Contraindications for Composite and Porcelain Veneers

Contraindications for Composite and Porcelain Veneers

Actually, some contraindications are similar for both types of veneers, but there are also differences. In general, the final decision regarding the use or non-use of veneers rests with your dentist, and they will determine the best treatment option after a thorough examination of your teeth and mouth condition.

Here are the contraindications for veneers (both composite and porcelain):

General Contraindications for Both Types of Veneers (Composite and Porcelain):

1. Poor Oral Hygiene: If your oral hygiene is poor and you do not brush and floss regularly, the use of veneers is not recommended. This is because poor hygiene increases the likelihood of plaque and bacteria accumulation around the margins of the veneer, which can lead to decay of the underlying teeth, gum disease, and bad breath. Before getting veneers, it is necessary for your oral hygiene to reach a satisfactory level, and you must have the ability and commitment to maintain your oral hygiene.

2. Active Tooth Decay: If your teeth have active and untreated cavities, the decay must be treated first. Placing veneers on decayed teeth hides the problem, and the decay can continue to progress and damage the tooth nerve.

3. Active Gum Diseases (Periodontitis or Gingivitis): If your gums are inflamed, red, bleeding, or receded, gum diseases must first be treated and controlled. Unhealthy gums are not a suitable foundation for veneers and can lead to problems with veneer longevity, as well as further gum problems in the future.

4. Severe Tooth Grinding (Bruxism): People with severe teeth grinding (bruxism) or those who intensely clench their teeth put excessive pressure on the veneers. This pressure can cause veneers to fracture, chip, or detach, especially porcelain veneers, which are more brittle than composite. In these cases, bruxism should first be controlled (e.g., with a night guard), and then the possibility of using veneers should be considered.

5. Large Gaps Between Teeth (Diastema): In cases where the gaps between teeth are very large (large diastemas), closing this space with veneers may not create a natural and aesthetic result. In these situations, orthodontic methods are usually recommended to close the space, and then, if necessary, veneers can be used to improve the shape and color of the teeth.

6. Severe Protrusion of Teeth (Protrusion): If the teeth are severely protruded outward (severe protrusion), a lot of tooth structure needs to be removed to place veneers. In these cases, orthodontic methods to correct tooth position and then the use of veneers may be more appropriate to avoid excessive tooth reduction.

7. Severe Dental Anomalies: In some cases, there are severe anomalies in the shape, size, or position of the teeth that cannot be corrected with veneers alone. In these situations, more complex orthodontic treatments or orthognathic surgery may be required.

8. Unrealistic Patient Expectations: If the patient has unrealistic expectations about the outcome of veneer treatment and believes that veneers can completely and immediately solve all their dental problems, they may not be sufficiently satisfied after treatment. Before starting treatment, the dentist should make the patient’s expectations realistic and fully explain the limitations and possibilities of veneer treatment to them.

9. Insufficient Enamel Thickness: To bond the veneer to the tooth, a sufficient amount of tooth enamel is necessary. In cases where the tooth enamel is very thin due to wear, acid erosion, or other factors, the dentist may not recommend using veneers.

Specific or Relative Contraindications for Composite Veneers:

• Severe Tooth Discoloration: Composite veneers are not as successful as porcelain veneers in covering severe tooth discoloration (such as tetracycline stains or severe fluorosis). In these cases, porcelain veneers are usually a better choice because they have a higher opacity.

• Need for Significant Tooth Shape Correction: If significant changes in tooth shape are required, porcelain veneers may create a more aesthetically pleasing result due to the limitations of composite shaping. Porcelain veneers are made in a dental laboratory, and it is possible to create more finesse and detail in their shape.

• Very Dark Tooth Color: In very dark teeth, composite veneers may not adequately cover the underlying dark color, and the dark shade may be visible from under the veneer. Porcelain veneers perform better in these cases due to their greater opacity.

Specific or Relative Contraindications for Porcelain Veneers:

• Teeth with Large Cavities and Extensive Fillings: In teeth that have had large cavities and extensive fillings, the remaining tooth structure may not be sufficient to support a porcelain veneer. In these cases, dental crowns may be a more appropriate option. Composite veneers can be used more cautiously in these situations because they require less tooth reduction and can preserve more tooth structure.

• Cases Requiring Fast and In-Office Repair and Correction: Porcelain veneers are made in a laboratory, and at least two dental visits are required for their placement. In contrast, composite veneers are directly shaped and placed on the tooth in the office by the dentist and can usually be done in one visit. Therefore, if the patient needs rapid tooth restoration and treatment in one session, composite veneers are a more suitable option.

• Higher Cost: Porcelain veneers are generally more expensive than composite veneers. If treatment cost is a very important factor for the patient, composite veneers can be a more cost-effective option.

• More Difficult to Repair if Fractured or Damaged: If a porcelain veneer fractures or is damaged, it usually needs to be completely replaced. While composite veneers are often repairable and correctable in the office.

Important Notes:

• These are general contraindications, and each patient’s situation is unique. Your dentist will make the best decision after carefully evaluating your condition.
• In some cases, by performing preventive or preliminary treatments (such as gum disease treatment, bruxism control, or orthodontics), conditions can be created for the use of veneers.
• Always talk to your dentist about all available treatment options and the pros and cons of each so that you can make the best decision for your smile.