Ceramic veneers: correcting shape and shade.

The most common situations: discolouration that whitening alone cannot correct, a tooth that is too narrow or too short, a worn edge, a slight misalignment that does not on its own justify orthodontic treatment, and old composite restorations that have deteriorated.

Whether a veneer is indicated is decided at the examination: what the teeth show, and what the other solutions would not achieve. The aesthetic request matters, but on its own it is not enough.

A request about shade alone calls for whitening. A badly broken-down tooth calls for a restoration that covers more of it. And when almost no enamel is left on the visible surface, bonding becomes less predictable, which takes away much of the point of the technique.

It also serves as a guide for the preparation. A tooth that is set back or too small sometimes needs very little reduction; a tooth that already sits forward needs more, to avoid a bulky result. The amount of enamel removed therefore depends on the final volume, never on a thickness fixed in advance.

Lithium disilicate, known by the trade name e.max, is pressed or milled, and is mechanically stronger. The choice depends on the tooth structure available, the starting shade and the functional context, that is, the way the teeth meet and the forces they are subjected to. This context can guide the choice of material, its thickness, the design of the restoration and sometimes the indication itself: a stronger ceramic does not, on its own, make up for unfavourable stresses. The journal article on feldspathic and e.max veneers sets out what separates these two materials.

Two veneers may be enough when only two teeth stand out from the rest. Treating the four incisors, or going as far as the premolars, is justified when the result cannot be achieved any other way. Making everything uniform on principle is not a clinical reason.

Over time, a veneer can crack, come loose or develop staining along its margin. Check-ups make it possible to monitor the veneers and to spot wear or a complication early.

The preparation, however, is not reversible: a prepared tooth will remain a restored tooth.

That is why the steps before bonding exist. Diagnosis, the plan, the mock-up and the temporary restorations all leave room for adjustment, and as long as nothing has been removed, you can still decide not to go ahead.

Treatment carried out for aesthetic reasons is not covered by the French national health insurance (Assurance Maladie), and a detailed written quote is provided before any decision. The table of fees sets out all the procedures and the factors that make each range vary.

This is followed by photographs and an analysis of the smile, then, when the plan warrants it, a digital impression. The alternatives are compared, a mock-up is offered when it is useful, and the decision is made afterwards, never on the same day.