A porcelain veneer fell off – do I need to have it recemented immediately?

I have 16 veneers placed by an excellent cosmetic dentist in Palm Beach, FL in 2004. I live in Maryland now and have found a regular dentist who takes care of my cleanings, and even placed a crown (okay job) to replace a lost veneer. My problem is that they keep falling off. I am sure it has to do with a moisture problem during placement of the original ones. I grind my teeth at night and that’s how the first one came off. Now this latest one has fallen out and I have to wait until Monday (it’s Friday) to call my dentist to recement. Is it okay to wait?

My biggest problem is that the veneers keep falling off, and it makes me extremely self-conscious and afraid. Is it possible that my Sonicare is the culprit?
- Alexandra from Maryland

Alexandra,
You said the dentist in Palm Beach who put these porcelain veneers on in the first place was an excellent cosmetic dentist. But excellent cosmetic dentists don’t place veneers that fall off like this, grinding problem or no grinding problem. There are ways to work around grinding problems and get veneers to stay on. And moisture control is a basic and required skill for an excellent cosmetic dentist.

To answer your one question, yes, it is okay to wait until Monday. You didn’t say anything about tooth sensitivity, so I’m assuming this tooth isn’t sensitive. It would be safe to wait a couple of weeks, actually, as long as you feel like you look okay and the tooth isn’t too sensitive.

And no, the Sonicare doesn’t have anything to do with the porcelain veneers falling off. It is actually an excellent toothbrush for maintaining cosmetic dental work – very effective at plaque removal.

But the dentist “recementing” the veneers also apparently doesn’t know how to do this properly, or they would stay on for good. It’s not a matter of just cementing – it needs to be bonded.

The correct technique for re-bonding a porcelain veneer is kind of elaborate. First, the old composite needs to be cleaned off the inside of the veneer and the surface of the tooth needs to be fully cleaned, too. The dentist should have what is called a “micro-etcher” to do this. This is a mini sandblaster that cleans and etches the surface. Then the inside of the veneer should also be etched with hydrofluoric acid, and then primed with a silane coupling agent. After that it can be bonded to the tooth with conventional porcelain bonding techniques. But a lot of dentists aren’t even fully familiar with those conventional porcelain bonding techniques, much less the more specialized techniques for re-bonding a veneer that has fallen off.

Get this done right.

This blog sponsored by Evanston dentist Dr. William Cohen