Pros and disadvantages of Lumineers porcelain veneers. – Element II

Which is the better choice, Lumineers or traditional porcelain veneers? In Part I of this hub I’ve discussed some of the differences between Lumineers and traditional porcelain veneers and how these differences allow that Lumineers can be placed using a “no drilling / no shots” protocol. In Part II of this hub I discuss how these differences and the use of this placement protocol can affect a patient’s case, either for the better or for the worse.

Potential disadvantages of Lumineers.A) Lumineers don’t always appear as lifelike as traditional porcelain veneers.
As mentioned in Part I of this hub, traditional porcelain veneers are usually on the order of .4 to .8 mm thick. A part of the reasoning associated with this thickness is that it allows a veneer to handle light in a similar fashion as tooth enamel. And it is this light-handling characteristic gives a veneer its enamel-like lustrous appearance.

The fact that Lumineers are only about half as thick as traditional porcelain veneers creates a dilemma. If they are fabricated using relatively translucent porcelain, then the veneer and its associated bonding may not be able to adequately mask the color of the tooth structure that lies underneath it. If more opaque porcelain is used, a color change will be easier to accomplish but the veneer won’t have optical properties that mimic tooth enamel and therefore won’t look as lifelike. Either way, there is a feeling shared by many dentists that a thicker veneer, in comparison to an ultra-thin Lumineer, allows the dental laboratory an opportunity to impart a greater amount of characterization and lifelike translucency into it.

Some dentists will refer to the appearance of a set of Lumineers as looking like “chicklets,” meaning bright white objects with no lifelike translucency. Now in light of the plastic, Hollywood-style appearance that seems to pass for beauty now days, this comparison between the lifelike nature of different types of veneers and different veneering techniques might be considered to be a pretty minor issue to many people. But this issue is one that is readily apparent to dentists and frequently debated by the dental community as a whole because a dentist’s goal is to make the most natural looking restorations possible.

B) It’s easy for Lumineers cases to create teeth that are over contoured or look too toothy.
If a dentist does not perform any tooth reduction (drilling) before a Lumineer is placed, then the tooth will, at least to some degree, be oversized and/or over contoured. It’s just a question as to whether this will compromise any cosmetic or biological aspects of the case.

1) Lumineers smiles can seem too toothy.
It is easy for a no-drilling Lumineers case to give an end result that is too toothy in appearance. After all, the front side of normal-sized teeth has been encased under a layer of porcelain. The teeth will undeniably be larger. However, just as mentioned above, a lot of people simply don’t notice things like this. When compared with the other cosmetic changes that their Lumineers have made, such as making their teeth whiter or more uniform in appearance, the resulting increase in size may not be much of a concern to them.

2) Functional and biologic considerations.
There can be concerns that a no-drilling Lumineers case will result in teeth that are over contoured and bulky. This can effect the patient’s speech, biting habits, or how it feels as they move their lips across or position them over their teeth. In the majority of cases, however, these issues will only be a temporary inconvenience and one that the patient will adapt to within just a day or so.

There can be other concerns associated with teeth that are over contoured. And while these problems are often less apparent to the patient, they can be potentially more detrimental.
See all 2 photos A veneer that is over contoured. (By permission of DMHI, Inc. / Dental-Picture-Show.com) Clearly, over contoured teeth are harder to clean. And if a tooth cannot be kept plaque free it is more likely to experience complications associated with tooth decay and gum disease. At a minimum, the development of these types of problems might just spoil the cosmetic appearance of the veneered teeth. In other instances they might undermine the veneers to a point where they have to be replaced, or worse yet, seriously compromise the health and long-term outlook for the teeth themselves.

In the majority of cases, the potential for problems associated with plaque accumulation can be kept in check with diligent oral home care (brushing and flossing). The key words of the previous sentence being “diligent” and “flossing.” Only the patient can determine if their expected future oral home care practices can make choosing an over contoured result a wise one. A person’s past oral home care habits are probably the best predictor of their future ones.

When is the placement of Lumineers indicated? When might they be the right choice?

Here is a listing of some of the situations where placing Lumineers using a no-drilling protocol might be a better choice than placing traditional porcelain veneers.

A) The patient demands a no-drilling placement process.

Some people have dental phobias. That’s just the way life is. The fact that ultra-thin Lumineers can be placed using a technique where no drilling is needed might make it possible for a person to have important cosmetic changes made whereas otherwise they would not. If this is the case, then it’s wonderful that Lumineers exist.

B) The patient demands a no-shots placement procedure.

Pretty much just ditto everything that was stated in the no drilling item above.

C) The patient demands a totally reversible procedure.
Lumineers that have been placed using a no-drilling technique do offer the possibility that they can be removed if the patient is unhappy with the appearance they have created. The dentist would need to drill off both the Lumineers and the bonding holding them in place. It wouldn’t be all that much fun for the patient, or necessarily all that quick a procedure. The dentist wouldn’t be able to promise that absolutely no tooth structure would be lost or that the patient’s teeth would feel as smooth as they did originally. But in theory, removing Lumineers and returning the patient’s teeth to their somewhat original state is a possibility that traditional porcelain veneer technique does not offer.

D) The patient demands a situation where they are not inconvenienced while their veneers are being made.
A luxury that no-drilling Lumineers protocol offers is that there is no intervening period between the teeth being prepared and that point in time when the veneers have been fabricated and are ready to be placed. For most people the inconveniences associated with this wait are minor. In many cases the dentist will make temporary plastic veneers that the patient will wear during this time frame. If not, there may be issues that the patient experiences associated with appearance, roughness, or thermal sensitivity. In most cases, however, these issues are at most a minor nuisance.

So what is the right choice, traditional porcelain veneers or Lumineers? You may have noticed that with each of the indications I’ve stated for placing Lumineers I started each line with the phrase “the patient demands.” Clearly that’s my bias. Yes, absolutely, Lumineers can fill a need. But in most cases the perceived need is simply one of patient preference.

The two things you might have noticed that I didn’t mention as reasons to place Lumineers is that they look better than traditional veneers or are better for the patient’s long-term dental health. Yes, placing no-drilling Lumineers may produce a result that looks just as good as traditional veneers and they may have absolutely no detrimental influence on the long-term oral health of the patient’s teeth but this technique does posses inherent obstacles that make these goals harder to achieve.

Having read this hub, the hope is that you realize Lumineers do offer a set of characteristics that can make them advantageous. However, the majority of these advantages are more closely associated with patient preferences rather than giving the dentist the greatest latitude in creating the most natural end result. If the “no-drilling / no shots” placement option of Lumineers is important to you, then specifically discuss this with your dentist. Otherwise let them evaluate you first and then make a recommendation regarding which veneering approach would seem most suited to your situation.

I’d like to thank DMHI, Inc., the owner of Dental-Picture-Show.com for granting me permission to use their pictures for this hub. They have more in depth information regarding porcelain veneers and Lumineers, as well as an assortment of other dental topics on their site. A visit just to view the animations is worth it.
Lumineers is a registered trademark of the DenMat Corporation.

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