Written by Dr Rhona
Image by @ellabalinska
Are more and more people concerned about the appearance of their teeth? Absolutely. People are faced with their teeth and their smiles now more than ever. Especially in dynamic movements. They’re also spending less time and money on holidays so there seems to be a shift towards spending more on your health with a newfound respect for health care professionals. I’ve certainly seen a shift where people are coming to health care professionals for advice, especially during the pandemic.
When it comes to dental aesthetic treatments, braces whether it’s Invisalign, a clear aligner system, or traditional braces, are among the most popular. Bonding and veneers are also incredibly popular too. Social media has played its part here. People are becoming more aware of treatments that are available to them. They look up to influencers and celebrities.
Bonding has been around for years. It is simply a white filling material used for the back teeth and it has also been used for the front teeth. The only thing is that over the last five to ten years the aesthetics have improved; the consistency, colour range and longevity. As such more and more people are using them for their front teeth.
What are the pros?
You don’t need to drill the teeth to place them. It can be placed in one or two sittings. If a piece of bonding chips it is easily repairable. It is good to use for cracks and chips and to even out the tooth. No injections are needed for the treatment, and if placed well it can be very aesthetic.
What are the cons?
It can chip and stain; it is very technique sensitive and if not placed well, it can look very poor. In fact, if it’s not placed well, it can also attract plaque which can cause gum disease. It’s quite high maintenance as you need to make sure that your diet is optimal to keep the bonding looking good. You will need to be reasonable about black coffee, red wine, and smoking. You also need to make sure that you’re going to the dentist and hygienist regularly so that they can clean the teeth and maintain the bonding.
In terms of whitening? Can bonding stain? Can bonding be whitened?
Teeth can only be whitened. So you need to whiten your teeth first, and then the dentist will match the material of the bonding to the colour of the teeth once they have been whitened. There is a limit to how white you can get. So in some cases, people opt for full coverage bonding instead of edge bonding. Full coverage bonding is also known as ‘composite veneers.’ The term veneer relates to how much coverage there is on the tooth. A veneer can be made out of ceramic or composite. Composite veneers are very high maintenance as well – it is dependent on the practitioner that you see to get good results. It is also non-reversible because removal often requires some drilling of the teeth.
How long can bonding last?
It completely depends on what materials were used, how well the material is placed, and how well the teeth are looked after by the person who has had the treatment. It can last between 2 to 5 years. People often experience that the material does dull down after a couple of years.
Who would benefit most from bonding?
I personally love doing edge bonding after orthodontic treatment so for example after Invisalign once the teeth are perfectly straight, we can place some edge bonding to make the edges of the teeth look neater. It is minimally invasive, long-lasting, and least destructive to the actual teeth.
What’s the average price for bonding?
Again, it depends on the practitioner, but prices can range from £150-£600.
What do you think is important to know before doing the procedure?
The difference between edge bonding and composite veneers. One must understand that the latter is less invasive than the former. That composite veneers may eventually lead to ceramic veneers. However, if you want a more full Hollywood look, composite veneers will give that over edge bonding. Edge bonding is only suitable for cases where the teeth are perfectly straight so you may need orthodontic treatment. If you’re considering composite veneers you may want to consider ceramics as they last longer, look better for longer, and are actually kinder to the tissues in some instances.
What are Veneers?
Veneers are thin layers of ceramic made from glass that are fabricated by a lab technician. The process involves doing a consultation by taking photographs and assessing the teeth including the condition of the teeth and the bite. Importantly, if we do something called facially driven treatments. What this means is that the shapes of the teeth, the colour of the portions and the sizes will be different from one individual to another. We take several records, send them to the technician and the dentist to plan the case with the lab technician. We create something called a diagnostic wax-up. This is a “try before you buy” model to show the patient. The idea is that when they come back to see me after the initial consultation they have an idea of how their teeth can look before they even begin. I often try the wax-up in the patient’s mouth via a stent. We are able to assess aesthetics and phonetics. The patient is also shown photographs with the new smile. If the patient is happy we then book a preparation appointment. At this appointment, the patient is given a local anaesthetic. The teeth are then prepared. Today’s techniques focus on cutting down as little tooth structure as possible. The teeth are cut – it is important to note that this is irreversible. Once this is done records are taken on the prepared teeth, we also take records of the bite. We take records of the jaw relationship too. The temporaries are placed on the teeth, this is based on the wax-up and the stent. After two weeks, once the veneers are made in the lab they are fitted in the patient’s mouth. At this appointment, the patient has been given a local anaesthetic. The temporaries are removed: veneers are tried and if you approve they’re fitted under a rubber dam. We will then review you one week later to check the bite and to ensure there is no cement between the teeth.
How do veneers differ from bonding?
They are completely different materials. Bonding is a resin. Bonding can also be placed on the whole tooth surface. If this is the case it is a composite veneer. Ceramic veneers are made from porcelain. Some key differences include the following: Bonding is more prone to chip in and staining, however, there is no cutting down of the teeth initially so it can be less invasive. Ceramic is longer lasting and more aesthetic. Bonding is placed directly on the teeth. Ceramic is fabricated by a lab and glued on so they are indirect. Several appointments are needed to complete the ceramic process where as bonding can be done in one or two sessions. Ceramic can be more invasive than bonding.
How have veneers evolved over the decades? You can now make them ultra-thin. Before you had to rely on mechanical retention to get a good fit or stick to the tooth with the veneer. We now have incredible bonding techniques. This means that we can rely on the cement or the glue as patients call it between the tooth and the veneer. As such we don’t need to cut down the tooth a lot to get the veneer to stay on. Also, the materials have moved on a lot. They are much more lifelike and less opaque and often people cannot tell that they are veneers.
What are the pros?
If done well and looked after, they can last 10 to 15 years or more. They are less prone to chipping and staining in comparison to composite bonding. They maintain their lustre and gloss more than bonding.
What are the cons?
Some preparation of the teeth needs to take place. This is irreversible and does mean enamel loss. They can break and if they do, you need to replace them. They don’t last forever and will need replacement eventually.
Who makes for the best candidate for veneers?
Whether it is for bonding or veneers, I always recommend having your teeth straightened first. The reason being is that the straighter they are, the less cutting needs to be done. If you delay getting veneers later on in life it means you’ve reduced what we call “the restorative cycle“ what this means is that the replacement cycle is reduced. Because one guarantee with any kind of dentistry is that you’ll need work replaced.
In terms of whitening? Do veneers stain? If so, can they be whitened?
They can stain, but this is at the margin. What I mean by that, is where the tooth is near join the neck and the tooth. Your dentist can try and remove some of the stains. Veneers cannot be whitened. To get them whiter you will need them replaced. However, as mentioned, they do maintain the colour and gloss for a very long time.