In 1928, pioneering dentist Charles Pincus was asked by Hollywood executives to perfect the look of an actor’s smile and the earliest form of veneers was invented. Synonymous with celebrities, demand for veneers has skyrocketed with the rise of social media and influencers; achieving the ‘Hollywood smile’ is an aesthetic goal for many.
The global dental veneers market was valued at £1.83bn in 2023, with a compound annual growth of 7.4 per cent. Since the wider induction of Zoom calls, Teams meetings and other video calling services since the pandemic, people have become more conscious about how they look. From observing themselves onscreen, more patients are looking to enhance their smiles. But knowing the right cosmetic treatment to get can be a hard choice.
Failing cases
For patients seeking veneers, they have two material options: porcelain or composite resin. Because of its malleable qualities that allow dentists to sculpt it directly to the tooth, composite resin is a more manageable material for veneers. Patients may prefer that no preparation of the tooth is required and that their desired aesthetics can be equally achieved with composite materials, making it an agreeable option. Moreover, composite veneers are cost-effective and far less time-consuming to deliver. The short application progress can be completed in one appointment, with minimal preparation. For patients not wanting multiple practice visits, composite veneers can provide the quick and non-invasive treatment they need.
Despite the ease of composite veneers, there are drawbacks. Patients with poor dental hygiene, bruxism or who eat hard foods may find that composite veneer failure is more likely, and so other alternatives could be more effective if the lifestyle choices are not changed.
The survival rate of a composite veneer is 87 per cent after three years and 75 per cent after 10 years. Patients may need appointments to repair, replace or remove damaged composite veneers, as the resin is porous and therefore more susceptible to wear and staining than materials like porcelain. Dentists may then have to decide the best way to repair the veneer: either to directly apply the composite resin to the broken surface or to remove the restoration and repair it in a laboratory. Repairing the broken restoration without removing it is often more satisfactory for patient and practitioner, even if durability is limited.
As porcelain is custom-made and more natural-looking, it is unsurprising that patients with composite veneers had a lower satisfaction rate (67 per cent) than those with porcelain veneers (93 per cent), as porcelain is more likely to survive.
One treatment only?
As veneer demand continues to rise, and more patients seek this treatment specifically, it is easy to rely on this as the main restorative solution. Abraham Maslow noted that “if the only tool you have is a hammer, you tend to see every problem as a nail,” when observing psychiatric treatments in 1966. For dentists, abiding by this cognitive bias would ignore other cosmetic solutions in favour of familiarity. Composite veneers may be easier to offer and do than other options, but it is important to avoid the pitfall of fitting patients into preferred treatment regimes, rather than working with what is best for each individual patient.
Decision-making can be affected by numerous factors, such as cost-effectiveness and professional bias. But being able to offer multiple cosmetic treatment options can both satisfy patients and minimise the risks of complications. For instance, a patient with enamel hypoplasia may prefer the minimal invasiveness of composite veneers to achieve their aesthetic desire. On the other hand, patients with severe issues like large gaps or extreme discolouration may find that composite veneers are not a viable solution.
Widen the range
For dentists who cannot offer the most appropriate treatment to a patient, referring them may be in the best interests for their long-term health. Providing one cosmetic treatment option is therefore limiting for both the patient and the practice, and expanding your skills can help prevent this.
The British Academy of Cosmetic Dentistry (BACD) provides the opportunity for cosmetic dentists to become accredited members. The accreditation process will allow dentists to show that they can diagnose, plan and execute various cosmetic dental treatment options to the highest standard of competency, ethics and safety. The skill set to be demonstrated includes composite veneers, indirect shade matching and posterior aesthetics, among others. Accredited members will have enhanced skills across the board of cosmetic dentistry, delivering first-class treatments for optimal patient care.
With veneer demand constantly increasing, knowing and navigating the logistical and ethical problems that composite veneer treatment can cause is essential so that patients receive the appropriate treatment that most benefits them.
References available on request.
For more information visit www.bacd.com