This is an important question because saying “no” to a patient who wants veneers is sometimes the most responsible thing I can do. I’m Dr. Emily Nguyen, Principal Dentist at Picasso Dental Clinic, and I regularly turn away patients who aren’t appropriate candidates because placing veneers on the wrong person guarantees problems.
Patients With Active Dental Disease
You absolutely cannot place veneers over decay or gum disease. This is non-negotiable. The decay will continue spreading underneath the veneer, eventually destroying the tooth. Gum disease causes bone loss and gum recession that compromises veneer stability and appearance.
I see patients at our Hanoi clinic who had veneers placed elsewhere over untreated cavities. Months or years later, they experience pain, abscess, or veneer failure. When I remove the veneer to address the problem, extensive damage has occurred that could have been prevented by treating the decay first.
Gum disease creates inflammation, bleeding, and progressive tissue destruction. Placing veneers on inflamed gums guarantees poor margins, bacterial accumulation, and accelerated gum recession. The veneers might look acceptable initially, but within months the gum problems become obvious and the aesthetic result deteriorates.
The solution is treating these conditions before considering veneers. I clean and fill cavities, perform deep cleanings or gum treatments as needed, and wait until everything is healthy and stable. Only then do we discuss cosmetic enhancements. Some patients become frustrated by this timeline, but I won’t compromise their dental health for cosmetic convenience.
Heavy Grinders and Clenchers
Bruxism is one of the most common reasons I decline veneer treatment. The forces generated during grinding and clenching far exceed normal chewing forces. Porcelain veneers, while strong, can crack, chip, or debond under this repeated stress.
I’ve replaced countless broken veneers in patients who grind. The pattern is predictable: veneers look beautiful for six months to two years, then chips appear at the biting edges. Eventually entire veneers fracture. The patient becomes frustrated, and I’m replacing expensive restorations that shouldn’t have been placed originally.
Night guards can protect veneers from grinding damage, but only if patients actually wear them consistently. During consultations at our Ho Chi Minh City location, I’m direct about this requirement. If you grind and refuse to wear a guard, or if you’ve tried guards and can’t tolerate them, veneers aren’t appropriate for you.
Some patients minimize their grinding habits or claim they’ve stopped. Wear patterns on existing teeth don’t lie. Flat biting surfaces, exposed dentin, and shortened teeth indicate heavy grinding regardless of what patients report. I examine evidence carefully before making recommendations.
Severe clenchers who don’t grind face similar issues. The sustained pressure on veneers can cause them to debond or can stress the underlying tooth structure. Not everyone with mild grinding is disqualified, but severe cases need honest discussions about risk versus benefit.
Those With Insufficient Enamel
Veneers bond to tooth enamel. Without adequate enamel, the bond is weak and veneer retention becomes unpredictable. Some people naturally have thin enamel due to genetics. Others have lost enamel through aggressive brushing, acid erosion, or previous dental work.
Before preparing teeth for veneers, I assess enamel thickness. If removing the necessary amount for veneer placement would expose dentin or compromise tooth structure, veneers aren’t appropriate. The risk of sensitivity, poor bonding, and tooth damage outweighs cosmetic benefits.
Teeth with large existing fillings present similar problems. When more than half the tooth structure is filling material rather than natural enamel, crowns typically work better than veneers. Veneers need solid tooth structure for support and retention.
At Picasso Dental Clinic locations across Vietnam, I sometimes suggest alternative treatments for patients with inadequate enamel. Composite bonding requires less or no tooth preparation. Crowns provide better coverage for compromised teeth. Sometimes accepting natural teeth makes more sense than forcing inappropriate treatment.
Patients With Significant Misalignment
Veneers can mask minor rotations, slight spacing, or small irregularities. They cannot correct severe crowding, significant rotations, or major bite problems. Attempting to use veneers instead of orthodontics creates both aesthetic and functional failures.
I’ve seen veneers placed on severely rotated teeth that look bulky and unnatural because the dentist tried to create straight-appearing smiles without addressing underlying positions. The veneers are too thick on one side, too thin on another, and the result looks fake.
Major spacing issues also respond better to orthodontics. While veneers can close small gaps, trying to close large spaces creates oversized, unnatural-looking teeth. The proportions become wrong, and the smile looks obviously artificial.
Bite problems like severe overbites, underbites, or crossbites need orthodontic or sometimes surgical correction. Veneers placed without addressing these issues may not function properly, can cause jaw pain, and often break prematurely from abnormal forces.
Since 2013, I’ve referred many patients for orthodontic treatment before veneer consideration. Sometimes after orthodontics, patients decide they no longer need veneers because their smiles improved sufficiently. Other times we place veneers after orthodontics to perfect the final result.
Young Teenagers and Those With Poor Judgment
Tooth development continues into the early twenties. Placing permanent veneers on teenagers means committing developing teeth to lifelong restoration. I’m extremely conservative about veneers for anyone under 25.
Teenagers also lack the maturity to commit to maintenance requirements. They’re more likely to engage in risky behaviors, less likely to maintain excellent hygiene, and their aesthetic preferences change as they mature. What seems perfect at 17 might look wrong at 25.
Patients with unrealistic expectations make poor candidates regardless of age. If someone expects veneers to solve relationship problems, guarantee career success, or transform their entire life, they need counseling, not cosmetic dentistry. Veneers improve smiles; they don’t fix personal issues.
People who can’t commit to basic oral hygiene shouldn’t get veneers. Daily flossing, regular brushing, and professional cleanings are non-negotiable. Patients who’ve demonstrated years of neglect typically continue those patterns after veneers, leading to predictable failure.
Substance abuse, particularly methamphetamine use, causes severe dental destruction. Placing expensive veneers on someone actively using drugs that cause dry mouth and dental decay is pointless and unethical.
Making Responsible Recommendations
At our clinics in Hanoi, Da Nang, Ho Chi Minh City, and Da Lat, I pride myself on honest evaluations. Turning away patients who aren’t candidates protects them from wasting money on treatments that will fail and protects my reputation by ensuring successful outcomes for appropriate candidates.
If you’re concerned you might not be a good veneer candidate, schedule an honest consultation where we discuss your specific situation, evaluate alternatives, and determine the best path forward for your dental health and aesthetic goals.
