When most people think of “bonding,” they are thinking of tooth-colored dental fillings, or composite fillings. To be completely technical for a moment (I try to avoid that as much as possible to not bore you 😉 ), “bonding” is actually the series of steps and the products we dentists use to make the tooth-colored fillings actually STICK to the teeth. OK – technical moment is over. Whew, aren’t you glad of that?
An issue that many patients have experienced in the past, is that their new tooth-colored fillings seem to be mildly or even extremely sensitive to cold, and sometimes hot, foods and drinks, even just to tapping your teeth together. Naturally, it’s not a fun experience, and one that all conscientious dentists try to avoid for their patients, but even in 2009, when one would imagine there is a solution, many patients still run into this problem. Here’s the thing, though……..THERE IS A SOLUTION!
OK, you’re probably asking, if there’s a solution, why is it still a problem? Well, it’s simply a matter of technique, really, and getting the technique for bonding is actually more difficult than it might seem to be. In addition, just as in the rest of the world, there are MANY bonding products that dentists can use when doing tooth-colored fillings, but just because the companies that produce them supposedly have research behind these products, they’re not all they’re always promised to be. Some work better than others in strength, sensitivity, durability…..and it can honestly be rather tough to sort through all the stuff that companies throw at us, just like for physicians with all the stuff pharmaceutical companies throw at them. So it is CRITICAL that dentists really stay up on the latest research, but here’s the thing…..just because something has the “latest and greatest, newest and most improved,” labels all over it, that doesn’t mean it actually works as well as the old stuff all the time.
There’s one other REALLY CRITICAL FACTOR for long-term success of composite fillings, and that is keeping the teeth DRY while the bonding is placed and activated, then the filling material is layered into the tooth. Saliva contamination is one of the most common reasons for bonded fillings to be sensitive, and it’s also one of the most common reasons bonded composite fillings fail earlier than they should. There are a couple techniques dentists can and SHOULD use to do this – a Rubber Dam or something like the Isolite2 Dryfield Illuminator system. Both are pretty inexpensive for the dentist to have (we have both and use them as appropriate), both are pretty easy to use, and to tell the honest truth, they actually make it EASIER for us to complete your dental work faster and with better results. I really don’t know why not all dentists use 1 or the other; I can’t imagine practicing without them, ’cause it’s a lot harder to get good fillings!
So there you go: 2 of the most common reasons why bonded, tooth-colored, composite fillings are often sensitive to hot and cold foods/liquids or even just tapping your teeth together.
The good news in our office? I’m fortunate to actually know the man who basically INVENTED bonding, and I not only use the techniques he teaches, but I even use the most current materials that he himself has developed and/or recommends, and I can honestly say that ALMOST NOONE who gets tooth-colored fillings in my office ever has hot/cold sensitivity afterwards. There are rare exceptions, ’cause I’m not going to claim perfection, but they’re quite rare indeed.
I sure wish I had the HD video hookup for my dental microscope already, but since I don’t yet, I’ll keep showing you stuff with my Canon cameras. 🙂
One of the most incredible benefits of the microscope is the ability to work on levels of detail that aren’t even imaginable without one. And that means that I can do VERY VERY VERY VERY SMALL, CONSERVATIVE fillings. I use teensy little burs to remove the absolute minimum amount of tooth structure, not really big ones that dig out way more than necessary. I just wanted to show you an example of how this looks using a patient from this morning; the benefits of this are pretty obvious:
You know, dentistry can be a very challenging job: working on very small teeth, teeth, tongue, cheeks, saliva all trying to get in the way, patient fears…..some days dentistry wears you out.
But other days like today? Wow, I had a patient come in this morning for whom we’d done a big tooth-colored filling (bonding) on her upper left eye-tooth a couple weeks ago. It had been really obvious in her smile, a big brown hole in the tooth that she had to hide every time she smiled, and trust me…….this is a lady who likes to smile a LOT. When we finished the bonding that day, she almost burst into tears of happiness, because she could smile with confidence again.
Honestly, this testimonial is the reason cosmetic dentistry is so big, whether it’s porcelain veneers, bonding, Six-Month Smiles (getting your teeth straight in only 6 months really is possible!), teeth whitening……read for yourself why I love what I do, even with all the challenges:
“After 17 years of being terrified of the dentist and avoiding simple preventive office visits, my smile had become my enemy. For years now, I have covered my mouth when I laughed and smiled, even avoided social settings.
Dr. Payet and his staff have been wonderful to me and have made me feel very comfortable while in the office. in just two visits they have given me so much to smile about! I almost bust into tears of joy when I smile in front of a mirror, and find myself in front of many mirrors lately! Dr. Payet has restored my confidence and for that I am truly grateful to him and everyone in his office! Thank you so much!
In our office, as I’ve demonstrated many times before, we use the power of digital dental photography to improve patient understanding of what’s going on in their mouths. Truly, as the 2 sayings go:
- Seeing is Believing, and
- A Picture is worth 1000 words.
I’ve added a new page to our website along these lines, and I hope you’ll enjoy it: Smiles by Payet Dental Photography
It’s still a work in progress, so please bear with me – more to come!