Episode 20: An In-Depth Look at Dental Veneers

Eon Engelbrecht ERadio(0:09 – 0:46)

Welcome again to Save Your Money, Save Your Teeth, the go-to podcast where curiosity meets dentistry straight from the experts. I’m Eon, and every week, I’ll be chatting with Dr Clifford Yudelman. Take a nice deep dive into the world of dental care from a consumer’s perspective. Whether you’re looking to brighten that smile or protect your wallet, we have got you covered with practical advice and also the latest insights.

So stick around as we uncover the secrets to maintaining both your dental health and also your finances. Dr Clifford Yudelman, welcome back.

Dr Clifford Yudelman OptiSmile(0:47 – 0:53)

Hi Eon, thanks for having me back, and we’ve got a great episode today for all our listeners.

Eon Engelbrecht ERadio(0:53 – 1:14)

An in-depth look at dental veneers, okay, so that’s going to be very interesting. A lot of the times, you see famous people with that perfect smile, you know, and then you go and you read, you know, and then a lot of times it’s dental veneers. What exactly are dental veneers, Dr Yudelman?

Dr Clifford Yudelman OptiSmile(1:14 – 2:18)

So basically, they are thin shells that cover the front of a tooth in many cases. Sometimes, they wrap around over the top or in between the teeth a little, and the main purpose is to improve appearance. They can be made from porcelain or more modern material called lithium disilicate or Emax, and then even newer now is composite resin veneers and they address issues like misshapen teeth or if a tooth is small or if a tooth is damaged or worn down or in some cases severely discoloured teeth that are not amenable to whitening.

They are less invasive than crowns, but they work better than just normal bonding, which we’ll talk about in another episode. The main focus at OptiSmile is preserving your natural teeth while enhancing your aesthetics.

Eon Engelbrecht ERadio(2:18 – 2:27)

Okay, so can you tell us about the different types of veneers? Because you just mentioned you’ve got porcelain and composite. What’s the difference between those?

Dr Clifford Yudelman OptiSmile(2:28 – 3:20)

Yeah, so porcelain or the newer version of porcelain, which is even stronger than the original porcelain. They’re very durable. They can pop out if they’re not bonded properly or not done properly, but in general, they stay in.

They’re stain-resistant. They can have a very natural appearance if you go to a dentist who specialises in them and uses a very good lab. Composite veneers are about a third of the cost; they don’t involve tooth removal, and they’re much easier to repair in the long term.

The porcelain can last longer, but it’s more expensive up front, and the composite is done all in one visit, whereas the porcelain requires several visits. At OptiSmile, we offer both options depending on the patient’s needs and preferences.

Eon Engelbrecht ERadio(3:20 – 3:25)

Okay, so what kinds of dental issues can veneers help with?

Dr Clifford Yudelman OptiSmile(3:25 – 4:52)

So the main thing that we see these days is erosion and wear on teeth. So a lot of times, that’s where patients have had crooked teeth for a long time, and then we straighten their teeth, but that doesn’t sort out the problem of teeth that have worn or misshapen because of wear and tear, severe staining on teeth that don’t bleach out or lots of little hairline cracks, discolourations and then gaps if there are gaps between the teeth. In some cases, there are gaps that can’t be closed with braces or Invisalign.

These are closed by changing the shape of the teeth. For instance, where teeth are small, like the side front teeth, they can sometimes be what’s called “peg-laterals”. So structural issues like chips, cracks, and already mentioned worn down teeth, misshapen and uneven. They are sometimes used as an alternative to orthodontics for misalignments.

In many cases, we see where they are overused or, should we say, abused, and you get this “Turkey-teeth” phenomenon that we’ve spoken about before. The patient would have benefited from having maybe 14 to 20 aligners like Invisalign or even braces. Our philosophy at OptiSmile is to have a comprehensive assessment to determine what’s best for you.

Eon Engelbrecht ERadio(4:53 – 5:01)

Okay, and now, doctor, can you walk us through the process of getting dental veneers at OptiSmile? What can we expect?

Dr Clifford Yudelman OptiSmile(5:01 – 6:38)

You can start with a video consultation which is a free video consultation. You send some photos through on WhatsApp or then we speak to you over a Google Meet or Zoom but basically then you come in, we do a full examination to check on your dental health. We take x-rays, we do photos and we do a 3D digital scan and the next step is creating a virtual model of what the expected result will look like.

It’s commonly known as digital smile design. So, using special software to design the size, shape and texture of the teeth, and then you’d come back if it’s for traditional ceramic veneers, and there’s tooth preparation where we smooth off or remove a little bit from the front of your teeth. Our preference at OptiSmile is to do the composite or injection moulded veneers, which doesn’t require any tooth removal, but there are cases where someone’s had veneers before or where the tooth the teeth needs the surface to be smoothed back a little to be replaced with the veneers and we basically after that we scan your teeth, we make temporary veneers, and then we send the scan to the lab.

The lab makes the new veneers, and you come back, and we bond the veneers into place. If it’s injection molding veneers, which we’ll speak about further, those are done directly onto the teeth, and then we follow up to make sure the patient’s happy and to give care instructions.

Eon Engelbrecht ERadio(6:39 – 6:45)

Alin, how does your digital smile design technology work, and why is it beneficial for all our patients?

Dr Clifford Yudelman OptiSmile(6:46 – 7:26)

So there’s now very advanced software and the technicians that we use, they use AI and also human artistic qualities to visualise how the patient’s face will look with the new teeth in place using the photos and the 3D scans, and we can show patients so they can see the expected results before they even undergo treatment and it’s tailored to individual patient’s face and preferences, and it gives us a very high degree of accuracy in the final result and our philosophy at OptiSmile is to use this technology so we get optimal patient outcomes.

Eon Engelbrecht ERadio(7:26 – 7:32)

When choosing between porcelain and composite veneers, what should patients consider?

Dr Clifford Yudelman OptiSmile(7:32 – 8:55)

I think it’s best to listen to the dentist. We’re seeing such good results with composite these days that we generally will discuss going towards composite in many, many cases, especially younger patients. The composite is more affordable.

The porcelain is more expensive. The porcelain can be more durable and stain-resistant. The porcelain can chip or break or come out later on and they’re more difficult to repair or replace and they end up being more expensive.

For porcelain, you also have to remove some teeth, as we discussed, whereas, for composite, we don’t have to remove any teeth. They both have a very natural look these days, and the composite is quicker to make than the actual ceramic ones. Just to give you an idea of the cost, the lab fee alone to make a single veneer, which we usually do six or eight or even ten upper teeth, in many cases and the lab fee alone is about three and a half to four thousand Rand to get a good veneer from a lab.

So, already, the cost of the lab fee is 40,000 Rand, and with injection moulded composite bonding, your total fee could be that, depending on how many teeth you have. So, there is a very big difference in the cost, but our philosophy at Optismart is to help patients make informed decisions based on their goals and their budget.

Eon Engelbrecht ERadio(8:55 – 9:01)

Do you have any situations where veneers might not be the best option?

Dr Clifford Yudelman OptiSmile(9:01 – 10:32)

Yeah. So, in cases where there’s extensive decay, a lot of the tooth is missing. Some of those teeth may need a crown instead of a veneer because the veneer is stuck onto, preferably stuck onto the enamel, which means that the tooth is still quite intact.

If someone’s got severe or has gum disease, they may require treatment before you can consider any kind of veneers, and we wouldn’t want to put veneers on someone who has bleeding or severe recession or gum disease or bone loss. If there’s a severe misalignment, we always recommend Invisalign or aligner treatment, or in some cases, we send patients for braces. We don’t like to use veneers to straighten teeth and structural limitations like if there’s not enough enamel for bonding or if there’s already a lot of the tooth that has been drilled away or missing for one reason or another.

If someone’s a very bad grinder, people who grind their teeth very, very heavily, then there might be cases where crowns would be better. You really want to make sure the dentist does an honest assessment and make sure that veneers are the right solution for you. You don’t want to just go into a so-called cosmetic dentist and say I want veneers and they’re going to say sure and give you the veneers when maybe it’s not what you need.

You need a dentist who’s going to give you the pros and cons and other alternatives as well.

Eon Engelbrecht ERadio(10:32 – 10:47)

So apart from compliments on the photos that you post on social media, people are saying, oh, your teeth look lovely. What kind of results can patients typically expect from veneers, and also, how long do they usually last?

Dr Clifford Yudelman OptiSmile(10:47 – 12:10)

So, generally, the teeth are much more even. You get an aesthetically pleasing smile. We can change the shade of the teeth and make them whiter.

We tend not to want to make them that very, very, very white colour, which is quite popular. I think those patients will find that when that trend is over, they’re going to be stuck with very white teeth that everyone knows are fake. Their teeth just can’t be that white.

So we tend to, it’s very rare that we always try and encourage patients towards a more natural look, more of a European look than an American look. Porcelain veneers can last 10 or 15 years. I just recently saw a lady who’s had veneers for 20 years, but they probably started looking a bit stained and problematic maybe five or six years ago, and she finally got them replaced before moving to Australia.

So we did ten veneers for her. They looked amazing. She was very, very happy.

And again, I didn’t make them super white. We just gave her something very, very natural. They look just like teeth.

There’s always a noticeable improvement after the procedure and one needs to make sure you go in regularly to make sure that they do last a long time. And we are always committed to delivering lasting and satisfying results.

Eon Engelbrecht ERadio(12:11 – 12:17)

Any success stories or patient testimonials that you want to share with us about veneers at Optusmile?

Dr Clifford Yudelman OptiSmile(12:20 – 13:22)

I’m not very keen on posting before and after photos. When patients come in, I will pull up five or ten or even more cases, such as recent cases where patients have agreed to let me show their photos one-on-one. In many cases, patients have gone to Google and written reviews.

Just in the last 10 to 14 days, we’ve had five or six reviews. A lot of them are from patients who have had veneers or injection-moulded composite bonding or injection moulded composite veneers. So if you go on our website or onto Google and you look at the reviews, patients mentioned veneers and you can see what type of results they’ve had based on what they’re saying.

And when you do a video consult with us or you come in, we’ll show you exactly similar cases and what type of results we’ve had. And yeah, we like to build trust with these types of success stories. It helps the patients feel good, and we always feel great, of course.

Eon Engelbrecht ERadio(13:23 – 13:33)

And then finally doctor, any tips that you have for us about keeping those veneers looking great and lasting as long as they possibly can?

Dr Clifford Yudelman OptiSmile(13:34 – 14:48)

Yeah. So the usual, what we’ve spoken about before is brushing and flossing, especially flossing before you go to bed, making sure that you use a soft toothbrush and you’re cleaning along the gum line, making sure that you don’t brush too hard with a hard toothbrush and get recession because then the edge of the veneer will show and eventually get stained, especially if you drink a lot of espressos or like me, Americanos or tea, rooibos tea, things like that can stain. Those types of stains can generally be polished off, but cigarettes generally never make your teeth look nice. I mean, we always recommend people try and give up smoking because not only is it bad for your gums, but it will stain around the veneers. Regular checkups for a lot of people, so getting a cleaning every six months and a checkup is very important.

Some people come more often; other people only need to come once a year. And yeah, we like to give people ongoing support and guidance so they have long-term dental health. I think we covered a lot today.

We’ll talk about dental bonding next week, which is fairly similar but it’s different. So I look forward to chatting with you next week.

Eon Engelbrecht ERadio(14:48 – 14:56)

Thanks, Dr. Yudelman. Yes, indeed. Looking forward to that, and thank you once again for your time and for sharing your expertise with us.

We really appreciate it.

Dr Clifford Yudelman OptiSmile(14:56 – 14:59)

Pleasure. Thanks for having me on, and I’ll speak to you next week.

Eon Engelbrecht ERadio(15:00 – 15:29)

And remember, while we strive to provide valuable insights here on saving your money and saving your teeth, we always recommend that you consult with your own dental professional for advice tailored to your personal health. Don’t forget to subscribe for more enlightening discussions, and join us again next week as we continue to explore the fascinating intersection of dental health and financial savvy. Until then, keep smiling and taking great care of your teeth.

[Speaker 3] (15:36 – 16:20)

Discover the world of dental excellence with OptiSmile. Join us for a weekly podcast featuring Dr. Clifford Ulluman, a seasoned expert with 40 years of dental experience across four continents. Gain unique insights and expert dental advice by visiting OptiSmile.co.za for articles that illuminate the path to optimal oral health. If you’re seeking unparalleled dental care in Cape Town, get in touch with OptiSmile or book directly online at OptiSmile.co.za. OptiSmile, where global expertise meets local care.