Ocean Clinic’s Cosmetic Dentist Dr Nina King tells us why she loves transforming patients’ smiles with orthodontics and porcelain veneers.
What is your favourite procedure to perform?
Doing orthodontics combined with porcelain veneers.
Why do you like it?
Orthodontics involves moving the teeth into the correct position and then the ceramic veneers change the colour, shape and size so we can completely transform someone's smile. Often my adult patients have been ashamed and embarrassed by their smile for a very long time and the boost in self-confidence is amazing.
How many times have you done it?
We have done many, many cases using these treatment techniques combined.
How is it carried out?
I work with a specialist orthodontist who tends to use “invisible braces”; clear retainers like Invisalign or a system called Incognito, which goes behind the teeth. This is because many of my adult patients are conscious of wearing a traditional metal brace.
Communication is absolutely essential between the orthodontist and myself as I plan and design the final result, normally using digital smile design techniques. We use this as a road map to direct where we want the teeth to be.
In this way, I can then prepare the teeth as minimally as possible and take the impressions for the new ceramic veneers to be fitted making sure that they are customised to meet each individual patient's needs.
What’s the most technical part?
Preparation for the veneers is a delicate procedure because there must be a balance between preserving as much healthy tooth structure as possible versus removal of enough so that the veneers sit well.
We can then create beautiful looking ceramic work, which will blend in naturally. I try to remove no more than 0.5mm of the top layer enamel.
Have there been any changes in the technique or technology used in this procedure?
With the onset of digital design and scanners, if we are using the invisible brace system Invisalign, we can now anticipate the final smile and get it preapproved by the patient. We enter this information into the system and simulate the movements and design the correct retainers for each phase.
Thus after the orthodontic work, the teeth are already positioned exactly as we need them to be. For example if I am using ceramic veneers to close spaces between teeth, the orthodontist can ensure the spaces are evenly spread out so we can have symmetrical final veneers.
How might this procedure change in the future?
I am doing more and more ceramic veneers in-house. That means that instead of taking traditional moulds and sending them to the laboratory technician, we can do milling in the surgery and have them ready in a matter of hours instead of days.
This is, however, still not appropriate for all cases due to limitations of the equipment. For example, how thin some of the ceramics can be prepared. I am sure that there will be even more evolution in the technology making it possible to do every case in-house.
Do you have any memories that stand out in relation to this procedure or the patients you’ve carried it out on?
Patients sometimes think it's too late for them… they are aware their teeth are very overlapped or crooked and they may have wanted the treatment in the past but for financial or time constraints simply not gone ahead.
When they realise what can be achieved and the effects that we can create, it truly is a wonderful feeling to be able to help someone's self-confidence grow.
Interested in redesigning your smile with orthodontics and porcelain veneers? Book an online or in-clinic consultation.