Whether you’re unhappy with your teeth because they’re crooked, discolored, too big or too small, you’re not destined to frown about your smile forever. Opting for veneers is a long-term and effective solution if you’re looking to makeover your pearly whites. However, if you’re someone who has anxiety simply thinking about the dentist, it may be hard to convince yourself that veneers are worth the stress of willingly subjecting yourself to a major dental procedure.
Luckily, there’s a new technique within the dental world that’s out to remedy this very conundrum: Sleep dentistry. We sat down with San Francisco dentist, Swati Agarwal, DDS to chat all things sleep dentistry along, with the latest veneer innovations.
NewBeauty: What should patients know about the latest technology for veneers?
Dr. Swati Agarwal: Veneers have advanced quite a bit. The material that we use has evolved, and it is a more advanced porcelain that transmits light just like your natural teeth would, so your teeth don’t look like big chalky blocks or Chiclets. The new veneers mimic natural teeth while looking really radiant and beautiful at the same time.
Another great thing is that with the new techniques available, we’re able to remove less tooth structure. Previously, you’d have to grind on the teeth and unnecessarily remove a lot of your healthy, natural tooth structure to place a veneer. Now, we can minimally prep the teeth and we can pick and choose [what to remove]. I can contour the tooth a little bit, so there are no sharp angles. In some cases, there’s no prep at all. It really is a great benefit because you get the best of both worlds: You’re able to get the great veneers without losing that natural tooth structure that’s irreplaceable.
NB: Are veneers able to be personalized?
Dr. Agarwal: Everything is customizable. There are different types of veneer shapes: One person may want more square teeth, one person may want more rounded teeth, so everything can be personalized to your liking. The material itself is customizable so you can do a lot with it too.
NB: Who would be the right candidate for veneers?
Dr. Agarwal: Literally anybody who is unhappy with their smile would be a candidate for veneers. Even doing just a couple of teeth can make a huge difference. Sometimes a lot of people will have two front teeth that are either too big or too small and just altering those can really change the appearance of their smile. Anyone is a candidate—no matter if they have crooked teeth, discolorations or don’t like the shape.
NB: Tell me about what the consultation process is like?
Dr. Agarwal: We call this our smile design process. How it works is that when a patient comes in for a consultation, they tell me about their concerns and expectations. It always helps if they bring photos of smiles that they like. Then we’ll take photos of their teeth along with molds and X-rays. After we collect all of this data, I’ll design their new smile digitally and physically with wax, based on their expectations of what they want to achieve.
Through the digital rendering, I’ll show the patient step by step how it’s going to change and then I’ll have it demonstrated on the model as well. I’ll review the smile with them—and I can even try the new smile in their mouth to show them what it would look like—before we do the veneer process, so they know exactly what they’re going to get. There is no guesswork. At this point, if they want to make any changes, they can of course do so, and then we’ll repeat the process.
NB: What is the actual procedure like?
Dr. Agarwal: It’s a two-appointment process. During the first appointment, the patient comes in and that’s when we contour the teeth to get them ready for the veneers and take impressions. Afterwards, the lab fabricates the veneers by hand. It takes about two to three weeks for that part to get processed, but in the interim, the patient goes home with temporary veneers so they’re not walking around with nothing on their teeth. At the second appointment, we cement the new veneers. We show everything to the patient first to make sure that they like them. Once it’s approved, we cement them in.
NB: How should you care for your new veneers?
Dr. Agarwal: Veneers are a big investment, so proper care is crucial. Think of them like a permanent contact lens for your tooth: It’s important to protect them. First, I tell patients to keep up with the regular cleanings, because we want to make sure nothing gets trapped underneath the veneers, that there’s no risk of decay forming, and that gums and the teeth underneath remain healthy. Additionally, I usually recommend a night guard to be worn, because in today’s world, every single one of us is stressed. We live such fast-paced lives, and I’ve noticed the trend that’s happening right now—it’s almost like an epidemic—that more and more people are showing up with cracked and fractured teeth due to the clenching down and grinding of the teeth. Most people don’t even realize they’re doing it, so having a night guard provides some relief for those six to eight hours when sleeping while protecting the veneers.
NB: How long do veneers last?
Dr. Agarwal: They can last for the rest of your life, but think of it like a car: If you’re constantly talking, speaking, eating with it, your veneers will require maintenance. Over time, maybe in ten years or so, they can show wear. In terms of color, they stay pretty solid, but what happens is that your natural tooth underneath can become discolored or if you don’t get veneers on all of your teeth, the other ones can get a little bit darker, so then the color doesn’t match. On average, veneers last about ten years, but I’ve seen people who have them for twenty years and they still look perfect. It really depends on how well you take care of them.
NB: I saw that your practice also offers a service called sleep dentistry. Could you tell me a little bit about what that is?
Dr. Agarwal: Veneers and sleep dentistry go hand in hand, because a lot of patients who do veneers opt to for the whole mouth. It’s a big process—it’s a lot of teeth. The procedure takes time, so people can get anxious. That’s when sleep dentistry comes into play. It’s when I have a dental anesthesiologist put the patient to sleep beforehand. You’ll have this really great, restful sleep, and then you’ll wake up and everything is done.
Dental anesthesiology just became a recognized dental specialty in the United States this past year, so I think you’ll see it become more common. This is especially true since you can do it for everything from a simple cleaning to major procedures like root canals and extractions. It’s ideal for anyone with crippling dental anxiety who puts off appointments, which can exacerbate their own oral issues.
NB: What has the reaction been to your sleep dentistry service so far?
Dr. Agarwal: It’s been a huge success. For example, I had a patient come in who hadn’t been to the dentist in years, because she was so scared. She was a really beautiful young woman in her early forties, but she wouldn’t smile and always covered her mouth with her hand. Then we introduced her to sleep dentistry. She had a lot of decay and problems that needed to be fixed, so to remedy it all took a long time, four appointments total. Thanks to sleep dentistry we were able to finish it all and give her an amazing smile. It changed her life. Now, she’s so much more radiant and confident in her appearance. While she had that before, what I realized is the smile really can either lift or drop your self-esteem, and just having a beautiful smile can bring out your inner self-confidence and let you take on the world. I know that sounds crazy, but I’ve seen it happen firsthand.
NB: That’s amazing. Is there anything else our readers should know about your approach to dentistry?
Dr. Agarwal: My practice is a smaller one and I’m the only dentist here. What that allows me to do is really focus on my patients to ensure I’m giving them the best care possible. When I schedule patients, I schedule one patient at a time as opposed to having multiple patients where I’m running back and forth between. What I realized is that I do much better dentistry when I’m able to focus on one patient and really understand their needs and give them the best care that I can possibly give. I think that separates my practice from others in San Francisco.
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