Direct Composite Bonding / Composite veneer

Dentists use tooth-colored composites (white or natural-looking materials) that they have in their offices to fill cavities, repair chips or cracks, close gaps between your teeth and build up the worn-down edges of teeth. Dentists place the materials in or on the teeth where needed.

Because direct composite bonding involves the precise placement of restorative material by the dentist, the direct composite bonding procedure usually is completed in one dental visit. More complicated or extensive treatments may require additional visits. However, there is usually no need for temporaries or waiting days or weeks for laboratory restorations.

The same composite materials also may be directly applied and sculpted to the surfaces of teeth that show most prominently when you smile, for minimally invasive smile makeovers. While dentists call them direct composite veneers, many people just refer to them generically as “bonding.” Composite bonding usually is an ideal and less expensive solution for people with chips, gaps between the teeth, staining and discoloration, slight crookedness and misshapen teeth.

Although direct composite veneers typically require minimal preparations, no mold-taking and no temporaries, the artistic skill and precision of the dentist you choose will determine the exact manner in which your direct composite veneers are created. For example, some dentists use putty stents based on an impression of the patient's teeth and a model of their desired smile to guide them when placing the composite. This helps ensure a satisfactory result.

Adhesive Bonding

Adhesive bonding refers to attaching a restoration to a tooth using an etchant, a bonding agent, an adhesive and a high intensity curing light. This method is typically used for esthetic and metal-free crowns, porcelain veneers, bridges and inlays/onlays.

Understanding the Bonding Process

Whether your treatment plan calls for direct composite restorations or adhesively bonded restorations, dentists start the bonding process by using a rubber dam to isolate the teeth, to prevent interference from moisture. Depending on the extent of the treatment, anesthetic injections may be required.

Your dentist would then apply a gentle phosphoric acid solution to the surface of the natural tooth, which won't hurt. Similar to how roughing up a surface with sandpaper can help paint adhere to it better, acid etching of the tooth surface strengthens the bond of the composite and the adhesive. After 15 seconds the phosphoric acid is removed, and a liquid bonding agent is applied.

For a direct composite restoration:

• Your dentist then will place a putty-like composite resin in stages on the natural surface of the tooth, then shape and sculpt it.
• A high intensity curing light will be used to harden that layer of composite, and the previous step will be repeated, then cured, until the filling or direct composite veneer has reached its final shape.
• Your dentist also will create an appropriate finish to ensure that the bonded resin does not dislodge or cause tooth sensitivity.

For a restoration from a laboratory:

• Your dentist will place the appropriate adhesive into the restoration, seat the restoration on the tooth and light-cure it using a high intensity curing light for the appropriate amount of time.

It is not uncommon for a bonded tooth – particularly one that has been filled or on which a crown or inlay/onlay has been placed – to feel sensitive after treatment. This minor sensitivity is often short-lived, but if it persists, see your dentist.