I have anxiety and cannot be numbed up. For the most part my bonding is still very much in tact. I would just like it touched up if possible to whiten my front teeth. Is this possible to do without having to drill out the teeth and start over again? Any opinions on whiteners like Supersmile that are supposed to whiten these dental bonds?
Old Bonding Has Discolored. Can This Be Retouched Up Without Drilling?
Doctor Answers 23
Retouching old bonding
While not the ideal way to do it, it is possible to add to old composite bonding material. If the areas to be
retouched aren't too extensive, it's also possible to do it comfortably without being numb. I would want to roughen the old bonding surface first though, and that means using a drill at least a little. This is done to get the best bond of new material to old. Composite filling material (bonding) can often extend further and deeper than it appears, so changing large areas could become uncomfortable without anesthetic. It depends on how much bonding was originally done. As for whiteners, they really only work well on tooth structure, not bonding.
You can touch up or repair old bonding.
Depending on the condition and amount of unsightly, damaged, or discolored bonding, you can repair most bonding if it had looked good to begin with. It normally can be done comfortably without the need for anesthesia. No tooth structure need be removed/ prepared in the process. If the problem is mainly discoloration some of the discolored surface material should be removed. Unless the discoloration is due to surface stains then whitening will generally not work.
Retouching discolored bonding
Older bonding materials were notorious for discoloring over time. Modern composite bonding materials are far more color stable and resist staining than the older tooth colored materials. If the material itself has discolored and there is no evidence of recurrent decay then simply abrading and polishing the surface of the filling may return the resoration to it's original appearance. If an x-ray reveals decay under or around the filling or a dark line or opening is seen along the outer edges of the filling, then replacement is necessary. Toothpastes and whitening products have little to no effect on tooth colored restorations. Products which are abrasive enough to remove stains from fillings are far more damaging to natural tooth enamel. I have found that patients hesitant to have the old restoration "drilled out" are usually anxious about having a painful experience. Ask your dentist which method of anesthesia is best for your level of anxiety, not all methods require a "shot".
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SuperSmile Toothpaste is great for maintenance care.
Great question about re- bonding to old composite. It is always challenging. The main reason is that the old composites are saturated with saliva. To re-bond you need non contaminated enamel. Sometimes you can do a little spot and need a sand blaster to remove the outer layer. My experience has been that removing the old composite and providing a clean surface guarantees a great result that will last.
I suggest having the bonding polished professionally and use Supersmile Toothpaste to see how the bonding looks. Decide why you need to rebond-for better color? for stain? for fit? Then make your decision based on the facts. Bonding is reliable and a great conservative solution to many dental issues. Good luck!! Dr. Wendy Spektor
Touching up Bonding
Bonding material will absorb color and stain or darken over the years. If the color is still pleasing to you, then bonding can be touched up to repair areas of wear. However, bonding cannot be bleached out or whitened with toothpastes or even professional whitening systems.
If they had to numb you the first time to do your bonding, then I am assuming the dentist removed some enamel off the front of your teeth. This is sometimes needed in a small percentage of situations. More commonly, bonding is done without numbing.
Touch up old bonding
If the stains are very superficial they may be able to be removed with polishing burs/discs. This could give some new life to the bonding.
If the stains are deeper or show on the margins you may be able to patch them up with minimal prepping but the issue may be a difference in the material that was used years ago to what is used now. Different types of composite (the material used in bonding) have different properties and that is especially true with old versus new composite filling material. So while there can be a "best match" the difference in the materials may not allow this to blend perfectly.
If you elect to have the bonding completely replaced, if the enamel was not or minimally removed during the original bonding then there should be minimal sensitivity during the procedure. If the underlying tooth (dentin) is exposed, you could have significant sensitivity or discomfort.
Discolored old bonding
A few things to consider: How did you have your teeth bonded the first time? How old is the original bonding? What are your habits (coffee, tea, red wine, tobacco use, etc)? Have you tried or considered some sort of sedation option (nitrous oxide, happy pills, IV sedation)? Assuming there are no underlying issues with the teeth (sensitivity, decay, open margins, etc), and that this is purely a color issue, the bonding can, in most cases, be re-surfaced without the use of any anesthetic to brighten your smile. Look for a highly skilled cosmetic dentist to help you achieve your dental goals.
Re-bonding without Freezing or use of Drill
Very frequently you can avoid being frozen for certain fillings including ones that only need to be changed due to discolouration. The use of an Erbium Laser (Hard tissue laser) can eliminate the need for any freezing but majority of dentist do not use such lasers. If the filling in question does not have a cavity and is stable then only the top layer might be needed to be removed and replaced with a lighter shade. Such approach is more superficial not requiring the need to replace the entire filling, hence no local anesthetics would be required.
Re-surfacing old bonding can be Painless
The great thing about a lot of bonding procedures is that they are usually painless. The other thing is that old bonded fillings can be repaired/re-newed. As long as there isn't any sign of bacterial leakage under the old bonding, the surface can be polished or re-surfaced to make it look as good as new.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.