A common question that surfaces in the mind of patients is: Should I choose a dental crown or a veneer? Here are the answers you've been looking to get.

Why do I need a dental crown or veneer?

For one, your teeth are damaged or decayed, exposing the dentine and pulp. Or they may be discoloured and worn out, with parts that have chipped off. For another, treatment is needed to protect these tiny but indispensable structures from wear and tear.

What is a restoration?

This is a procedure that brings a tooth back to its original state, or better. The dentist first prepares the work site by cutting away the damaged or decayed parts. Then he or she places material to cover over the exposed dentine and pulp. In smaller areas, this can be fixed with a filling. However, when the defect is larger, or for aesthetic reasons, either a veneer or a crown may be used.

What is a dental crown?

It acts as a protective layer that encircles the structure. It is like a cap on a tooth that has been reduced due to root canal treatments and large cavities. The crown restores both structure and strength that have been compromised by chips and cracks. Think of it as a bumper for your car - if there is a high force onto your bumper, it will break but the frame will still be protected.

Similarly, if there is any high force that is large enough to damage the tooth, the crown breaks instead, absorbing the impact. It is fitted onto your teeth, beside the neighbouring and opposing teeth. The difference between this and dental implants is that the latter serves to replace missing teeth.

What are dental veneers?

These are thin shells that are adhered to the tooth. Mostly done on the front surface for cosmetic reasons, they are effective when the dentine and pulp are not exposed. Veneers are custom made to suit the shape, size, and colour (shade) of your jaw. The cosmetic dentists at our clinic are interested in less reduction of your original tooth structure because the restoration is more successful.

The main advantage here is the improvement of your smile. Teeth actually have many shades and shapes. The job of a dentist is to skillfully design one that will suit the rest, making it virtually indistinguishable from the other structures. The material is carefully painted and stained by trained laboratory technicians to make it match your natural teeth colour.

Veneers come in two materials, ceramic (or dental porcelain veneers) and composite resin veneers. There also are traditional versus modern ones. If you want no grinding down included, your doctor might recommend prepless veneers.

How do you choose the right dentist?

Indications of a good professional include one that will explain to you what your condition is and what treatment options you have. This includes all the pros and cons of picking each procedure, as well as long-term considerations. When you are settling for a permanent, long-lasting treatment like these two are, you need to be assured that the specialist is capable of delivering an outcome that you will be satisfied with in the long run.

Your choice actually lies between digital versus traditional dentistry. An orthodontist will best be able to advise whether to restore your tooth using a crown or a veneer. However, being the patient, you have the autonomy to select an expert who has upgraded their skills to the new revolutionary methods. Talk about intra-oral scanners that are less intrusive and nicer versus traditional unpleasant impressions. Or those 3-4 hours spent to restore your tooth versus two appointments with a wait of up to two weeks.

The most dedicated professionals invest in technology such as the 3D intra-oral scanner to design your smile. Using the software in their clinic, they have total control over the entire process. By contrast, traditional dentists sub their work out to dental laboratories and the quality of the job depends on the technician's skill.

What are the main considerations of choosing between the two treatments?

• Generally speaking, a crown is done if the teeth are decayed or a root canal procedure has been carried out, resulting in not enough material left for the dentist to place a veneer.
• Veneers are approximately 0.5-1mm in thickness, and used on the outer tooth surface. This means your original structure is kept intact as much as possible. This saves you money in the long run. The material is placed with the shape of your smile in mind.
• If you lack enamel on the facial (the surfaces of the tooth touching the cheeks), veneers are not the best way to go. They require an adequate amount of enamel in order to attach and remain stable on the surface.
• Many dentists prefer crowns in lieu of veneers because the latter option can be difficult to fit in.

Regardless of the procedure you opt for, you still need to maintain a good oral hygiene routine in order to sustain the results.

What is involved in a visit to the dentist for dental veneers?

To answer this question, the typical traditional dentist’s workflow must be explained. For dental crowns, they first prepare your tooth to create the space it takes to fit in. They then make a hold or impression of your prepared tooth and send it to the traditional laboratory to mould. Next up, they place or restore a temporary preparation on your tooth, and this marks the end of the first appointment.

Typically, you have to wait about two weeks until the laboratory has made your restoration. In the meantime, do keep in mind the following. First, the temporary fixture is rough, hence you should be careful to not dislodge it when brushing and flossing. Second, you ought to avoid chewing hard or sticky foods on that side so as not to break it. The tooth may also be more sensitive as it is not fully covered.

After two weeks, you will have to go back to the dentist and they will place the actual dental crown.

Alternatively, you can narrow down your appointments to one if the products are made by a CEREC trained specialist. Instead of placing a traditional temporary crown or veneer, they can design your tooth immediately after the preparation work is done.

CEREC revolutionises this conventional method. In general, the whole process of starting and completing the treatment can be done in around three hours. The first visit is the preparation which takes one hour. After that, you can go back to work or have coffee while you wait. The restoration will be CAD/CAM milled in our CEREC machine, individually stained, glazed and hand-finished. In an hour’s time, you return to the dental clinic and have the permanent material fitted in.

This means no more troublesome unreliable temporary restorations, and fewer appointments. The visit itself will be more pleasant with the 3D intra-oral scanning experience, compared to the normal dental impressions that leave you gagging in the dental chair.

I Want to Improve my Smile, Can I Do That with Veneers in Singapore?

Veneers can change the shape and size of your smile to a more alluring appearance, with the added bonus of teeth whitening.

However, if you require orthodontic treatment, you will be advised to go for it ahead of time. This is because your teeth need to be straightened before anything else is done to them. If the crookedness is massive, excess material will be ground away and the structures will be reshaped. Not to mention, the orientation is essential as well. It is important how the occlusal surfaces of your dental arches for the top and bottom teeth impact enamel wear and tear.

So to sum it up, veneers are mainly used to restore a beautiful smile when sufficient tooth structure is available. They cannot be stained with coffee, tea, and wine. On the other end of the spectrum, dental crowns are used for more damaged structures because they provide wider coverage and protection, replacing missing teeth.

Our Commitment to Quality Dental Care

At Dental Designs Clinic, we offer same day crowns since we are capable of milling the restoration with our CEREC machine. Therefore, you only have to come for a couple of hours in one day to complete your treatment, unlike most other clinics which require two appointments. This frees up your valuable time.

Getting the restorations made in-house means we have total control over the designing, finishing, and quality of the process, as opposed to traditional dental laboratories whose work depends on the technician's skills. We strive to improve your overall oral health so you can have a normal life for years to come before you need to make another trip to your dentist.

References

1. Crowns and Other Extra-coronal Restorations: Porcelain Laminate Veneers
   (A Walls-J Steele-R Wassell - https://www.nature.com/articles/4801489)
2. Clinical evaluation of etched porcelain veneers
   (https://europepmc.org/article/med/2597374)
3. Clinical Observations Of Porcelain Veneers: A Three‐year Report
   Gordon Christensen-Rella Christensen - (https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1708-8240.1991.tb00994.x)
4. Us3934348a - Method Of Forming a Porcelain Crown
   (https://patents.google.com/patent/US3934348A/en)
5. Effects Of Opaque and Porcelain Surface Texture on the Color Of Ceramometal Restorations
   Alejandro Obregon-Richard Goodkind-William Schwabacher - (https://www.sciencedirect.com/science/article/abs/pii/0022391381902225)
6. Marginal distortion of the porcelain-bonded-to-metal complete crown: An SEM study
   (https://doi.org/10.1016/0022-3913(82)90178-0)