By: Howard Farran, DDS, MBA, MAGD
Publisher, Dentaltown Magazine

It is so amazing how a change in one’s mind can make everything seem so different. I was a graduate of the University of Missouri–Kansas City dental school in 1987. Everything I ever learned about veneers was based on the assumption that you had to reduce the tooth structure to compensate for the thickness of the porcelain. I was taught and always believed that if you did not prep the teeth, the veneers would look thick and bulky.

Having practiced 18 years, I have seen a lot of my own veneer cases many years after their placement. Every dentist I know will tell you filing off the facial enamel of the front 10 maxillary teeth is a very aggressive procedure. I can’t tell you how many of the veneers I placed needed more treatment 18 plus years later. Every time you perform dentistry on a tooth you condemn it to a life of re-treatment. The best dentistry in the world is no dentistry at all.

I also have noticed the inconsistencies of some cosmetic dentists who demand orthodontics and bleaching for their own children, and then veneers for their patients. Treat other people as you would want to be treated. I would never ever let any of my four boys get veneers, let alone my wife Judith or myself.

Fortunately, I had the chance to meet four practicing dentists who came up to me during four separate seminars and told me they flew down to Den-Mat in Santa Maria, Calif. and had the founder of Den-Mat, Bob Ibsen, DDS do permanent whitening with no-prep veneers using Den-Mat’s Cerinate porcelain. They looked awesome! The dentists each had stated that they wanted permanent whitening, but did not want their teeth filed down. After the fourth dentist’s comments I decided I would take the course myself.

This summer my wife Judith and I packed our four boys in a 29-foot camper and drove around the western states for a month. Since I keep hearing many of my boys in the dental operatory saying, “Ooh, gross, and disgusting,” Judith and I thought we would expose them to the cleaner side of dentistry, stopping at Den-Mat, 1-800-DENTIST, and A-dec during our trip.

While at Den-Mat we visited with Bob. Bob is old enough to be my dad and could easily be the Vince Lombardi of dentistry. He asked me how I was doing my veneers. I told him in detail including how I anesthetized the teeth and reduced the enamel 1.5 mm. He shook his head in disbelief. Bob asked, “So you really think your patients love getting shots with needles?” “Of course not,” I answered, “but it just had to be done or, you know, it would look bulky and all.”

Bob asked, “So you think the teeth are better off having all of their facial enamel removed?” This question always makes me ill since I know removing enamel is dental carnage at its finest. Then Bob asked another no-brainer, “Would you rather bond to enamel or dentin?” Everyone knows that bonding to enamel is stronger and lasts much longer than bonding to dentin.

Finally, Bob asked me to watch over his shoulder as he did a few cases. We then went in his office and went over 100s of PowerPoint cases of no-prep veneers. In fact, the whole family ended up spending the night at his home since the discussion kept going until all hours of the night.

So, I went back to my office with a new paradigm. When patients want their teeth whitened I always recommend in-office bleaching with Den-Mat’s Sapphire light. (I bought the Sapphire because the light can cure 5 mm of lightly shaded composite in 3 seconds; as shocking as this sounds Dr. Gordon Christensen confirmed that it is true.) Then, when patients come back and want their teeth even whiter, I tell them I can either do veneers with anesthesia and remove the enamel off the front of their teeth, or I can do it with no shots, no drills, and leave their teeth intact. Wow! What a different response rate!

My final word is this; you must do a case before you truly “get it!” These Cerinate veneers are the same thickness as a contact lens. They look awesome. Secondly, once you do a Cerinate no-prep veneer case you get on Den-Mat’s veneer referral list for your area. Den-Mat has a full-page ad in the top-10 women’s magazines showing off these cases with a 1-800 number. You can get several calls each month, which is HUGE.

The case below was a 40-year-old man. His wife made it very clear she wished he would get his teeth fixed. He was very conservative and did not want them filed down. I told him we could do it without any shots or drills. He was very excited. When we delivered the case there wasn’t a dry eye in the room.