I am at my wits end. About three years ago I went in to get porcelain veneers. Since then it has been nothing but a disaster. It seems like every few days they keep falling off. When I went in the dentist assured me that they wouldn’t take much tooth structure off. but when they fall off what is left of my teeth looks like tiny little nubs. The dentist always puts them back on but I live in a constant state of fear that another one will fall off. Plus, every time she has to put them back on she gives me an Ativan which knocks me out for the whole day. I never get to see what anything looks like until I wake up. Is it normal for the porcelain veneers to be popping off so much?
Annette
Dear Annette,
I am sorry that this happened to you. You, indeed, have what I would consider a cosmetic dentistry horror story. It sounds to me that what your dentist provided for you was not porcelain veneers, but porcelain crowns. I’ve posted an image above that compares the tooth preparation of a dental crown with a porcelain veneer. As you can see, the veneers only remove a few millimeters of tooth surface from the front of the tooth. However, for porcelain crowns, a great deal of structure is removed around the entire tooth.
Often, dentists who do not have a great deal of cosmetic dentistry experience, will point their patients toward crowns instead of veneers in order to save themselves the embarrassment of admitting that they do not know how to do the procedure. While not in the best interest of the patient, that is a bit better than what your dentist has done. Your dentist gave you crowns and told you they were veneers.
What confounds me is how your dentist is not able to even keep those in. Dental crowns are one of the first big procedures dentists are taught in dental school and no one should have graduated without being able to successfully place one. It sounds possible that he over prepared the contour of the area and that is causing them to fall off.
A third thing that bothers me here is the dental sedation. It is not typically used for cosmetic work because we want the patient to be able to look at and approve the work before it is permanently bonded on. Even if you were to have dental anxiety and need some sedation, I would lean toward a nitrous oxide, which gets you back to normal quickly. Then, even if you needed something stronger, like oral conscious sedation, Ativan is a bad choice. It has a serum half-life of 24 hours. I think you’d find most sedation dentists use something that has a half-life of three hours, so you are not useless for a full day afterward.
I think, because you were misled about what you were getting for your smile makeover AND the work is so poorly done it won’t even stay in your mouth, that your dentist should pay to have this fixed by a dentist of your choosing. Just make certain you choose an expert cosmetic dentist this time.
This blog is brought to you by Kalamazoo Dentist Dr. Susan Dennis.