Composite Veneers: Full Front-Surface Bonding

A direct composite veneer is built on the tooth in the chair; a laboratory-made one is shaped outside the mouth, then bonded on. In general, indirect veneers can be made in composite or in porcelain.

• Direct composite veneer: in general, composite is placed on the tooth in layers, each hardened with a curing light, then shaped and polished in the mouth.
• Laboratory-made (indirect) composite veneer: in general, the planned shape is made outside the mouth, where the composite can be hardened further, and the finished veneer is then bonded to the tooth.

Both direct bonding and indirect, laboratory-made composite veneers are available at Deepcar Dental Care. No laboratory work is sent overseas.

Freehand composite is sculpted by eye on the tooth; an indexed technique uses a silicone key copied from a wax-up to guide the shape. A wax-up is a model of the planned new shape. In general:

• Freehand sculpting: each layer of composite is built and shaped directly on the tooth, without a guide.
• Silicone key from a wax-up: a silicone key, or index, made from the wax-up guides where the composite goes.
• Injection moulding: flowable composite is injected into a clear silicone index placed over the teeth and light-cured, copying the wax-up with little or no tooth preparation.

What an index achieves is transfer of a planned design: technique articles describe injection moulding as a way to copy the planned wax-up shape into the mouth. Freehand work is shaped as it is built. One article describes freehand bonding with the natural layering concept, which uses only two composite masses, dentine and enamel, as well suited to patients after orthodontic treatment, where keeping tooth tissue matters, and to generally healthy teeth.

For direct composite veneers at the practice, the technique is chosen to suit the case. Options include freehand sculpting, a silicone key made from a wax-up, injection moulding, layering several shades, or a single shade. The material is a premium composite system selected to suit the case; our guide to dental composite materials explains how composites differ. A mock-up in the mouth lets you see the planned shape before you commit.

For direct composite veneers, the practice recommends a professional re-polish every 6 months, and their review appointment is 2 weeks after treatment.

Polishing matters because composite slowly loses its gloss, and a rougher surface holds more plaque. A six-year study of direct composite veneers found fine polishing at recall visits was needed to keep their appearance. The polishing page explains why some bonding stays shiny. At home, NHS cleaning advice applies:

• Brush twice a day for about 2 minutes, including last thing at night, with a toothpaste containing at least 1,350 ppm fluoride, then spit rather than rinse.
• Clean between your teeth with floss or interdental brushes.

Composite can also pick up stain, and in one seven-year study discolouration of front-tooth composite was linked to what patients drank.

If you grind your teeth, the practice requires a night guard alongside direct composite veneers, and the night guard is charged separately. The NHS says grinding can cause worn-down or broken teeth and loss of fillings, and advises seeing a dentist if you grind and have tooth damage or sensitive teeth. The night guards page covers a guard for grinding. For day-to-day care of bonding, browse the aftercare section.

The bonding cost page explains what it costs, and our finance page covers spreading the cost of treatment.