Dear Editor,
Congratulations on another excellent Aesthetics issue. I do have concerns about one of the published articles however. ‘6 Reasons You Should Consider Getting Dental Veneers’ is presented as an ‘educational article’ for patients. (Chao S. 6 Reasons You Should Consider Getting Dental Veneers. Oral Health 113(4):68-69, Apr 2023.)
It is not just the factual errors that trouble me. (Orthodontists do not place veneers.) My concerns have more to do with ethics. Veneers are medical treatment, not an impulse purchase, and patients should certainly not be dictating treatment. Rather it is the patient’s role to present their concerns. It is the dentist’s job to determine the appropriate course of action to address those concerns. We would not expect a patient to present with the request that we perform ‘nonsurgical root canal therapy on tooth #26 followed by a lithium disilicate crown’. The appropriate treatment for esthetic concerns is not always veneers. To suggest otherwise is to say the least, inappropriate.
Further, in those cases where we determine that veneers are in fact the appropriate treatment, it is absurd to suggest that they can be done properly in three appointments. Veneer treatment that meets contemporary professional standards requires at a minimum a diagnostic session with a thorough clinical examination, radiographs, photographs, models and records mounted to a semi-adjustable articulator, and a thorough discussion of expectations. Once the treating dentist has spent the time to evaluate the case, developed a treatment plan, and fabricated a diagnostic waxup, a case presentation can be scheduled where the clinician and the patient come to agreement on an acceptable course of treatment, and the fees for that treatment. In many cases there will also be consultations with, and potentially treatment by, other specialists. Only when all this is done can a preparation appointment be scheduled. Once the teeth are prepared, provisional restorations are fabricated and inserted, usually from a stent fabricated from the diagnostic waxup. Provisional restorations are refined for esthetics and occlusion, and the patient released to ‘test-drive’ the restorations. Once the patient can feel their teeth and face again and have had a chance to live with them for a few days, they can be seen for a session to further refine the restorations. Once the patient and the clinician are both satisfied with function, phonetics, and esthetics, models and records are made for articulator mounting, and the case can be sent to the lab with the instructions ‘duplicate provisionals’. If all goes well (and sometimes it does), the patient can be scheduled for insertion of the veneers. The patient should be seen one last time a few days post-insertion for refinement of occlusion. By my count that is a minimum of six appointments. To reduce all of this to ‘installing veneers’ creates unrealistic expectations and does a great disservice to patients and esthetic dentists alike, not to mention leaving the practitioner wide open to a malpractice suit should he actually treat patients this way.
Shameless marketing of dental treatment for profit reduces us to the level of Painless Parker and his travelling dental circus. I thought we had left that embarrassing episode well behind us.
EDITOR’S NOTE:
Upon further review, with this article’s focus on patient education, we realize it should not have appeared in Oral Health Office. Our apologies.
