Dental Bounding

A common question we are asked is what is cosmetic bonding? The term itself does not mean a great deal and is not self-explanatory. Well, I will try to explain as best as I can in simple terms and how the treatment is actually completed.

WHAT IS COSMETIC BONDING?

Cosmetic bonding involves the adding of a very aesthetic white filling to one or several of your teeth to make them look nicer. For example, if there is a chip on the edge of one of your teeth or it is worn down or there are gaps this can be corrected with cosmetic bonding.

The beauty of this technique is that we do not need to drill away any tooth to provide the treatment in the majority of cases. On occasion, some sharp edges or thick enamel may need to be removed prior to the bonding but this would be very minimal. Therefore, cosmetic bonding is reversible! Is that not great? A cosmetic treatment that can be reversed should you wish. I have never been asked to remove any bonding as of yet, but there is always a first time, I guess!

If we look back a few years to the time of Extreme Makeover (remember that program?), virtually all of the cases involved a smile makeover using porcelain veneers and crowns. These look beautiful, no doubt. However, to make a porcelain veneer or crown especially, we have to cut the teeth down a great deal to make space for the porcelain. This is destructive and removes virtually all of the enamel from the tooth. Tooth enamel is the hardest tissue in the body and protects the biological aspects of the tooth such as the dentine (inner surface) and nerve area. Therefore, the tooth will be more prone to problems in the future without question. Now there is a time and place for porcelain veneers and crowns but, in my opinion, not on virgin teeth and with a minimal preparation as possible.

My point is therefore, that with a technique like cosmetic bonding, there is NO risk at all to the underlying tooth. The worst that could happen is that it chips, stains or becomes discoloured. Disaster! Not quite; the bonding can simply be replenished without fuss.

HOW IS IT DONE?

There are a few simple steps, which I will share with you now:

  • The tooth is washed with an acid etch of phosphoric acid 30% for 15-30 seconds. This sounds harsh but enamel is a mineral. It can take it. The etch enhances the bonding.
  • A bonding resin is placed over the tooth and is activated by a light. We use LED these days which generates less heat that the old halogen lights.
  • The white filling material is then layered over the tooth sequentially and set with the light. I use Empress Direct and GC G-aenial as my preferred composites.
  • We may need to use certain cords, clear strips, wedges in between the teeth to create a sound margin to the tooth.
  • Once the tooth is build back up, it is contoured to size and polished in a few steps with lots of water.
  • The bite is checked and the final polished is completed.

Sounds simple? Well, it is. However, it takes a few years to get really good at cosmetic bonding. As with everything in life, the more you do of something, the better you get.

TEETH GAP FILLING

The technique for teeth gap filling is similar to above but we want to fill gaps between teeth rather than enhance the appearance of a single or multiple tooth. In this case, I advise a very simple mock up where we can add the cosmetic bonding directly to the tooth/teeth to fill the space and show you how the bonding would look prior to actual treatment. As long as the proportions of the teeth remain natural, the result can be incredible. On occasion, it just does not look right especially if a single tooth is widened too much. In this case, it may be that orthodontic treatment is needed or minimal preparation porcelain or composite veneers.

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