What You Need to Know About Dental Bonding
Hey everyone, this is Dr. Mike Hardcastle from Village Dental Care. I routinely get questions about various parts of dentistry. Today, I want to talk to you about the most recent question I got about dental bonding.
What is dental bonding?
Dental bonding is basically an alternative to porcelain veneers, a less expensive alternative. It's where we use tooth-shaded, aka white filling materials, to reshape and reface the front of your teeth. It's the same material we use for white fillings in the back teeth, but we use them for cosmetic purposes. When we call it dental bonding, most people are referring to the cosmetic reshaping of your teeth in a very direct, one-appointment fashion compared to porcelain veneers, which would require two appointments.
When is dental bonding recommended?
Dental bonding can be recommended in a few different situations. The most common are for young people whose teeth are still developing. Their body is growing, and as they grow, the gum line changes position relative to their teeth. If some cosmetic improvement is needed on someone's teeth who's young and still growing, dental bonding is a less expensive approach and certainly strong enough in most situations to get them through their growing phase. Often, it lasts so well that it will continue to look good for a long time, depending on the age they had the dental bonding placed. The other option would be for people who want a cosmetic improvement but can't afford porcelain veneers, and dental bonding fits their budget better.
What are the advantages of dental bonding?
The advantages of dental bonding are a couple of main ones that come to mind. One is the fact that dental bonding can be done in one visit. That's nice—no temporaries or anything like that. You come in and leave the same visit with essentially a smile makeover. Another reason someone might choose dental bonding is that they don't have the budget for porcelain veneers, but they're self-conscious about their teeth. They want to feel more confident, and they want a specific look they don't currently have but can't afford veneers. So, the second group of people would be those looking for a more budget-friendly way to enhance the appearance of their teeth.
Do bonded teeth look natural?
My answer is it depends. Dentistry is an art, and it really depends on the palette we're given to work with. That's one component. Another is the artistry of the dentist doing the work. The third thing would be the expectation of the patient. There are certain things that patients want sometimes that we just can't achieve with direct bonding, and we have to do something a little more involved to produce the outcome. Good communication about what the expectation is, is crucial. In most situations, dental bonding can look very natural as long as you communicate to your dentist the outcome you're looking for. Bringing old pictures or anything like that will help us understand what you're hoping to achieve. But 99.9% of the time, we can produce a very natural-looking outcome for the patient.
Which is better, bonding or veneers?
"Better" is a dangerous word. There are pros and cons to every treatment. So, better is really a subjective question. If your goal is a budget-friendly cosmetic enhancement of the teeth, then in that case, bonding is better because it meets your goal of what you feel like you need. On the other hand, if you want the most natural result and have the budget for more expensive treatment, then porcelain veneers are, by most standards, better. From a long-term outcome, "better" as defined by the dentist would mean what's going to look the most natural and what is going to last the longest so that you don't have to keep getting teeth fixed when things chip and break. In most situations, porcelain veneers would be better. There's also some in-between options, like minimal or no-prep veneers, which are more expensive than bonding but stronger, less invasive, and less expensive than traditional porcelain veneers. But there are limitations to that option, so it's not a great solution for everybody, but there are options.
What takes place during the dental bonding procedure?
The technique will vary slightly from dentist to dentist, but in general, we typically don't have to numb the teeth, so that's nice—no shots. We clean the tooth surface, roughen it up slightly, but we remove minimal tooth structure. Then we go through the process required to make the bonded filling material adhere to the teeth. It's a three-step process where we clean it and apply a bonding agent, similar to a primer for paint, but it doesn't look like a primer for paint—it's clear. Then we stack, layer, and shape the soft bonding filling material so that it looks like we want it to look. We shine a light on it, it cures it, and then we do some shaping and polishing to make sure it's the shape, size, and look we're going for. I always finish by giving my patient a mirror, letting them look, and if there's anything they want to adjust or touch up, we can do that so that they leave happy. Ultimately, our goal in all treatment is for our patients to leave happy.
Is dental bonding painful?
In almost all cases, no, not at all. There's really no sensitivity. There are some situations where a person has some recession of the gums, and they've got some root exposed. Not all people, but some people find that the root is very sensitive to cold and air. If it's sensitive to cold and air, in those situations, to keep the patient comfortable, it's better to numb the patient so we can do the work. There's a lot of washing and spraying water and air on the tooth during the process. We want to make sure you're comfortable. So, if we discover that your teeth are sensitive to cold and air initially before we start, then we definitely don't want to make it a painful experience. We would go ahead and numb in that situation.
Can I brush and floss my teeth after bonding?
The answer is yes. If I do my job as your dentist to apply the material properly, the last thing I'm going to do is make sure that I can floss each of your teeth and that it doesn't tear the floss up when we do that. It should be able to go in and out fairly easily. We definitely want you to brush your teeth, whether you have fillings or no fillings, bonding or no bonding. It's important to keep everything healthy so that the dental work lasts as long as possible and the gums stay healthy, and you don't get any cavities around the dental work we've done. That's the quick overview on how you maintain that.
Are there any special instructions for caring for bonded teeth?
In short, there are no special instructions. I teach my patients, no matter what kind of dentistry we put in their mouth, we want to teach you how to have a healthy mouth. If we can teach you how to have a healthy mouth, you won't get cavities, and your dental work will last the longest. All dental work has a shelf life, so to speak. No dental work is going to last forever; it will have to be updated. It wears out over time, just like tires on your car. Maintaining and keeping things clean is the way to get the longest life out of it. A person who drinks sodas and eats candy all day, hardly ever brushes and flosses—their bonding, let alone the rest of their dental work, will only last a year or two. Someone who enjoys that stuff occasionally but brushes the sugar off their teeth and generally maintains good home care, their bonding may very well last 15, 20 years pretty easily. There's a certain responsibility on the patient to take care of things, and the other is on the dentist to do a good job to ensure everything is smooth and fits nicely. That teamwork effort can really make your dental work last decades.
How much does dental bonding cost?
We actually get that question on every procedure available in dentistry. The quick answer is it depends. It depends on the practice and the area you're in. Typically, if I were to compare it as a percentage of a traditional veneer, a porcelain veneer can cost anywhere from $1,500 per tooth up to $2,500 or $3,000 for some high-end offices in high-end areas. I would say that dental bonding typically costs about half or less than half the cost of porcelain veneers. It's a great way to save some money. There are some highly discounted practices that may charge less. I get a little concerned about having cosmetic dentistry done in a heavily discounted practice because they have bills to pay, too, and the only way they can pay the bills is to go faster. Fast and good don't always go hand in hand. So, don't let price be your determining factor. Although it's important to consider relative to the cost of veneers, if you're going through the effort of elective cosmetic dentistry and you choose bonding, no matter who you go to, you really want the outcome and results to be your litmus test for which office you choose.
Does insurance cover dental bonding?
In most cases, no. Most cases of dental bonding would be considered cosmetic procedures. There are times in my practice that we're going to kill two birds with one stone. The tooth has some fillings that it needs in between the teeth due to decay. Maybe it's a young person that didn't brush their teeth well, and they've got a lot of scarring that's residual from when they had braces, and we want to make that look better for them while they're growing and going through school, and not getting teased, and all that. We'll coat it as a filling because we're doing the other fillings and cleanup anyway, but I'll incorporate the bonding part just as another surface on the tooth so that we can fix the decay but also make the tooth look better, or the teeth look better generally, so that the kid can have a normal, confident, happy smile. In that case, we can usually get some help, but if you go in just looking for cosmetic improvement, most of the time, just know that it's not going to be covered by insurance.
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