Direct dental bonding pertains to the restoration of a damaged tooth with composite resin. Composite is a tooth-colored filling material. Porcelain veneers, on the other hand, refer to the thin shell of translucent ceramic made to fit the front surface of a tooth. The placement of either a composite or porcelain veneer can dramatically enhance the appearance of a patient’s smile.
Restoration with bonded composite is a quicker, less invasive method of restoring damaged teeth. It is cheaper than porcelain veneers although it is less resistant and generally does not last as long. Other differences between the two include the cost as well as the length of time needed to finish the restoration.
For dental teeth bonding, the dentist will first remove the decayed or damaged portions of the tooth. The reduction will be very minimal. Once done, a bonding agent will be applied on the prepared tooth surface. Then, the actual composite filling will be fused to the tooth structure through the action of the bonding material. A curing light will be used to harden the filling. Afterwards, it will be trimmed and polished to blend naturally to the entire tooth.
Much like dental bonding, porcelain veneers are also fused to the tooth structure. The only difference is instead of using composite (plastic), ceramic (glass) is used. Also, the amount of tooth reduction is much greater. The dentist will have to remove structure on the entire front surface of the tooth in order to accommodate the veneer.
Dental bonding procedures are performed entirely in a dental clinic. With porcelain veneers the tooth preparation and placement of the restoration for porcelain veneers are performed in the dental clinic. The actual veneer is fabricated in a laboratory by a dental technician.
The porcelain veneers produced by dental laboratories mimic the natural teeth. Technicians utilize layers of porcelain in different shades to get the best esthetic possible. That is very difficult to do with dental bonding. Even though dentists use different colors of composite to copy the natural shade of the tooth, the results are not as good.
Dental bonding and porcelain veneers are both typically used to manage gaps between teeth, chips/fractures, and misshapen teeth. Tooth bonding is used in small gaps while porcelain veneers are for much larger gaps. Chipped teeth can also be managed using these restorative techniques depending on the size or extent of the damage. Porcelain is much stronger than composite. A fully-cured composite is rock-hard, but is nowhere near as hard as porcelain. That is why porcelain veneers are recommended for cases of extensive damage. Dental veneers can also be used to change the overall color of the patient’s smile as well as the inclinations and positions of the front teeth.
Patients should note that porcelain has a much more abrasive compared to a natural tooth structure. They need to be very careful when biting, especially if the veneer opposes a natural tooth, because porcelain can wear the tooth enamel faster than an opposing natural tooth.
For kids, dentists typically like to stick to dental bonding mainly because it is less invasive and anesthesia is not necessary most of the time. More importantly, kids are growing and so is their bone structure. Many things change over time and the last thing parents need is to spend a lot of money for veneers on someone that is still growing. When they reach adulthood, the veneers may not look as good and need to be redone.
Furthermore, the oral hygiene habits of a kid are not as good as an adult and the veneer may fail because of that. Porcelain veneers are an investment and a person wants to make sure they last for as long as possible.
Composite bonding can cost anywhere from $250 to $600. Obviously, the repair of small damages is cheaper while teeth that require greater coverage will cost more. The price is also dependent on the shades that will be used.
Porcelain veneers, on the other hand, can cost anywhere from $700 to $2,500. One factor for the variation in price is the location of the dental clinic. Dentists in some big cities (i.e Beverly Hills) charge more compared to those in smaller cities. The laboratory where the veneers are made is another factor. High-quality labs charge three times as much as an average lab and that is reflected in the price that the dentist charges the patient. These labs usually have good-quality porcelain and a very skillful ceramic artist. The veneer is only going to look as good as the artist who made it. So for a really talented ceramist, dentists usually go for a high-end laboratory.
Patients usually think that doing porcelain veneers hurts. It does not. Usually, there is some discomfort but it is nothing that cannot be managed by administering local anesthesia. Most dentists use anesthetics when doing veneers. If the patient is afraid of needles, there is always some topical anesthesia that can be used before the injection. Once the topical is applied, the tissues get numb and the patient will not feel the needle. Dental bonding produces no discomfort to the patient.
Another misconception is how long dental bonding and porcelain veneers last. Patients seem divided on whether dental bonding lasts longer or if porcelain veneers last longer. On average, dental bonding lasts for a good five to seven years while dental veneers last for 15 years or more. They can last even longer as long as they are properly maintained. That is where another misconception comes in. If a dentist tells patients that porcelain veneers will last for 15 years, they think the veneers will just fall off after 15 years. That is not the case. Veneers do not come off for any reason. They get removed either because they fractured or there is leakage and recurrent decay underneath.
Dental bonding or porcelain veneers may not be recommended with patients who have problems with their occlusion (bite). If the patient’s occlusion has been traumatized either because their teeth do not line up or they have a habit like teeth grinding, neither dental bonding nor porcelain veneers may be suitable for them. The composite or porcelain will only fracture if placed in a traumatic environment. Composite wears easily while porcelain is brittle.
An alternative to both dental bonding and porcelain veneers is a dental implant. It is much stronger because it uses the bone as an anchor. However, it requires the removal of the entire tooth. The dentist will extract the tooth and replace it with an implant. A bridge may also be done to replace the extracted tooth but an implant is recommended more often, especially for the anterior teeth. The final choice depends on the patient’s case and his/her budget. Dental implants are more expensive than dental bonding, porcelain veneers, and fixed bridges.
There is not a lot of downtime with dental bonding and porcelain veneers as long as the dentist does the procedure properly. There are no eating restrictions after the treatment is finished. Patients are advised to practice meticulous oral hygiene in order for the restorations to last as long as they are supposed to, or even longer.
Porcelain veneers are resistant to staining. They do not change color over time. The patient’s teeth will get darker but the restorations will not. That is why patients who are planning to undergo teeth whitening are advised to do so first before getting their restorations. That way, the shade of the composite or porcelain will be matched to their already-whitened teeth.
Dental bonding lasts for an average of 5 to 7 years while porcelain veneers last 10 to 15 years. They might even last a lifetime as long as they were done properly and the patient does an excellent job of maintaining them.
Maintaining a mouth full of healthy teeth is a lifelong process. Practicing good oral hygiene and brushing on a regular basis are just two of the necessary steps to having a healthy and happy mouth. In cases where brushing does not succeed in keeping a patient’s teeth healthy, dental bonding and porcelain veneers are a good solution to fixing damaged teeth. Consult with an experienced doctor before making the final decision between dental bonding and porcelain veneers.
Written by Cosmetic Town Editorial Team - AA
Based on an exclusive interview with Dr. John Schmid in Austin, TX