Digital smile makeovers

Dental bonding is a very versatile restorative that can be used in a variety of ways.

This page’s digital makeovers illustrate how it can be used to repair tooth damage, like cavities (Case #1), or make changes that are purely cosmetic in nature (Case #2).

Case #1: Using bonding to repair damage caused by tooth decay.

Dental history and concerns:

1) This makeover’s “before” picture provides a good illustration of the various stages of tooth decay formation. And our “after” picture shows how bonding can be used to repair it.

The brown spots visible along the gum line are tooth decay.

View makeover’s animation.

All of these defects are the result of the same set of events, dental plaque accumulation and the subsequent formation of cavities. We’d like to point out that the different color lesions you see are representative of decay at various stages of development.

• The white areas found along the gum line – A very early stage of tooth decay formation.
• The dark areas on the teeth – Active and/or arrested tooth decay.
  

For more information about how cavities form, check out our topic: Tooth Decay.

After dental bonding has been used to repair the decay.

View makeover’s animation.

Treatment solutions:

The advantage that bonding offers is that placing it only involves making a repair in the area of the actual damage, not the entire front surface of the tooth. Bond is also the cheaper, although probably less durable, repair.

We will say that until this person improves their oral home care habits, their chances for new or recurring cavities is high. For that reason, tooth bonding probably makes the best first choice. Then later, if their home care does improve, a different, more durable solution might make a reasonable choice.

2) This person’s oral home care needs improvement. – An important part of this patient’s treatment will be to help them understand why their cavities are forming. In most cases, high decay rates are associated with inadequate brushing and flossing or else a diet high in sugar intake, or both. Any and all future dental work this person has will be at risk for failure if their decay rate is not brought under control.

Case #2: Using tooth bonding to change the shape of teeth.

There’s a large space between the central and lateral incisors.

View makeover’s animation.

Dental history and concerns:

1) This person’s chief cosmetic complaint is the gap that lies between his two upper left incisors. (Dentists use the term “diastema” to refer to this type of space.) His other concern is that his two center upper teeth aren’t the same length.

Treatment solutions:

The gap has been closed by placing dental bonding.

View makeover’s animation.

a) Some aspects of a tooth can’t be changed with bonding.

Dentists usually close a space between teeth by making each of the teeth framing the gap slightly wider. You may notice, however, that in our “after” picture we still show a hint of a space up by the gum line.

When a dentist places bonding they have a great deal of control over the final shape of those portions of the tooth that lie above the gum line. But the contours of the tooth right where it emerges from the gums cannot be significantly altered or masked. Here’s why.

Bonding can’t just be bulked on a tooth in this region (so to give the illusion of a different shape or alignment) because doing so may create a dental plaque trap (an area that is hard to clean when the patient brushes or flosses).

In our “after” simulation this is why you see a small space still remains. We’re suggesting that creating contours for the bonding that are easy to clean may result in a small portion of the gap still being left. (This scenario does not always take place but is a possibility that you may need to discuss with your dentist.)

b) Closing a gap may widen the teeth too much.

There’s another possible complication with this type of work that may need to be considered. Since the teeth on this person’s left side will now be wider than they were before, will this person’s smile still look symmetrical and uniform?

Most people we interact with will not pick up on small tooth-width discrepancies. But the patient and dentist both need to consider this possibility before treatment is begun.

2) Making corrections for the shape of other teeth. – Our “after” picture also illustrates some shape changes for the remainder of this person’s upper front teeth. In regard to making them, the biting edge of the patient’s center-right tooth could probably be brought into alignment just by trimming it with a dental drill. The shape of other aspects of this tooth, as well as others, could be refined and idealized with the addition of dental bonding.