelain) and a distinction between it and the veneer will become obvious.
With repairs located in areas where substantial forces are involved (like the biting edges of teeth), the bond between the veneer’s porcelain and the dental composite patch may (likely will) prove to be troublesome.
Managing minor chips.
If only a small bit of porcelain has flecked off, one solution is for us to trim and buff your veneer until the chip’s divot has been polished out.
This makes a very lasting solution. However, neighbouring teeth may need to be recontoured in a similar fashion so the symmetry of your smile is maintained.
Cracks in veneers.
You may have encountered the situation where you’ve discovered a crack or craze lines in your veneer but otherwise, it remains whole and in place on your tooth.
The veneer has come off, generally intact. As dental veneers are bonded to the tooth, there is some chance that the bonding agent may fail, resulting in the veneer “popping” off the tooth. If this happens, bring the veneer with you to our office. We may be able to easily re-bond it to your tooth. Place your debonded Veneers on a sturdy small box.
Chances of porcelain veneers falling off?
On an average, the ratio of falling of porcelain veneers is minimal compared to its success, still, it cannot be denied that they may fall off or break down in some cases, for a variety of reasons.
The common reasons are as follows.
-Damage to the frontal face, Habit of grinding teeth, Tooth decay behind the veneer, Eating very hard foods like ice or candy and sugary sticky foods regularly.
-When there is a strong impact on your face, the teeth take the brunt, it may cause the porcelain veneers to loosen from the bond it has with the original teeth. Damage to the face has a natural consequence of teeth taking some of the damage.
-Many people have a nervous habit of grinding teeth when they are angry or upset. This habit may lead to loosening up the veneers from the bond that attaches them to the original teeth and may cause a falloff the veneers.
-Sometimes the tooth decays and the decay causes the chemical in the bond to loosen making the porcelain veneers detaching from the tooth and fall off.
-Ice is one of the hardest food to bite into. If you keep biting onto hard foods like ice, and candy, it will cause the veneers either to break or loosen up and fall.
-Similarly, sticky foods like candy and sugary sweets stick to the teeth and are difficult to remove, causing veneers to lose contact with the original tooth.
-Negligence: Your veneers will be more prone to breaking or coming off if you treat them harshly. Veneers are durable, but if you often chew on hard things like ice and hard candies, or grind your teeth, your veneers won’t last quite as long. All of these things damage both your veneers and your natural teeth, so it’s best to stay away from them.
For whatever reason, if a porcelain veneer breaks, or chips or falls down, what is one to do?
What you should do in the unlikely event of the veneer breaking or falling off is to keep them safe, and call us immediately. It is vital that you get an appointment with us within a day or two of the event. In many cases, we will be able to reapply the veneer which has come off with little difficulty. But in the event that the veneer is broken beyond repair, then we will order a new veneer and during the time the veneer gets ready, we will apply a temporary treatment till the broken piece is replaced with a new one.
You should never try to glue back the fallen off veneer yourself.
TAKE NOTE: Very important to place your debonded Veneers on a small sturdy box to protect it.
What is our Clinical Process of recementing a debonded Veneer?
We send your case back to our Dental laboratory for them to remove excess used cement and prepare the internal surface of your veneer ready to be cemented. The lab uses a sandblasting process, which involves an operation of forcibly propelling a stream of abrasive material against a surface under high pressure to remove cement and smoothen a rough surface. There is a small, remote RISK involve in cleaning your thin veneers is that it may crack or break during the sandblasting procedure. The lab is not giving a warranty nor do we. Our warranty includes our service of recementation but not the lab related fees for cleaning your veneers or redoing a new one. If your veneers break, you will be charged with the lab fees of redoing you a new veneer.
After the Lab clean your Veneers and return your Veneers back to us, we will need to schedule you for recementation appointment.
You can hand us your veneer but if you live far away to the CBD or is working, you can send us your veneer by registered express post.
We expect that you will receive many years of service from these veneers. However, after watching veneers for many years, we have seen the following situations occur occasionally. They are unavoidable and may require restoration replacement.
- Extreme force or trauma can break porcelain veneers just as the same force can break natural teeth. Use care in sports or other potentially traumatic situations. Do not bite extremely hard objects with one tooth. Breakage usually requires remaking the restorations, but occasionally they can be repaired.
- After a few years, some veneers may show slight stains on some locations around the edges. Please tell us if this occurs. Repairs can usually be accomplished. If you are having periodic 6 monthly hygiene, this occurrence can be minimised or prevented.
- The gums (gingival) may recede from the veneers, displaying discoloured tooth structure underneath. This usually takes place over several years and requires veneer replacement. If you follow proper brushing habits, this occurrence can be minimised or prevented.
We have done our best to provide you with the finest quality oral restorations available today. However, as with many restorations, nothing will last forever. Replacement of these restorations may be required in many, many years to come. Longevity will much depend on how you look after your teeth and Porcelain Veneers
How long these beautiful restorations last depends a lot on how well you take care of them. The porcelain itself wears as well or better than your natural teeth. The bond between the laminate and the tooth is very strong. The porcelain is also immune to tooth decay, however, the uncovered part of the tooth is still susceptible to decay, so you can get cavities with veneers. If you consume carbohydrates frequently between meals, or if you do not floss and brush diligently, you will have a greater chance of this happening. If you take excellent care of your teeth, they will last many long years. It would be best not to think of them as being permanent—think of them as lasting ten to twenty years, or more, with good care.
LEGAL FINE PRINTS
3 YEAR LIMITED WARRANTY – IMPLIED TERMS & WARRANTIES
The Warranty refers to the entire work done, i.e. all materials, labour work/our own services and treatment EXCEPT LAB RELATED FEES. It is only valid for procedures that we’ve done in our clinic. Costs arising from work done in other dental offices are not covered under our warranty. The warranty of any of our treatment is only valid if our dentist completes the full work. If a problem arises during the 3 years warranty period, the patient has to contact the clinic as soon as the problem arises.
- All warranties and conditions expressed or implied by statute, common law, equity, trade, custom or usage or otherwise howsoever are to the extent permitted by law expressly excluded from the Sales Contract. The Patient acknowledges that neither the Company nor any person purporting to act on its behalf has made any representation or given any promise or undertaking which is not expressly set out in the Sales Contract whether as to the fitness of the Services for any particular purpose or any other matter.
- The Patient acknowledges that without relying upon the skill or judgement of the Zenaidy Castro P/L or any person purporting to act on its behalf it has determined that the Services conforming to the contract description will be fit for its purposes. Any description of the Services and/or Goods used in the Sales Contract is for identification only and shall not constitute a contract of sale by description. The provisions of this clause 4 shall not apply insofar as their application is prevented by the Trade Practices Act 1974 as amended or any other State and Territory laws.
3. Subject to the terms of the Supply Contract, the Company offers certain limited dental warranties in relation to the Services and/or Goods it provides to the Patient. The Patient acknowledges that the long-term success of any dental treatment provided by the Company corresponds directly to the Patient’s home care, regular dental check-up and professional cleanings. As a pre-condition to the operation of any limited warranty provided by the Company, the Patient agrees that:
- a) Following the completion of treatment, a Patient will attend a minimum of two (2) examinations and scale and clean in each year in our office and has followed the recommended preventative dental treatments and maintenance program as recommended by the Company. It remains the Patient’s responsibility to contact the Company to make an appointment and attend the six-monthly exam and prophylaxis failing which the limited warranty will be forfeited. It remains a fundamental condition for the operation of any limited warranty under the Sales Contract that the Patient maintains professional cleanings and check-up/exams at the Company’s office as often as is recommend by the Company (usually 2-4 times a year).
TAKE NOTE: NON-ATTENDANCE OF 6 MONTHLY CHECK-UP AND HYGIENE APPOINTMENT IN OUR OFFICE WILL MAKE THIS WARRANTY VOID
- A bite splint is worn at night as recommended by the Company in cases where the dentist detects a history of grinding and/or clenching.
- There is no outstanding balance on the Patient’s account or monies owing to the Company unless otherwise agreed to by the parties in writing.
- The Company is confident of the durability of the treatment it prescribes for its Patients.
a) Primary to a Patient’s long term success is spending a few minutes a day on home care including but not limited to brushing, flossing, using fluoride and prescribed products.
b) A secondary factor is regular professional examinations, cleanings, x-ray films and fluoride treatments ( at 2-6 month intervals depending on the Patient’s condition). This warranty does not cover accidents that cause damage to the teeth or dental prosthesis. This limited warranty is only between the patient and the Company and does not include any agreements or contractual terms with insurance companies or any third parties. They will be billed in full. Only that amount of out-of-pocket expense paid by the patient will be credited toward the fee for replacement service.
- Teeth whitening is not included or covered by the Company’s limited warranty under this clause or under the Supply Contract due to its high unpredictability.
6 Restorative dental treatments as provided by the Company are permanent and recommended as the most appropriate method of dental treatment at the time of the Patient’s consultation. If for any reasons including financial reasons the Patient is not able to have the recommended treatment as presented by the Company and opts for a treatment regime which is assessed by the Company in its absolute discretion as less than optimal including but not limited to a short-term fix, patchwork or any other temporary measures until definitive treatment is provided then any limited warranties provided by the Company under any Sales Contract will not take effect.
- In cases where it is difficult for the Company to predict the likely future outcome or diagnosis at that time, that a Patient’s tooth will either most likely (or on a 50/50 chance) require a root canal treatment, any future root canal treatment is not covered by the Company’s limited warranty.
- If a Patient’s current dental treatment fails and requires replacement or repair and consequently different dental materials, techniques or treatment due to clinical failure (ie failure not covered by the Company’s limited warranty) and is deemed to be necessary as advised by the Company acting in its sole discretion, then only the difference in treatment fee will be due and payable by the Patient.
- Failure by the Patient to have continuing care visits including x-ray and exams as recommended by Company as above voids any and all limited warranties. It remains at all times the Patient’s responsibility to contact the Company to make an appointment and attend the six-monthly exam and prophylaxis.
Treatments Under Limited Warranty
PORCELAIN VENEERS, CROWNS, BRIDGES, INLAYS AND ONLAYS
The Company gives a limited warranty on these procedures for a maximum period of three (3) years. The Zenaidy Castro P/L agrees to recement INTACT debonded Veneers due to normal use at no additional charge for our service to the Patient during this 3-year period EXCEPT LAB RELATED FEES.
RECEMENTATION WARRANTY OF NEWLY CEMENTED PORCELAIN VENEERS:
- If the newly cemented Veneers come off 1 week after the cementation appointment, we will recement it for free if your veneer is intact and not broken – we will absorb all the lab fees.
- If your newly cemented INTACT, unbroken Veneers come off 1 month after the cementation appointment, we will recement for free. Our warranty is for our service, except for lab fees. In these instances, there will be a small charge of $40 per veneer to cover the lab fees of cleaning and preparing your debonded Veneers.
- If your newly cemented Veneers came off but is BROKEN, or damaged, or got lost, we can’t recement this veneer. Our service of recementing and anything related to redoing for you a veneer is FREE, but there will be a charge to cover the lab fees of redoing a new veneer -which may range from $150-300 per veneer or the cost of a new Veneer.
This warranty does not operate in the following circumstances:
- The crown, veneer or bridge has been damaged by trauma, accidents and excessive force by severe grinding and clenching of the teeth that could also break normal healthy teeth;
- Neglect such as new decay, misuse, abuse, accidents or additional dental treatment done elsewhere.
- Failure of the tooth underneath the crown or onset of root infection is not covered by the warranty.
- Root fillings and non-standard treatments are not covered by the operation of this clause.
- The Company cannot predict, if and/or when gum or nerve treatments may be required on the covered tooth. If needed, they will require payment of additional fees by the Patient. If a veneered or onlayed tooth is damaged or decayed to the extent that a crown is necessary, the full fee originally paid for the veneer or onlay will be applied by the Company in payment towards the crown and the Patient will only be liable for payment of the difference.
The prosthetic treatment provided is warranted for replacement at no cost should a failure occur under the following conditions.
Failure constitutes technical and construction faults only and does not include
- Recurrent decay due to poor patient oral hygiene;
- Overload failure due to patient non-compliance in wearing a prescribed splint for grinding habits (if applicable);
- Failure due to accident or injury;
- Failure due to wilful or habitual damage (eg. nail-biting);
- Failure due to a change in the patient’s perception of the aesthetics of the final case after completion of treatment
- Failure due to loss or damage whether or not due to negligence on the patient’s behalf.
- Other dental professionals may be involved in the provision of services in complex treatment plans. Failure of treatments performed by other practitioners is not warranted.
The limited warranty period is for 3 years from the date of initial placement of the prosthesis and is only valid if the patient returns for an annual review appointment or as prescribed on your individual cases.
These appointments are to review and check the prosthesis only and may include its cleaning, however, they are not a substitute for regular recall examination and tooth cleaning services. Whilst the warranted period extends to 3 years, this does not mean that your prosthesis will not last longer if well maintained.
In extreme rehabilitative or reconstructive cases, the dentition may be so compromised that even complicated, high-quality prostheses may have a guarded or poor long-term prognosis. In such cases, a normal warranty cannot be provided. If a normal warranty cannot be applied, it will be indicated in your treatment plan letter.
The following events are not covered in general by the Company’s three-year limited warranty:
- Failure or repairs resulting from a Force Majeure Event, neglect, abuse, failure of the supportive tooth or tissue structures, wilful damage to the prosthetics, improper adjustments or improper dental hygiene.
- Failure to follow periodically (minimum 6 months or 3-6-9-12 months) dental visit as prescribed by the Company for a professional exam, X-rays and cleaning.
- Failure to complete necessary dental treatments as prescribed by the Company. The Company is not liable or responsible for the treatment or dental work done by any other dentists and there remains no obligation on the Company to rectify other dentist’s work.
- Any lab-related fees incurred in the process of cleaning up debonded Veneers or redoing a broken or broken Veneers
- The Company cannot give a 100% foreseeable prognosis if and/or when gum or nerve treatments may be required on a covered tooth. If needed by a Patient such additional Services will require payment by the Patient of additional fees. Unless otherwise advised all recommended dental treatment(s) by the Company will be performed by Dr Zenaidy Castro (with the exception of specialist treatments specifically recommended elsewhere).