Dental Bonding: An Everyday Practice in Dentistry

Authored By: Lesley Ranft
Reviewed By: Brian Quesnell, DDS
In dentistry, “bonding” describes the linking of dental material to a natural tooth. Today, virtually every dental procedure involves some form of bonding. In particular, many of today’s dentists have an affinity for using the bonding process to correct a defect and make a tooth glimmer. 
Bonding can be painless and non-invasive. It is accomplished in one visit to the dentist — no mold-taking, no “temporary,” no lab-fabrication. Bonding can also serve as a solution for chips, gaps between the teeth, staining, splotches from wearing braces, crookedness or even misshapen teeth. Plus, it’s relatively inexpensive.

Bonding Types

Bonding for Linking One Surface to Another: The bonding process may be used to attach a “white colored” composite filling or silver amalgam filling to a natural tooth. Bonding can also be used to secure crowns as an alternative to the traditional cementing process; this is typically referred to as adhesive bonding.
Direct Bonding: Bonding has recently grown in popularity as a solution for the repair of a cracked, decayed, chipped or otherwise cosmetically unattractive tooth. With the direct bonding technique, the bonding resin material is painted or sculpted on the natural tooth to fill, cover and protect the flawed area.

Bonding Options

Cracked, decayed, chipped or otherwise unattractive teeth can be repaired through several types of procedures, including direct bonding, dental veneers or dental crowns. Your dentist will evaluate the extent of your cosmetic and/or functional defect in order to determine the appropriate treatment plan for your tooth.
Direct Bonding for Minimal Flaws: Direct bonding may be the right choice for a minimally damaged tooth, particularly for a front tooth. While certain adults may be candidates for direct bonding, the process is the optimal restorative option for children under the age of 18. Also, your dentist may recommend a direct bonded veneer if you are including a smile makeover in your treatment plan.
Bonding for Significant DamageVeneers may be recommended as part of a treatment for more significant adult imperfections and may be included as part of a smile makeover or cosmetic dentistry treatment plan. A porcelain veneer may serve as the material choice for adhesive bonding in a smile makeover case.
Bonding for Large Imperfections: In cases where a defect cannot be repaired adequately with a veneer or through direct bonding, your dentist may recommend a dental crown. A crown can be attached to the tooth through the adhesive bonding or traditional cementation process, depending on what crown materials are used.

The Composite Bonding Process

During the composite bonding process, the damaged tooth is isolated. Tooth isolation is critical to the success of bonding techniques because it prevents moisture from interfering with the process.
Following tooth isolation, a gentle phosphoric acid (this does not produce discomfort) is applied to the natural tooth surface. This "acid etching" of the tooth surface enhances the bonding strength of the resin. After 15 seconds, the phosphoric acid is removed and a liquid bonding resin is applied. A putty-like composite resin is placed in stages on the natural surface of the tooth, where it is shaped and cured into place with a blue light. The process is repeated in layers until the resin has achieved its final shape and form. 
The composite bonding process is sensitive to each dentist’s technique, so your dentist must follow the steps diligently and produce an appropriate finish to ensure that the bonded resin does not fall off or cause tooth sensitivity. It is not uncommon for a bonded tooth to feel sensitive after treatment. This minor sensitivity is often short-lived; however, if sensitivity persists, it is recommended that you schedule a follow-up appointment with your dentist. Usually, the bonding process is not associated with complications.

Bonding Costs

The cost of bonding depends on a variety of factors, including:

  • The dentist performing the procedure.
  • The location where it is performed.
  • The type of dental insurance you have.
  • The type of restoration the bonding process is associated with. For example, dental insurance may pay for a portion of bonding associated with a dental filling but not for bonding associated with veneers.

Dentists with advanced bonding training may charge more for performing the procedure. For some people, the benefit of using a dentist with great technique justifies the extra costs associated with selecting a highly trained professional.
The supplementary costs associated with the bonding process may depend on whether additional equipment is used or additional time required (in some procedures, up to 50% more time is needed).

Additional Cost Considerations

In the treatment of larger defects, direct bonded veneers using composite resin are usually less expensive than adhesively bonded porcelain veneers. Be aware, though, that it may take more time for the dentist to perform the procedure to create the direct composite bonding veneers than for adhesively bonding porcelain veneers. The later, however, do require more than one office visit. 
So, over time there may not be a considerable financial difference between a bonded porcelain veneer and a direct bonded composite veneer.