Q. I got Lumineers on my front 8 teeth, I am now having problems with my gums, they have a smell to them, I am always brushing and flossing them and it is not helping. Is this going to get worse? I never had this problem until they got put on. What do I do?

A. As a restorative/cosmetic dentist I cannot condem Lumineers if done properly. Great care needs to be taken when placing any type of veneers to make sure that gum health is maintained and is is at an optimum level during treatment.

Lumineers are a marketed very well and seem like the solution to all smile problems but they are only suitable for a small number of patients. Although it is good to be as minimally invasive as possible when preparing teeth for veneers and it is obviously best not to have any preparation at all for the teeth, there are many other factors that need to be taken into account when improving a persons smile.
We have to look at the health of the gums and whether they need to be reshaped, if they do we have to make sure that we are within the correct parameters for correction, otherwise it can create gum problems.

We have to take into account whether there are any fillings present in the teeth to be veneered. Veneers shouldn’t be placed over existing fillings because this can create reasons for failure of the restorations. When the filling fails and it will, so will the veneer. By definition, Lumineers are no prep veneers so I must assume that they are placed over existing old fillings.

If the teeth were initially crowded, then by having non prep veneers ledges are created on the teeth by the gingival margin which can act as plaque retention factors and cause inflammation of the gums. If the margin of the veneers have been placed underneath the gum to hide the ledge then the biological width may have been invaded. This is a vital area in the gum. It is an area of approximately 3mm from the edge of the gum to the bone holding the teeth in. It provides protection of the area and helps fight bacteria and is the natural defence of the gum. If it is invaded by the porcelain it can lead to chronic inflammation.

I can’t tell the cause of the inflammation without looking at your teeth and talking to you about your procedure. Inflammation can always be cured and gums can become healthy, it may however come at a cost.

If it is due to the invasion of the biological width by the veneers then either the lumineers can be removed the gums can be treated and new veneers can be placed. If you want to keep your Lumineers, some gum surgery can be carried out to resolve the inflammation. You will find that the gums shrink after the surgery as they become healthy.

If the inflammation is due to the ledges in the porcelain then they can be smoothed off and recontoured. The downside to this is that the porcelain is roughened and can be polished but is not the same as glazed porcelain previous to adjustment.

My advice would be to go and see a private dentist that is used to carrying out all kinds of cosmetic procedures. A dentist that performs veneer and restorative procedures and has a good portfolio of before and after pictures should know what he/she is doing. Make sure that the dental practice that you go to has a hygienist.

If you want to go back to the dentist that did your Lumineers then address some of the issues I have brought up in this reply and ask if there is anything that can be done. Definitely ask to be referred to his/ her hygienist.

If you do want a second opinion then I would be happy to see you for a consultation at my practice.
I hope this helps
Kind Regards

Dr Komal Suri
Smile Design Dental
www.smiledesigndental.co.uk
33 High Street, Wendover,
Buckinghamshire HP22 6DU
Tel: 01296 624163