Veneers can improve the appearance of teeth that are:

• chipped or broken
• stained
• crooked or misshapen

Veneers also can mask the gaps in your smile. They are different from crowns because they cover only the front surface of a tooth rather than the entire tooth structure.

Types of veneers

The two main types of veneers are porcelain and composite. Each type has its benefits.

A porcelain veneer is a thin shell custom-made to fit on the front surface of your teeth. Porcelain veneers are strong, long-lasting and natural-looking. They tend to be the more expensive option.

A composite veneer is made from a tooth-colored filling material that is bonded to the tooth. Composite veneers may require less tooth enamel to be removed and fewer visits to the dentist. They are easier to fix if damaged but are not as stain- or wear-resistant.

Before you get a veneer

Understand the following before you get a veneer:

• Treatment is not reversible because tooth enamel is removed to place a veneer.
• Your dentist must first treat any dental issues you have like decay or gum disease. Placing veneers over unhealthy teeth may worsen existing dental problems.
• A veneer may chip, crack, wear down or loosen over time, requiring your dentist to re-bond, repair or replace it.
• If you clench or grind your teeth, or have a deep overbite, veneers may not be a good choice.
• Veneers are considered cosmetic dentistry so your veneer may not be covered by insurance unless it’s deemed medically necessary.

As with all your dental care, discuss your dental history, treatment expectations, and reservations with your dentist. They will help you determine if veneers are the right choice for your smile.

Here are some warning signs that can signal a problem:

• gums that bleed easily
• red, swollen, tender gums
• gums that have pulled away from the teeth
• persistent bad breath or bad taste
• permanent teeth that are loose or separating
• any change in the way your teeth fit together when you bite
• any change in the fit of partial dentures

Some factors increase the risk of developing gum disease. They are:

• poor oral hygiene
• smoking or chewing tobacco
• genetics
• crooked teeth that are hard to keep clean
• pregnancy
• diabetes
• medications, including steroids, certain types of anti-epilepsy drugs, cancer therapy drugs, some calcium channel blockers and oral contraceptives

See your dentist if you suspect you have gum disease because the sooner you treat it the better. The early stage of gum disease is called gingivitis. If you have gingivitis, your gums may become red, swollen and bleed easily. At this stage, the disease is still reversible and can usually be eliminated by a professional cleaning at your dental office, followed by daily brushing and flossing.

Advanced gum disease is called periodontitis. Chronic periodontitis affects 47.2% of adults over 30 in the United States. It can lead to the loss of tissue and bone that support the teeth and it may become more severe over time. If it does, your teeth will feel loose and start moving around in your mouth. This is the most common form of periodontitis in adults but can occur at any age. It usually gets worse slowly, but there can be periods of rapid progression.

Aggressive periodontitis is a highly destructive form of periodontal disease that occurs in patients who are otherwise healthy. Common features include rapid loss of tissue and bone and may occur in some areas of the mouth, or in the entire mouth.

Research between systemic diseases and periodontal diseases is ongoing. While a link is not conclusive, some studies indicate that severe gum disease may be associated with several other health conditions such as diabetes or stroke.

It is possible to have gum disease and have no warning signs. That is one reason why regular dental checkups and periodontal examinations are very important. Treatment methods depend upon the type of disease and how far the condition has progressed. Good dental care at home is essential to help keep periodontal disease from becoming more serious or recurring. Remember: You don’t have to lose teeth to gum disease. Brush your teeth twice a day, clean between your teeth daily, eat a balanced diet, and schedule regular dental visits for a lifetime of healthy smiles.

Possible causes include:

• Tooth decay (cavities)
• Fractured teeth
• Worn fillings
• Gum disease
• Worn tooth enamel
• Exposed tooth root

In healthy teeth, a layer of enamel protects the crowns of your teeth—the part above the gum line. Under the gum line a layer called cementum protects the tooth root. Underneath both the enamel and the cementum is dentin.
Dentin is less dense than enamel and cementum and contains microscopic tubules (small hollow tubes or canals). When dentin loses its protective covering of enamel or cementum these tubules allow heat and cold or acidic or sticky foods to reach the nerves and cells inside the tooth. Dentin may also be exposed when gums recede. The result can be hypersensitivity.

Sensitive teeth can be treated. The type of treatment will depend on what is causing the sensitivity. Your dentist may suggest one of a variety of treatments:

• Desensitizing toothpaste. This contains compounds that help block transmission of sensation from the tooth surface to the nerve, and usually requires several applications before the sensitivity is reduced.
• Fluoride gel. An in-office technique which strengthens tooth enamel and reduces the transmission of sensations.
• A crown, inlay or bonding. These may be used to correct a flaw or decay that results in sensitivity.
• Surgical gum graft. If gum tissue has been lost from the root, this will protect the root and reduce sensitivity.
• Root canal. If sensitivity is severe and persistent and cannot be treated by other means, your dentist may recommend this treatment to eliminate the problem.

Proper oral hygiene is the key to preventing sensitive-tooth pain. Ask your dentist if you have any questions about your daily oral hygiene routine or concerns about tooth sensitivity.