15 Tips For Doing Better Veneers

November 15, 2021

1. Teamwork Makes the Dreamwork Build a team of all stars. Teach your team about cosmetic dentistry and veneers, show them what’ s possible, and get them involved. Having a solid team that believes in what you do and can support you and your patients is essential. I couldn’t do what I do without my team. 

2. Choose the Best Lab Working with an awesome cosmetic lab is extremely important. To be successful with porcelain veneers you must work with a high quality lab and an experienced ceramist. As with anything, you get what you pay for. Be prepared to pay high-end fees for great results. It is worth it to help save headaches and reduce chair time, not to mention have happier patients who refer you. I recommend Danny Evanson with Reliance Dental Designs Lab and Bob Clark with Williams Dental Lab. 

3. Show What is Possible Photography is key for building a cosmetic practice and doing more veneers. Taking pictures of a patient’ s smile and imaging them with an app like the DSDApp by Coachman or another app is helpful. Another option is to take a picture with an iPad® or iPhone®, and use markup to edit and draw on the picture to show the patient the changes you plan to make. 

4. Lead with the Centrals Measuring the length of the central incisors is a daily activity for me. The goal of this is to always be in control and mindful of the overall size of the teeth, as the centrals are the basis for the entire smile. I use a Boley Gauge every day and in every case. I use an old school analog gauge, but a digital one will work as well. I use it to measure the pre-op length, gum tissue alterations, the desired length for the wax up, to verify the length of the temps, and then to cross check the length of the permanent porcelain veneers. There are many factors that go into deciding the final length of the veneers, but for me it always starts with measuring the upper centrals and referencing that. 

5. Document With Images I use a digital Nikon camera with dual flashes that was preset and purchased through PhotoMed. It’ s great for headshots and close up pictures. We also use our iPhone® everyday for photos and to capture video. Do they want pointy canines Do they want rounded corners Do they prefer open or closed embrasures What kind of overall look they are going for If they like the centrals and laterals to be level Through photos and video, you can also document each step of every one of your cases. If your patient consents and approves (either full face or just their close up smile) this visual content can be used for social media. Use these images for yourself, to review your cases, for your lab, for your patients, and for your future patients. 

6. Start with a Blueprint for Success Diagnostic wax-ups from our lab are essential for success in our veneer cases. When designing a smile, you have to have a roadmap and a solid direction towards your destination, wax-ups ensure you know where you’re going with your design and great-looking temps. In general, I get a wax-up for any smile makeover I do that is four or more teeth. In the long run, it saves time and takes a lot of guesswork out of the equation. I also use incisal reduction guides and facial reduction guides to ensure consistent results based off of the wax-up. A putty stent of the wax up also helps ensure great-looking temps. 

7. Desired Teeth Shapes and Smile Styles I use the LVI Smile Catalog to show our patients sample shapes and designs of teeth and smiles. Ultimately, we want to know: The LVI Smile Catalog shows 12 different styles with varying shapes of teeth. Our favorite is the “LVI Natural” Style with “Softened” canines. We also always ask the patient to show us some of their favorite social media influencers or celebrity smiles. 

8. Pay Attention to Gum Levels We use a soft tissue diode laser in almost all of our cases. You can ’t have good-looking veneers without having symmetrical gums. Even if the patient doesn ‘t show their gumline, we still try and take a few minutes to create some harmony with the gum line. 

9. Tissue Management and Clear Impressions I routinely use Traxodent® for tissue retraction and tissue management prior to final impressions and/or seating the final restorations. I’ll use Clear ViscoStat™ or a half and half mix of water and hydrogen peroxide to help with hemostasis while prepping and generally do a round or two of Clear ViscoStat™ before seating final restorations. For final impressions, I use Take 1™ Advanced™ Light Body Wash Fast set (orange) with a small tip around the margins and Take 1™ Advanced™ Medium/ Monophase Fast set (light blue) for the tray. I see fewer pulls and drags and a more consistent final impression with this combination. 

10. Visibility For doing multiple unit veneer cases, it’ s appealing to have consistent retraction and visibility. The OptraGate® retractor by Ivoclar is a game-changer. Once it is placed, it saves a lot of time. During the veneer prep and seat visit, the OptraGate® will be in place for 80-90% of the procedure. 

11. Level and Straight Smiles I use the Symmetry Stick Bite® (Clinician ’ s Choice) for marking the midline and eye line. If done correctly, this can help prevent canting or slanting in the final restorations. 

12. Understanding Color and Final Shades I use the Ivoclar® Prep (stump) Shade Guide and Bleach Shade Guide. Get comfortable with talking to patients about veneer shades. It’ s also vitally important to understand when to consider using a different ingot (base color translucency/ opacity) when completing cases. With Emax®, we ’ re usually choosing a BL1, BL2, or BL3 shade and most likely using a HT (high translucency) or MT (medium translucency ) ingot. My go-to is HT BL1 or MT BL2. Talking with your ceramist about how they build color, natural characteristics, and block out dark prep shades is really helpful. 

13. Great Looking Temps We mostly always use Luxatemp® Shade BL. This is a solid and greatlooking temporary material. When used with a putty stent based off a wax up, the temps should look amazing. Good looking temps alone can help you do more cases. 

14. Choose A Natural Looking Restorative Material Choosing your material is an essential part of your case. I’ ve used Ivoclar Emax® as my material of choice for porcelain veneers for years now. It is easy to work with while also being durable and natural-looking. 

15. Patient comfort Offering light oral sedation, nitrous oxide, and having a mounted TV with headphones for the patients to watch Netflix® have all been big “ wow ” factors. Making the extra effort to make patients feel more relaxed and comfortable goes a long way toward building confidence, earning trust, and helping patients commit to treatment plans. 

If you’re interested in learning more about our Video Veneer Course for Dentists visit www.veneertraining.com 

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