In this article I will describe teeth bonding and answer most common questions about it.
What is Teeth Bonding?
If you research teeth bonding on the web you may run into several different descriptions of this procedure. One of the first things I will try to do in this article is to clarify the definition of teeth bonding.
Most commonly teeth bonding refers to the process of attaching artificial tooth colored composite resin restoration to the natural tooth. Composite resin is made out of dental polymer (plastic) material. It is shaped directly in the patient’s mouth and this approach makes it a time and cost efficient alternative in comparison to other artificial dental restorations. It is important to mention that in this context teeth bonding is a layman’s term and correct definition used by dental professionals is a direct composite restoration.
The term teeth bonding (adhesive bonding) is also used by dental professionals to describe the process of attaching artificial dental restoration to the natural tooth with a dental adhesive. In this context teeth bonding is applied to many different categories of dental restorations such as direct composites, ceramic veneers, ceramic inlays/onlays and crowns.
In this article I will limit my discussion of tooth bonding to the Direct Composite Restorations.
What are the Indications for Teeth Bonding (Direct Composite Restorations) ?
Treatment of tooth decay
Teeth bonding is the most common treatment for tooth decay. We have Teeth Bonding Before & After images here. In this case diseased tooth structure is repaired with tooth colored dental filling which restores appearance and function of the affected tooth. To learn more about dental filling for treatment of tooth decay please click here.
Treatment of tooth wear
Tooth wear is an irreversible loss of tooth structure which occurs as a result of chemical and mechanical processes in the oral cavity. In some instances tooth bonding is an option for the restoration of worn down teeth.
Treatment of fractured and chipped teeth
Tooth bonding is indicated for the restoration of the teeth which fractured or chipped as a result traumatic accident, tooth clenching and tooth grinding.
Change in teeth color
In some instances there is a need to change the color of the teeth. Tooth discolorations may occur as a result of congenital defects, dental trauma, and root canal infections. In some instances tooth bonding is indicated to make desired changes in color of the teeth.
Change in teeth size and shape
In some instances there is a need to change to size and shape. Dental bonding is indicated to improve size and shape of the affected teeth.
Treatment of congenital tooth malformations and developmental defects
Tooth bonding is used to treat irregularities and defects caused by certain genetic conditions which may affect tooth enamel and dentin. Enamel and dentin defects can also result from the acquired conditions which occur during the development of the teeth and bonding is used as well.
Diastema (Gap) closure
Diastema is a space (gap) between two teeth. Diastema occurs due to the discrepancy between size of the teeth and size of the jaw. Tooth bonding ia\s a treatment option to close the gap between the teeth.
What Materials are Used in Tooth Bonding (Direct Composite Restoration)?
Composite restorations are specially designed biomaterials. They are designed to look just like natural teeth, and could also withstand harsh conditions of the oral cavity. Most important components of composite include synthetic resins, filler materials such as silica glass, and photoinitiator. Composite resins come in several different colors and viscosities.
Typically the first step in teeth bonding is application of liquid adhesive. Adhesive is set with a blue-spectrum LED light. After application of an adhesive liquid, restoration is buildup by hand with paste like material. Similarly to the liquid adhesive is set with an LED light.
What is a Process of Teeth Bonding ?
Teeth bonding includes a number of steps. In the diagnostic/evaluation step we develop treatment options and presented them to the patient.
Once a decision is made, patient is scheduled for a clinical appointment. In some instances we may also get tooth molds and make diagnostic prototype of the restorations. This prototype (typically it is made out wax) serves us a the guide in the making of the final restorations.
Tooth bonding is typically performed under local anesthesia, but in some instances it can also be completed without it. In may instances we use rubber dam device to isolate the tooth from the oral environment.
Decayed and softened tooth structure is typically removed by a dental drill. Tooth structure adjacent to the defect is also roughened by a dental drill or sandblasting. It is also etched by a phosphoric acid in order to get a desired surface characteristic.
After this step liquid adhesive is applied and polymerized with an LED light. In the next step dentist applies paste like filling, shapes it to the desired form, and polymerizes it with an LED light.
In the final stage restoration is finished and polished. Tooth bonding is typically performed in one appointment, however if there is a need to restore multiple teeth it can be sequenced over a number of appointments.
The tooth bonding is typically monitored during recall appointments. If there is a need the surface of the restoration can be polished or repaired.
What are the Pros and Cons of Teeth Bonding (Direct Composite Restorations)?
Advantages
Conservative
The most important advantages of tooth bonding include its conservative nature. Typically it does not require significant removal of healthy tooth structure.
Less expensive
Tooth boning is also less expensive than restorations which are completed in the laboratory such as ceramic veneers, ceramic onlays and crowns.
Less treatment time
Tooth bonding is an efficient procedure which is typically completed in one appointment
Disadvantages
Degradation over time
Tooth bonding is typically performs well over a short to medium duration of time, about 5-10 years of service. However over time the restoration with start breaking down. Material degradation typically includes chipping, cracking, and discoloration. There are also situations where material can breakdown earlier than intended, for example under stresses of trauma and tooth grinding.
Cosmetic limitations.
Direct composite restorations are shaped directly in the mouth and there are limitations to what can be achieved in regard to appearance with this procedure. In some situations use of the ceramic materials and outsourcing restoration fabrication to the dental laboratory is a better option.
Possibility of an allergic reaction
In some rare instances a patient may be allergic or develop an allergy to composite restoration. In this case, use of a different group of materials such as ceramics is a better option.
What are the Alternatives to Tooth Bonding?
Alternatives to tooth bonding include dental restorations which are made made outside the patient’s mouth in the dental office or dental laboratory. Ceramic veneers, metal and ceramic inlays and onlays, and dental crowns can be an alternative to dental bonding.
What is a Cost of Tooth Bonding?
Tooth bonding presents with low to moderate cost of treatment. It costs less than restorations which are made in the dental laboratory.
Thank you for reading.
Dr. Alexander Shor.
