To treat a cavity, we remove the decayed portion of the tooth and then "fill" the area on the tooth where the decayed material once lived. Fillings are also used to repair cracked or broken teeth and teeth that have been worn down from misuse (grinding of the teeth is a good example).

The steps to filling a tooth are as follows. First, we numb the area around the tooth to be worked on with a local anesthetic. Next, we remove the decayed portion of the tooth while using a dental drill. In addition, we test the area during the decay removal process to determine if all the decay has been removed. Once the decay has been removed, we prepare the space for the filling by cleaning the cavity of bacteria and debris. If the decay is near the root, we may opt to put a liner made of glass ionomer, composite resin, or other material to protect the nerve. Generally, after the filling is in, we will equilibrate the bite and polish the restoration.

Today, several dental filling materials are available. Teeth can be filled with gold; porcelain; silver amalgam (which consists of mercury mixed with silver, tin, zinc, and copper); or tooth-colored material, which is also called composite resin made of plastic and glass materials. The location and extent of the decay aids in determining the type of filling that will best address your needs. Of course, we discuss the different options with our patients prior to restoring with the appropriate material.

Dental bonding is a procedure in which a tooth-colored resin material (a durable plastic material) is applied and hardened with a special light, which ultimately "bonds" the material to the tooth to restore or improve a person's smile.

Dental bonding is an option that can be considered:

• To repair decayed teeth (composite resins are used to fill cavities)
• To repair chipped or cracked teeth
• To improve the appearance of discolored teeth
• To close spaces between teeth
• To make teeth look longer
• To change the shape of teeth
• As a cosmetic alternative to amalgam fillings
• To protect a portion of the tooth's root that has been exposed when gums recede

Procedure

Little advance preparation is needed for dental bonding. Anesthesia is often not necessary unless the bonding is being used to fill a decayed tooth. We usually use a shade guide to select a composite resin color that will closely match the color of your tooth. Next, the surface of the tooth will be roughened and a conditioning liquid applied. These procedures help the bonding material adhere to the tooth. The tooth-colored, puttylike resin is then applied, molded and smoothed to the desired shape. An special “curing” light is then used to harden the material. After the material is hardened, we trim it, shape it, and polish it to match the sheen of the rest of the tooth surface. The procedure takes about 30 to 60 minutes per tooth to complete.

Advantages: Bonding is among the easiest and least expensive of cosmetic dental procedures. Unlike veneers and crowns, which are customized tooth coverings that must be fabricated in a laboratory, bonding usually can be done in one office visit unless several teeth are involved. Another advantage, compared with veneers and crowns, is that the least amount of tooth enamel is removed. Also, unless dental bonding is being performed to fill a cavity, anesthesia is usually not required.

Disadvantages: Although the material used in dental bonding is somewhat stain resistant, it does not resist stains as well as crowns. Another disadvantage is that the bonding materials do not last as long nor are as strong as other restorative procedures, such as crowns, veneers, or actual fillings. Additionally, bonding materials can chip and break off the tooth.

Because of some of the limitations of bonding, some dentists view bonding as best suited for small cosmetic changes, for temporary correction of cosmetic defects, and for correction of teeth in areas of very low bite pressure (for example, front teeth). At the time of consultation, we aim to review the best cosmetic approach for your particular problem.

Dental bondings do not require special care. We recommend to follow good oral hygiene practices. Brush your teeth at least twice a day, floss at least once a day and see your dentist for regular professional check-ups and cleanings.

Because bonding material can chip, it is important to avoid such habits as biting fingernails; chewing on pens, ice or other hard food objects; or using your bonded teeth as an opener. The lifespan of bonding materials depends on how much bonding was done and your oral habits. Typically, however, bonding material lasts from 3 years up to about 10 years before needing to be touched up or replaced.