Cosmetic Dental Bonding

Cosmetic Dental Bonding
Bonding in dentistry technically means attaching a material
substance to the tooth structure through a chemical bond.
Typically it is used by many people to describe three
different processes: recontouring front teeth to fill
unsightly gaps, repairing chipped corners or edges on front
teeth or putting a veneer of composite resin over the whole
surface of a tooth to change its color or contour.

Bonding is actually used in many ways in cosmetic dentistry
today:

1. Repair or fill abraded and sensitive areas of teeth at
the gum line
2. Fill cavities or chipped and broken areas of front teeth

3. Minor reshaping or recontouring teeth to provide more
natural contours and contacts between teeth
4. Filling cavities in back teeth with composite resins in
place of silver amalgam
5. Sometimes resurfacing the whole face of a tooth (best
accomplished by bonding a porcelain veneer rather than
composite resin)
6. The sealants used to "seal" and protect the grooves in
children's teeth are bonded flowable composite resins

7. Bonded cements are used now to chemically bond crowns
and bridges to their anchor teeth.

If properly applied, bonded restorations preserve more
tooth structure than traditional fillings because deeper
drilling is not required just to "retain" the material as
with older methods. Bonded restorations are strongest at
the place where tooth and bonding meet, so these
restorations do not tend to chip and pull away from tooth
structure and leak at the margins as the older materials
did.

Since there is ofte less drilling required and less
marginal leakage, bonded restorations are typically less
sensitive afterwards than the older methods and often can
be done during the appointment without anesthetic.

These restorations are much better looking than the older
materials. Composite resins come in many shades to better
match tooth color. Due to the bonding and expansion
properties of composites, there seem to be fewer cracked
and broken teeth with these restorations.

Tooth bonding itself is a one visit procedure, though the
bonding can be associated with restorations that have been
made in a laboratory. If the area of tooth to be restored
is small, the materials used usually require only one
visit. Larger areas require the two visit procedures. If
done in two visits, there will be a temporary restoration
(usually also a composite resin) placed with a sedative
temporary cement.

Before bonding, any decay or old filling material present
is removed. Then the tooth surface to be bonded is slightly
roughened and treated with a mild etchant to provide
maximum bond strength. Then the bonding materials are
placed in a layered sequence and "cured" with a high
intensity light after each layer. Then the restoration is
shaped and polished to a smooth finish and proper contour
and fit with adjacent and opposing teeth. Sometimes the
tooth and bonding are then treated again and "sealed" with
a clear sealer layer of bonding material.

It is very important to maintain the bonded restorations
just like teeth by carefully brushing and flossing using a
non-abrasive toothpaste. If many of the biting surfaces of
teeth have been restored or there is a history of grinding
or clenching of the teeth, then the dentist may recommend a
plastic guard, called "occlusal guard" or "night guard"
since many people wear them at night. This guard protects
the jaw joints and teeth as well as the restorations.

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Steven J Brazis DDS has practiced family and cosmetic
dentistry for 35 years. He practices is Sacramento, CA.
Visit his website:
http://www.toothhaven.com
Order his new book at:
http://www.yourchildrensteeth.com