Hygienist Precautions when Cleaning Veneers

Q: I invested a lot of money in upper and lower porcelain veneers. What does my hygienist need to know to properly clean them?

A: Every once in a while, one of my columns is suitable for framing. This may not be one of them, but it is just begging to be cut out, or printed, and brought to your hygienist at your next maintenance visit. (Most people use my newspaper column for puppy training, birdcage lining and DIY painting projects. Apparently, my face has been covered with more wood varnish than aisle 23 at Home Depot.)

A quick review: Porcelain veneers are the permanent method of creating a new smile by affixing thin porcelain facings to the fronts of usually 10 to 20 front teeth. They don’t stain, unlike tooth bonding, and could last a lifetime if done correctly, you practice meticulous home care and you see your hygienist more than your hair stylist. (Cosmetic dentistry is not a recognized specialty; it is an “emphasis of practice” in general dentistry. There is no official board certification such as orthodontics, or oral surgery. Make sure you go to an office that is doing this procedure FREQUENTLY.)

Hygienist Checklist when Cleaning Veneers:

• Be extremely careful with the “shank” of the scalers and your angle of approach. Very often the shank, or the cutting edge, can make charcoal gray, crisscross scratches on the face of the veneers.
• Avoid directly scaling the margins of the veneers to prevent a leverage force which can dislodge the veneer.
• Try to use a rubber prophy cup around delicate margins vs. cutting edges of scalers.
• Caution the use of ultrasonic scalers which can loosen the cement under the veneers.
• Use the least abrasive paste to do any final polishing to avoid scratches. No pumice.
• Check the margins with sharp explorer for any softening of tooth enamel.
• Use and intra oral camera for crack detection
• Use a fluoride varnish at the end of the appointment to prevent decay and sensitivity.
• Update X-rays to avoid missing any problems.
• You must have a custom night guard made to prevent wear and breakage.
• If the patient has veneers only on the upper teeth, have them recite the alphabet in the mirror to see if they are showing their lowers when they speak. Very often patients cannot see how badly miss-matched their upper and lower teeth are. Often the lowers don’t show when smiling, but are revealed when speaking.