Composite bonding is the process of bonding layers of composite resin over existing tooth structure in order to close gaps, change the shape of the tooth, mask difficult to remove extrinsic stains or build-up tooth structure that has been fractured or worn through grinding or consumption of acidic foods and drinks.
Many patients come in to see us not happy with the gaps in between their teeth. A diastema, or gaps in between teeth, can occur if the teeth are small, or not the usual shape for a particular tooth. These teeth are commonly referred to as peg shaped or microdontia. Alternatively, if the jaw is larger than usual the teeth are more spaced out.
Different presentations require different approaches to treatment. When presented with a diastema or gaps in between their teeth, the options we give our patients include:
Orthodontically close the diastema. At K Dental Studios we have a specialist in orthodontics who has had years of certified training in order to be able to offer any orthodontic device safely and effectively for the best possible result.
Porcelain veneers may be an option to close the spaces. This is a quicker option than orthodontics, but it does involve irreversibly cutting away healthy tooth structure in order to allow space for the veneer. This comes with repercussions with respect to the health of the tooth as well as long term maintenance.
Composite bonding may be an option in the situations where patients do not want to go through orthodontic treatment or are unhappy with shaving down healthy tooth tissue for porcelain veneers. It may also be advised in situations where the teeth are small in size and closing the gaps with orthodontics may not give the adequate aesthetic end result since the teeth will still look too small.
There are three main reasons why a patient may have worn their teeth. A summary is provided below, but for more information please click here.
Attrition – through grinding or clenching teeth together.
Erosion – through the consumption of acidic food and drinks.
Abrasion – through over-zealous tooth brushing technique.
Once the underlying problem for causing the tooth wear is stabilised, we can offer composite bonding in order to build back the tooth structure that is missing.
An alternative to composite bonding is potentially replacing the missing tooth structure with crowns. This requires shaving part of the teeth to create space followed by sending an impression of the prepared tooth to the technician in order to fabricate the crowns.
Stains can build up on the inside of the tooth due to everyday eating, drinking or smoking. In some instances, teeth may become discoloured because of certain antibiotics that patients have had to take during the teeth’s development, or after root canal treatment. Other causes could also include certain disorders such as Amelogenesis Imperfecta or Dentinogenesis Imperfecta.
Our first approach would be to attempt to whiten the teeth through our customised home whitening treatments.
If the teeth do not respond well to this then our next options are either composite bonding or porcelain veneers to try to mask the discolouration.
Trauma is the biggest cause of fractured teeth and we know the distress it can cause patients.
At K Dental Studios we are able to see patients on the same day to help assess the damage and provide the initial restoration of the fractured tooth/teeth by composite bonding. At a later date and only if necessary we can discuss the option of porcelain veneers.
We always start with a thorough assessment of the patient to determine the cause of the underlying problem. The dentist will take the appropriate x-rays and discuss the possible treatment options using photos of your teeth. You will have the opportunity at this stage to also let your dentist know what you like and dislike about your teeth so that the dentist can incorporate that in the treatment.
Once it has been decided that composite bonding will be the treatment of choice for the patient, moulds of your teeth are taken. Your dentist will then wax up what the teeth can look like after the composite bonding.
On a separate appointment the dentist will use the wax up to simulate on the patient what the end result may look like. This is called a mock-up and it gives the patient the reassurance that they need before proceeding to the treatment but also it is a way for the patient to let the dentist know if they want any changes. Our patients can show us if they want teeth to be longer or shorter, with square or rounded corners etc. This is what makes this treatment so great. We make it bespoke to you, and you can see it before we do the definitive treatment.
Our patients can decide whether they want all or some gaps closed during the mock-up appointment.
The dentist will use the next appointment to build up the teeth. Composite resin will be hand painted on each individual tooth, shaped and smoothed until you are happy. It’s a very artistic process.
A review appointment is booked to further polish the composites to ensure that both the patient and the dentist are happy with the result.
There are always different ways to achieve the aesthetic result that patients request. In these cases, porcelain veneers can be another option as can orthodontic treatment to close gaps if this is the main objective.
We are privileged at K Dental Studios to have clinicians who have further training and are able to offer patients all options available and to be able to deliver care to the highest quality. We also pride ourselves in that we always ensure that the treatment the patient opts for will be safe, conservative and effective. We will discuss with the patient all the risks and benefits of each treatment option and the long term maintenance involved.
Nothing is for life unfortunately. Every treatment you undertake in dental care will require an element of maintenance and aftercare.
Composite will pick up stains and will require polishing. This is easy to do together with your regular hygiene visits, by asking to have the jet polish cleaning. We advise that you have this approximately every 6 months but may be more regularly depending on the type of coloured foods and drinks you ingest.
Nothing is as strong as your real teeth. Composite veneers may chip and will also wear with time. We may advise that you wear a mouthguard for sleeping to prevent this from happening and avoid having certain foods which may cause the resin to chip more easily.
If they do chip or wear however, because we have your wax models, we are able to rebuild your teeth to how they looked originally.
Porcelain veneers which are the alternative to composite bonding also have to be maintained long term. Although they do not stain as readily as composite, they can also chip, but are not as easily repaired as composite veneers. The porcelain veneers may be more aesthetic but they come at a cost of shaving healthy tooth structure. Having spaces orthodontically closed, will not necessarily have the maintenance of stains and chips that you may have with composite bonding or composite veneers, but in order to keep the teeth from moving back to their original positions, we advise long-term wearing of a removable retainer at night or having a fixed wire on the back of the front teeth which is much more difficult to clean and requires even more regular visits to the hygienist.
We want to be open and transparent with patients and we always ensure that our patients understand all their options, including their aftercare responsibilities, before we start treatment.