We are proud of the ways in which dentistry can restore broken or decayed teeth to full beauty and function. One of the easiest and least expensive ways of doing this is with dental bonding.
Bonding uses tooth-colored materials to replace missing tooth structure or hide cosmetically unappealing minor defects in a tooth — chips, discoloration, and even minor spacing irregularities. Bonding materials are called “composite resins” because they contain a mixture of plastic and glass, which adds strength and translucency. The composite actually bonds, or becomes one, with the rest of the tooth.
Composite resins come in a variety of tooth shades for truly lifelike results. When bonding is done with a skilled hand and an artistic eye, it may be impossible to distinguish the bonded tooth from its neighbors. Though bonding will not last as long as a dental veneer, it also does not require the involvement of a dental laboratory and, most often, can be done without drilling of the tooth. It's a particularly good solution for teens, who often need to wait until their teeth have finished maturing before choosing a more permanent type of dental restoration.
Tooth Bonding - Step by Step.Because it does not involve dental laboratory work, tooth bonding can usually be accomplished in a single visit to the dental office. Expect the whole procedure to take 30 minutes to an hour. First, the surface of the tooth to be bonded will be cleaned so it is plaque-free. The surface will then need to be “etched” with an acidic gel that opens up tiny pores in the surface. After the etching gel is rinsed off, the liquid composite resin in a well-matched shade is painted on in a thin layer, filling these tiny pores to create a strong micromechanical bond. A special curing light is used to harden this bonding material. Once the first layer is cured, another layer is painted on and cured. Layers can continue to be built up until the restoration has the necessary thickness. The bonding material is then shaped using a dental drill to give it just the right form. Once the tooth not only looks great but fits in perfectly with your bite, it will receive a final polishing.
Bonded teeth should be brushed and flossed daily, and professionally cleaned at the dental office twice per year, just the same as the rest of your teeth. The most important thing to keep in mind about caring for your bonded tooth is that composite resin can absorb stain, just as natural teeth can. Therefore, you will want to avoid smoking, red wine, coffee and tea to the extent possible. Also, while composite can darken, it cannot be lightened. So if you are thinking about having your teeth whitened, it should be done before your tooth is bonded so that a composite shade can be selected to match the lighter color of your whitened teeth. If you whiten your teeth after bonding, the bonded tooth may not match all the rest. Finally, try not to bite your nails, hold writing implements in your mouth, or use your teeth in other ways that could put excessive force on the bonding material and chip it. With proper care, a bonded tooth should stay beautiful for 3 to 10 years.
The most likely location for a cavity to develop in your child's mouth is on the chewing surfaces of the back teeth. Run your tongue over this area in your mouth, and you will feel the reason why: These surfaces are not smooth, as other areas of your teeth are. Instead, they are filled with tiny grooves referred to as “pits and fissures,” which trap bacteria and food particles. The bristles on a toothbrush can't always reach all the way into these dark, moist little crevices. This creates the perfect conditions for tooth decay.
What's more, a child's newly erupted permanent teeth are not as resistant to decay as adult teeth are. The hard enamel coating that protects the teeth changes as it ages to become stronger. Fluoride, which is found in toothpaste and some drinking water — and in treatments provided at the dental office — can strengthen enamel, but, again, it's hard to get fluoride into those pits and fissures on a regular basis. Fortunately, there is a good solution to this problem: dental sealants.
Dental sealants are invisible plastic resin coatings that smooth out the chewing surfaces of the back teeth, making them resistant to decay. A sealed tooth is far less likely to develop a cavity, require more expensive dental treatment later on, or, most importantly, cause your child pain.
You can think of a sealant as a mini plastic filling, though please reassure your child that it doesn't “count” as having a cavity filled. Because tooth enamel does not contain any nerves, placing a sealant is painless and does not routinely require numbing shots. First, the tooth or teeth to be sealed are examined, and if any minimal decay is found, it will be gently removed. The tooth will then be cleaned and dried. Then a solution that will slightly roughen or “etch” the surface is applied, to make the sealing material adhere better. The tooth is then rinsed and dried again. The sealant is then painted on the tooth in liquid form and hardens in about a minute, sometimes with the help of a special curing light. That's all there is to it!
A note about BPA: A 2012 study that received wide press coverage raised concerns that trace amounts of the chemical bisphenol-A (BPA) found in some (but not all) dental resins might contribute to behavioral problems in children. The study authors noted that while they had found an association, they had not actually proven that BPA in dental sealants causes these problems. In fact, BPA is far more prevalent in food and beverage packaging than in dental restorative materials. The American Academy of Pediatric Dentistry and the American Dental Association have since reaffirmed their support for the use of sealants.
Taking Care of Sealants
Sealed teeth require the same conscientious dental hygiene as unsealed teeth. Your child should continue to brush and floss his or her teeth daily and have regular professional cleanings. Checking for wear and tear on the sealants is important, though they should last for up to 10 years. During this time, your child will benefit from a preventive treatment proven to reduce decay by more than 70 percent.
What makes a smile beautiful? That's a complex question, but some qualities of a lovely smile are immediately identifiable: good tooth color, shape and alignment are a few of the most important ones. If your teeth could use improvement in any of these categories, porcelain veneers could be just what you're looking for.
You may already know that a veneer is a thin covering over another surface. In dentistry, a veneer is a wafer-thin layer of super-strong porcelain that convincingly substitutes for natural tooth enamel. When bonded to your teeth, veneers can create a natural-looking, beautiful new surface. That's because dental porcelain, like natural tooth enamel, is translucent and tough. But it doesn't stain like tooth enamel does.
Recent years have brought remarkable advances in dental porcelain technology. These days, veneers can be made so thin that they can sometimes be bonded directly onto your existing tooth surface. In other cases, a very thin layer of tooth enamel — as thin as the veneer itself — needs to be removed to fit the new porcelain surface and make it look as lifelike as possible. Either way, the results are sure to make you smile.
Veneers can be used to improve any of the following characteristics of your teeth:
Color — Teeth can become stained by the foods and drinks we like, from smoking, and even normal aging. Veneers are available in numerous shades, from the most natural to the brightest Hollywood white.
Size & Shape — Teeth can become worn down from grinding habits, or may not have the shape or size you want to begin with. For example, some people consider rounder teeth more feminine and squarer teeth more masculine. Veneers can be shaped and sized in whichever way is most flattering to your face.
Alignment & Spacing — Veneers can be used to close small gaps between teeth or make slight corrections in alignment while improving tooth color and shape.
There are some situations in which veneers would be inappropriate. For example, if you have significantly misaligned teeth or a large gap, orthodontics might be a more appropriate solution than veneers. And if you have lost a lot of tooth structure from decay or trauma (or a particularly severe grinding habit), it might be better to restore your teeth with porcelain crowns that cover the entire tooth.
The first step in creating a new smile with porcelain veneers is to communicate exactly what you don't like about your smile as it is now. It's a great idea to bring in pictures of smiles you do like, as a starting point for discussion. It's possible to see how veneers would look on your teeth in one of several ways. A model of your teeth can be created over which wax “veneers” can be placed; sometimes acrylic (plastic) or tooth-colored filling material can be placed directly onto your teeth to demonstrate the effect veneers would have on them.
Once the plan has been agreed upon, your teeth will be prepared by removing a small amount of enamel, if this step is necessary. Molds of your teeth will be taken and used by a skilled dental laboratory to create your veneers, and you will receive a temporary set of veneers to wear during the few weeks it will take to create your permanent veneers. When the veneers come back from the lab, they will be cemented onto your teeth.
Just like the teeth nature gave you, teeth restored with veneers need gentle brushing and flossing every day. This will remove dental plaque and ensure good gum tissue health around the veneers. Regular checkups at the dental office will remain as important as always to your oral and general health. And keep in mind that as tough as veneers are, they may not be able to withstand forces that come from using your teeth as tools (to open packages, for example) or biting into very hard foods like candy apples — which isn't good for your natural teeth, either! And if you grind or clench your teeth at night, you might be advised to get a custom-made nightguard to protect your veneers — and your investment.