Repairing damage caused by tooth decay with dental bonding.

This digital smile makeover illustrates how dental bonding can be used to repair the damage caused by tooth decay.

It's hard to believe that it's only been since the 1960's that placing "bonding" has been an option for dentists. Prior to that, white fillings were routinely placed but the restorative that was used characteristically provided an inferior appearance match to neighboring tooth structure and restorations typically had sub par longevity.

Case issues and concerns:

This makeover's "before" picture provides a good illustration of the various stages of tooth decay formation.

There are dark areas along the gum line on some of the upper teeth. And, different in color but similar in location, others have chalky-white discolorations (especially the teeth on the patient's lower left).

All of these defects are the result of the same set of events, dental plaque accumulation and the subsequent formation of cavities. The different colors of lesions you see are representative of decay formation 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.

  • Gum-line tooth decay.
    Gum-line tooth decay. Gum-line tooth decay.
  • After dental bonding has been placed.
    After dental bonding has been placed. After dental bonding has been placed.
 

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Treatment solutions:

1) Placing dental bonding. -

We've used our "after" picture to show how dental bonding (white fillings) could be used to repair these teeth. As an alternative approach, some dentists might consider the placement of porcelain veneers.

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 failing if their decay rate is not brought under control.

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