The options can be overwhelming when seeking a tooth touch-up. Here, dentists discuss the merits and pitfalls of dental bonding and take us deeper into what goes on during and after the treatment.
What is dental bonding?
“Dental bonding is the adhesion or bonding of a material to the tooth structure,” explains Boca Raton, FL cosmetic dentist Clive Rosenbusch, DDS. He notes that the material is usually a dental composite material, while Rockville, MD cosmetic dentist Joseph Kravitz, DMD tends to use plastic fillings or resins. Though it’s a chemical bond, Dr. Kravitz says there is often mechanical retention as well. Dental bonding can last between three and 10 years before a touch-up is needed, or a replacement, he adds. The treatment is used to repair chips, close gaps or change the shape and color of a tooth, says Atlanta cosmetic dentist Ronald Goldstein, DDS. Unlike other cosmetic dental treatments, such as porcelain veneers, bonding is reversible. “It’s perfect for patients who want a less-expensive solution to change the appearance of their tooth, in both shape and color,” says Dr. Goldstein.
When does dental bonding come into play?
Dr. Goldstein describes bonding with composite resin as “one of dentistry’s most important developments in the last 60 years in so many areas, from repairing chipped or fractured teeth to cementing (attaching) porcelain veneers, crowns or inlays to prepared teeth.” He adds that bonding could also be used as a form of veneers in place of porcelain if economics or a tooth emergency call for it “because no laboratory expense is incurred and the procedures can take place in one appointment.” According to Dr. Goldstein, other uses for dental bonding include tooth-colored cavity fillings and replacing older anterior and posterior restorations when patients want a tooth-colored cosmetic solution. “It could also be used for bonding crowns or inlays,” Dr. Rosenbusch adds. Furthermore, Dr. Kravitz says the technique could be used to address broken dental work repairs and denture repairs.
Dental bonding vs. veneers
Why should a patient choose bonding over other treatments? According to Pittsburgh cosmetic dentist Rob Klaich, DMD, it’s the more conservative option. Dr. Goldstein recommends dental bonding over veneers when the patient wants to close spaces between their front teeth or make other minor cosmetic changes. Veneers, on the other hand, are preferred when patients are looking for a complete smile makeover, either with composite resin bonding or porcelain.
Each expert has their preference, and if a patient is looking for veneers, Dr. Rosenbusch says he prefers porcelain over direct bonding veneers, “because they are more translucent and life-like, and therefore have better aesthetics and are stronger. They last longer, and they also stain a lot less.”
What to expect at a dental bonding appointment
The first step is to have any tooth reduction or alteration done, says Dr. Goldstein, and then “a mild tooth etchant is applied and washed off to create retention into the enamel.” Following that, “a liquid resin is applied to fill in the retention areas and then it is cured with light. Then the bonded material is applied, and the dentist contours the material into the desired shape.” The dentist will then cure the tooth with intense light to polymerize it. Finally, “the restoration is shaped with tiny diamond or carbide rotary instruments and then polished,” Dr. Goldstein explains. Bonding is a generally quick and painless procedure. Dr. Rosenbusch says, “Local anesthesia is only necessary if the sensitive part of the tooth is being worked on.”
Pros of dental bonding
“When placed by a reputable cosmetic dentist, bondings can be an exceptionally beautiful treatment option for patients,” says Dr. Klaich. “Natural contours, tints and translucency can be built into the restorations.” Composite resin bonding is more easily repaired, offers immediate results with little tooth reduction, and is more affordable, adds Dr. Goldstein. The flexibility of bonding is also a plus. Bonding is reversible and adjustable— the color can be shifted to match natural teeth or to lighten the shade. In a single appointment with no anesthesia, patients can leave with a repaired smile.
Cons of dental bonding
While Dr. Rosenbusch notes that the latest generation of composite materials stains much less, bonding generally still has a higher potential for staining. Dr. Goldstein says this results in a more limited aesthetic life with more maintenance required. He adds that chipping and wear over time is to be expected, so plan for more in-office appointments. Dr. Klaich notes that bonded teeth are more difficult to care for overall and can lose their polish over time.
Post-procedure after care
Before launching into the after-care requirements, Dr. Goldstein acknowledges that he knows they’re lengthy, “but they happen to be the most important thing for patients if they expect to have long-lasting results.” Dr. Klaich notes that regular exams must be scheduled to ensure the integrity of the bonding. If the patient grinds their teeth, Dr. Klaich recommends they wear a bite guard while they sleep. Additionally, Dr. Goldstein suggests patients ask their hygienist “to avoid using ultrasonic scaling or air abrasives on their bonded teeth.” Also, be careful when biting into hard foods like ribs, apples, carrots or almonds, and avoid chewing crusts of bread or ice.
