Bonding is a procedure that uses tooth-colored dental resins and composites to change the shape and color of your teeth as well as to close gaps. Bonding can also be instrumental in repairing chipped or broken teeth, as well as in covering up unattractive stains. Because direct bonding only requires a little bit of tooth reduction, it is a very conservative procedure, unlike the other treatment options such as crowns or caps. Back to top

The surface of the tooth is made rough and somewhat porous through an etching technique that uses a weak phosphoric acid solution. After that, a composite (plastic) resin is applied to the roughened tooth surface, shaped and hardened with a special curing light. It is then further contoured and polished to create a natural look. This painless procedure usually requires only one visit. Back to top

Four to eight years is the standard lifespan of a bonded composite, though it often lasts longer if it is properly maintained and well placed within the patient's mouth. The area can be touched up and even re-bonded whenever necessary. Back to top

Bridges fill the gaps that result from lost teeth. For several reasons, it is vital to fill such gaps in a timely way. Firstly, the teeth neighboring the gap can tilt, shift or even super-erupt into the gap. This tilting and shifting make the neighboring teeth more vulnerable to decay and gum disease. Moreover, the form of a patieny's bite can be affected by the shifting, which over time can aggravate the jaws, muscles and mandibular joints. Such aggravations can disrupt the ability to chew, and can in some cases lead to changes in the appearance of the face. Back to top

It takes at least two visits. During the first visit, the neigboring teeth are reduced, an mold is taken and sent to a dental laboratory for the bridge to be made. During the second visit, the bridge is permanently set in the mouth. Bridges are similar to crowns in that they can be made from a number of different materials for varying strength, shape and coloration. A fixed restoration is usually the preferred solution for tooth replacement, though it should still be discussed with your dental professional. Back to top

Natural tooth-colored fillings have become the standard in dentistry and at times when looks are an important concern, they are often used in place of metallic alternatives. Studies have shown that the use of certain tooth-colored fillings can serve to strengthen a tooth, another reason that overall they are better than metallic amalgam. Composites and ceramics are the two forms of tooth-colored restorations currently in use. Back to top

Composites have been in use for many years, but their chemical composition has been dramatically improved over the years. The adhesives used to bond the composites to the teeth have also evolved. Thus, the widely accepted methods of bonding are used for a number of important procedures, such as closing undesirable spaces, improving the shape, size and color of a tooth, replacing an unattractive amalgam restoration, covering stained or damaged areas of a tooth. Broken teeth and sensitivity to heat and cold can also be treated using composites. Back to top

Once the tooth has been prepared and all decay removed, chemicals and materials are placed on the tooth to increase bond strength and to protect the tooth. Next, the composite material is placed incrementally into the tooth and is hardened by exposure to a special curing light. The restoration is then contoured to fit the bite and then is highly polished. These fillings require a bit more time than the amalgam fillings because of the number of steps involved. Composite fillings can also be a bit more sensitive, at first, to extreme hot and cold and they may discolor over time if the patient smokes or drinks a lot of coffee, tea or cola. They can also be more expensive and some composites may wear faster than amalgam fillings; however, they yield a much more natural and aesthetic result.

Ceramic fillings, like composites, come in several different types that can be used for different situations. Ceramics are typically used for the larger and more broken down areas. In these cases, an inlay or onlay to cover more of the tooth's surface may be indicated. These restorations are indirect because they require two visits and fabrication by a dental laboratory. The ceramic restorations are considerably more expensive and therefore simple, one-visit composite fillings are typically used instead. Ceramic restorations are much more durable and will not stain. Naturally speaking, the final result with ceramics is spectacular. Back to top

Veneering a tooth means to cover its facial or front surface. It is actually very similar to placing acrylic fingernails on top of natural nails. Veneers are used to enhance shapes and colors of teeth as well as to close spaces between teeth and to cover up significant stains such as those caused by tetracycline. Back to top

There are two types of veneers: direct and indirect. Direct veneers are done in a single visit and with a composite or plastic material. Indirect veneers are usually done in two visits and require a dental laboratory to fabricate the final restoration. The indirect veneer can be either a composite material or more commonly, a porcelain material. Due to the advancements in the porcelain substrates and the bonding materials used to place them, they are often used in place of crowns for a more conservative and natural looking smile. Back to top

First Step

During the first visit, a local anesthetic is used and the tooth or teeth are reduced by approximately 0.5mm - 2.0mm. An impression of the teeth in this state is then taken and sent to a dental laboratory for fabrication of the veneers. This usually takes one to two weeks to complete. A temporary restoration may or may not be placed depending on the amount of reduction necessary. There may or may not be slight sensitivity to hot and cold during this period.

Second Step

At the second visit, a local anesthetic may be used for the patient's comfort in seating the veneers. After thoroughly cleaning and preparing the teeth, the veneers are then placed with a resin material and cured or hardened with a special curing light. Back to top

There are many different variations of porcelains used today and this should be discussed with the dentist ahead of time. Typically, the porcelains should last about 15 years, however, with proper care and maintenance, they can last longer. Porcelain veneers resist staining, reflect light and are among the strongest and most natural looking restorations available. Back to top

Bleaching is a very conservative and non-invasive approach to creating a brighter and more appealing smile. Teeth can often take on a darker and unattractive appearance with age or from contact with staining substances. The discoloration can be caused by tobacco, coffee or tea, juices, poor hygiene, genetics, and natural aging. Back to top

There are two commonly used methods for bleaching: at-home and in-office. Both begin with an office consultation to determine if the patient is a good candidate for the bleaching process. The at-home technique is the most popular and least expensive. The in-office method allows the dentist to place a higher concentration of bleach over the teeth.

At-Home Method

A custom mouth piece or "tray" is made to fit your teeth by the dental office. This tray fits over the patient's teeth and holds the bleaching material against the teeth for a specified period of time. There are different concentrations of bleach that are worn via the tray for one to two hours per day for an average of 5 to 10 days. The regimen will be determined by the dentist and may differ for each patient. If the teeth become more sensitive to hot and cold, a "desensitizing" material may be used in the same tray on alternating days. Results are usually excellent with this method.

In-Office Method

The gum tissues are covered to protect them from being irritated by a higher concentration of the bleaching material. The bleach is then activated by a high intensity light or a laser to accelerate the process. This method is usually stronger and longer lasting sensitivity to hot and cold. Often procedure has to be repeated at separate appointments and is considerably more expensive than the at-home method. Most patients require a touch-up after one to three years, depending on the patient's habits and desires. Back to top

Both at-home and in-office treatments are considerably more effective than the whiteners available at retail. The over-the-counter products have much lower concentrations of bleach and sometimes use materials and ill-fitting trays that can cause damage to the teeth and gums. Back to top

Please see the American Dental Association website, or call us. Back to top