Direct Composite Dental Bonding

Direct composite dental bonding is a way to modify the shape, color, position and texture of the teeth to recreate a smile. Direct composite dental bonding can address issues such as cracked or chipped teeth, closing gaps between the teeth, improving the discolored appearance of teeth and changing the shape of the teeth. A tooth-colored resin material is applied to the treated area and is bonded to the tooth using adhesives and a high intensity curing light.

Am I a Good Candidate for Direct Composite Dental Bonding?

GOOD CANDIDATES for this treatment include patients with:

• Chipped or broken teeth
• Discolored teeth
• Crooked teeth
• Spaces between the teeth
• Teeth that are projected forward or rotated

Patients who are likely NOT GOOD CANDIDATES include:

• People with generally healthy teeth that can be brightened simply through dental whitening
• Patients who do not practice good oral health since they probably have issues that dental bonding can’t solve
• Patients with crooked teeth whose teeth can be straightened by the use of dental braces

How is Direct Composite Dental Bonding Performed?

The tooth that will be treated will be prepared (cleaned) and then the surface is etched with an acid type gel in order to make it easier for the composite material to adhere to the tooth. The composite material, also known as the bonding agent, is applied to the tooth.

The dentist then shines a light source, called a “curing light”, on the treated tooth and this causes the composite material to harden and become solid. The composite material is often applied in layers so the doctor can monitor it more closely to achieve the desired results. Once the material has hardened, it is polished to give a smoother appearance that also matches the surrounding teeth. 

Tooth Reduction

There are times when the tooth will need to be reduced before the bonding process is performed but this is not always the case. For example, when a tooth is projected forward to an extreme degree, there is a need to reduce that area of the tooth. But if there is room to add more volume to an area, there is no need for tooth reduction. 

Direct Bonding vs. Porcelain Veneers (Indirect Bonding)

• As described above, the direct method is when the composite material is applied directly onto the tooth structure layer by layer. Indirect is when an impression is taken of the actual tooth structure to make it indirectly outside of the mouth. It is created on a model made up of a composite material and it is eventually glued onto the tooth.
• Direct bonding is a method where teeth do not need to be reduced substantially. It also creates a better match to adjacent natural tooth structure and neighboring teeth because the dentist is working on the actual tooth. Direct bonding, as opposed to porcelain veneering, has room for modification and alterations and can be done on just one tooth (if necessary) or any odd number of teeth. On the other hand, porcelain veneers should be done in even numbers for them to look and resemble one another. It is not simple to match porcelain veneers to natural tooth structures since an impression is made and then the veneers are manufactured outside of the mouth.
• There are more dental visits involved for an indirect procedure. There are at least two visits because the impression has to be taken during the first visit and then the patient comes back once the laboratory finishes the indirect bonding. Direct bonding is completed in one visit. The process itself may take anywhere from one to four hours, depending on how many teeth are involved, but it is all done at once.

Other Treatments

While dental bonding provides good results, some patients choose to combine it with other treatments to get more dramatic results:

• Teeth Whitening – Patients who want to whiten their teeth while having dental bonding need to have the whitening performed first. The dentist can then match the composite resin to the color of the teeth that have been whitened.
• Gum Contouring – Patients with large gums, or an uneven gum line, can have the unwanted tissues removed. This treatment can be performed using handheld tools or a laser to remove the tissue and to seal off the remaining tissue to reduce swelling and sensitivity after the treatment.
• Dental Crowns – This treatment is ideal for teeth with more severe damage. Dental crowns fit on the top of the teeth to add stability and strength to them. They also cover large chips, cracks and larger cavities.
• Smile Makeover – Dental bonding is often part of a process called a “smile makeover”. This larger procedure address dental damage that is widespread as well as any larger aesthetic issues. Along with dental bonding, the dentist often performs dental implants, gum contouring, places dental bridges and addresses other issues to improve the overall function and appearance of the mouth.

What is the Cost of Direct Composite Dental Bonding?

The cost depends on the number of teeth treated as well as the type of bonding performed and if insurance covers any of the costs. In general, the cost of direct composite dental bonding is $350-$600 per tooth while the price of porcelain veneers is $700-$1500.

Recovery and Downtime

There is little RECOVERY time after direct composite dental bonding. Any pain or discomfort is temporary and will resolve itself within a few hours or a day or two.

Patients need to be careful not to bite on anything that is too hard, crunchy or abrasive. They have to be cautious for the first few weeks to allow the mouth to get used to the new shape of the teeth. They should also stay away from food and beverages that may darken the bonding.

Results

Dental bonding provides immediate results once the procedure is completed. The hardened material looks natural and blends in with the other teeth. Overall, the results can last anywhere from 8 to 12 years.

As time passes, direct composite dental bonding may become dull looking and change color. It may also chip but that can be repaired. They should be treated like normal teeth with brushing and flossing. They can trap plaque and decay at the margins in-between the teeth and at the gum line. The bonding may stain at the margins. A patient has to be extra diligent with proper home care and visits to their dental office for routine cleanings and check-ups. Porcelain veneers can also chip but not as readily as bonding. However, if the porcelain cracks or chips, a new veneer may be necessary.

If bonding darkens over time, bleaching can reverse some of the stain build-up and whiten the teeth. The shade or color of the bonding cannot be reversed after it is placed. A person cannot go brighter than the specific shade that has been put on the tooth. However, if the bonding darkens a bit over the years, it can be reversed to its original color with professional whitening. It is better to have a professional supervise the whitening. If a patient applies it incorrectly, they may actually weaken the bonding.

Limitations and Risks of Direct Composite Dental Bonding

Before making the final decision to have direct composite dental bonding, there are some LIMITATIONS patients should be aware of:

• There is a limit as to how long direct composite dental bonding lasts compared to porcelain veneers. The average bonding lasts 8 to 12 years before there is a need to remake them entirely or simply resurface the outer surface to freshen them up. Porcelain veneers are longer lasting at 15 to 20 years. It depends on how much the patient wants to spend because bonding is cheaper than porcelain veneers.
• The material used in dental bonding is not as strong as the material found in natural teeth.
• It is not as strong as other restorative dentistry procedures such as veneers or crowns.
• It is limited to less dramatic restorative impact so it is best suited for smaller cosmetic changes and for teeth correction in areas with low bite pressure like the front teeth

Some of the more commons RISKS of direct composite dental bonding include:

• Discoloration
• Cracking, chipping or coming off completely
• Swelling after bring placed
• Discomfort when being placed
• Infection if not properly cared for by the patient
• Increased sensitivity after being placed

An Artistic Touch Can Improve the Smile

Direct composite dental bonding can improve a smile in many ways. From modifying the shape and color to improving the texture of the teeth, a smile can be enhanced by a doctor with an artistic touch. Due to the nature of the treatment, it is important to find a specialist in the realm of cosmetic dentistry with the necessary knowledge, hands-on experience and skills in performing bonding procedures. An experienced doctor can help patients determine if direct composite dental bonding is the right choice to fix their dental issues.

Written by Cosmetic Town Editorial Team - MA

Based on an exclusive interview with Emanuel Layliev, DDS in New York, NY