Veneer replacement and periodontitis treatment NHS or Private?

[inca78]

Hello, I’m new to this and badly in need of some advice about the problems I am having with my gums and teeth. Sorry it’s a long one!!!

I was given fluoride tablets as a child which led to me having mottling and discolouration on my adult teeth. My mother decided, when I was 15 that having veneers would be the best course of action (and this was recommended by my dentist) I had veneers fitted on my 6 front top teeth. These veneers were effective and remained ok until 1999, when 2 of them had chipped, which I understand is not unusual, veneers having a limited life span.

In 2003 I had new veneers fitted by my local dentist. Since then I have had repeated problems, in particular with two of these veneers. These veneers repeatedly come off and I have been back to my dentist several times to have them refitted. More problematically though, the veneers would come off whilst I was out and unable to go to the dentist. The teeth underneath are noticeably small, discoloured and have no enamel. I experience some sensitivity in one of these teeth. Thus I bought some temporary dental cement and used this when the veneers come off . 2 of my veneers are now fixed on (badly!) with this cement.

Ideally I would have no veneers at all, but I can't do this as my teeth underneath would be exposed, with no enamel. One enquiry I have is whether I could qualify for NHS veneers, given that I am not now seeking them for purely cosmetic reasons, I have no real choice about it. I also had limited choice when the original veneers were fitted when I was 15, and was not mature enough to make a properly informed decision. If this was not possible I would like to find out where the best place to go for private veneer replacements. I would also like some advice about what the differences in quality of veneer I would get, whether on NHS or in different private places, is there a wide variety of materials etc. I’m not really looking for a ‘Hollywood smile’, I mainly would like to have teeth that look like my own would have – and to have veneers that I can eat with and they will stay on! I am also interested in knowing more about cerec veneers, as the same day option appeals to me, though I’m gathering from some forum posts that ‘temporary restorations’ which are put in place until the veneers are made, can be ok (unlike the very obvious ‘tempraries’ I had when my last veneers were done, meaning I was rather embarrassed to smile!

A complicating and worrying factor has now come about however. I have now got periodontitis. I only noticed the symptoms of this 3 weeks ago. My dentist took ex rays and made an appointment for me to go back for cleaning at the end of this month. She intended also to remove (and then replace with new) the 2 veneers around which the problem is worse. I feel unsure about undergoing this procedure and having new veneers fitted there, because of my past experience. My gums also are getting worse on a daily basis and I'm quite alarmed at the rapidity of the deterioration. I therefore found and saw a private periodontist. He did a thorough examination and diagnosed mild periodontitis. He suggested deep cleaning of my teeth and gums, before replacing the veneers. Doing things this way round made sense to me, but I am concerned as I suspect that due to two of the veneers not fitting properly, they will either come off and maybe break during the cleaning, or stay in place, still harbouring infection and/or causing aggravation to my gums because they are ill fitting. The fee for treatment with the periodontist is also unmanageably high for me, though if it was likely to be the best course of action I would consider taking a loan. I just don't want to go down the wrong route and end up with more long term problems, as I'm aware of the associated health risks from periodontitis as well as being very worried about the venners not being effective again.

I am also unsure if periodontitis can be treated by an NHS dentist. Ideally I would like to have it all dealt with ‘under one roof’, but am not sure where the best place to go for this would be. I suspect that I should have my periodontitis dealt with by an NHS dentist and then perhaps have veneers done privately, if the standard is significantly better.

I would be grateful for any advice

inca78

[Dr Pav Khaira]

I can certainly understand your frustrations. You may be able to get treatment for periodontitis on the NHS but this will not be of the same quality as if you had it treated in a quality private practice.

I think it is highly unlikely that you will be able to have the veneers done on the NHS. Given your previous problems I would highly recommend against this. The NHS simply cannot use the same world class labs a private dentist can. Do make sure you mention to your dentist you do not want a hollywood smile. The very best veneers just look like natural teeth and you should not be able to distinguish them from our surrounding teeth.

For yourself, I would also not recommend the veneers fitted on the same day or even for a few weeks. From the history of fracture I would say that you need quality temporary veneers placed and left for several weeks. If you continue to break the veneers it will give your dentist chance to identify and correct the problem before placing the final veneers. You may also be grinding your teeth at night and causing them to fracture that way, this also needs to be investigated.

Please do not rush into treatment, I can appreciate that finances are a concern but you really need very high quality work done for you this time to have a stable long term solution you can be happy with.

I hope this helps

Kindest regards