Bonding Maxillary and Mandibular Anterior Teeth - Dental Minute with Steven T. Cutbirth, DDS

[@user-fishodontist]

Watching these awesome videos is a scholarship for me

[@centerforard]

Glad you like them! Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month.

[@mrroache5169]

Greetings from England, I really enjoy your videos Doc, and will implement your tips

[@centerforard]

Glad you like them! Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513

[@SomeoneWhoCares-jm7lj]

I’m so glad I found this channel. Plus I have some dent in my front teeth, not a decay but due to clenching at night. I went to dentist and she said composite bonding not going to work for me since I’m grinding my teeth. I asked what if I wear night guard it will help and she said NO! Started to push me getting veneers and Invisalign. Now I see bonding can be done!

[@centerforard]

Glad the video was helpful. The nightguard is the key, along with not biting anything harder than a tunafish sandwich or hamburger with your front teeth. That is true of almost anyone, even if the teeth are natural and non-restored. The biting angle of the front teeth is not good for biting hard things.

[@SomeoneWhoCares-jm7lj]

@@centerforardthank you for reply! Seeing another dentist who I found and who does bonding. Can wait to get my night guard. I’m 38 and due to a lot of stresses for last 3 years started to notice my teeth are wearing down. Did some research and figured out I need night guard. So far using over the counter one till can get one from dentist.

[@centerforard]

If the teeth were restored with composite bonding, the methods I present in the video should be followed. A conservative preparation must be cut in the flat, worn dentin to place the composite. If the composite restoration is placed directly on the flat, worn dentin, it will break off. The conservative "lug" or "ditch" cut into the flat dentin protects the restoration, but you still must wear a nightguard and not grind your teeth during the day or you will wear the incisal edges of the anterior teeth again. There are several important parts of the equation to make a composite restoration on the incisala edges of worn/chipped anterior teeth hold up. You do not think of a composite restoration on the incisal edges of worn/chipped anterior teeth as a long term fix. They will probably have to be replaced periodically due to breakage of stain.

[@LeNguyen-nl1dk]

Hello Doc! Would you charge this procedures as fillings, or do they cost more?

[@centerforard]

They are anterior composites. They normally cost more than a routine filling because they also have to be cosmetic.

[@Overdrivepony]

Are there any new or soon to be released composite products that promise lasting longer than current products? Perhaps some that could outlast a few nights without the night guard?

[@centerforard]

I'm not aware of any. If the patient wears and chips their natural teeth, they will do the same thing with most restorative materials. You bring up an interesting point. If pressure is placed on something, something has to bend, loosen or break. In the case of a tooth, if a person places pressure on the tooth/root/restorative material, either the tooth, restorative material or root must break or the tooth must become loose, i.e., the bone around the tooth weakens. For that reason, I am not a big fan of all zirconia crowns. If the patient places extreme force on the zirconia crown through clinching/grinding, then either the tooth has to break or the bone around the tooth must weaken and the tooth become loose. Bottom line, something has to give if the patient is a big clincher/bruxer. For that reason most of my patients have night guards and certainly all the patients with anterior restorations (incisal composites, veneers, etc.) I cannot force them to wear the Nightguard, but if they do not, and they continue to clinch and grind while sleeping, they will absolutely break the anterior restoration, just like they did their teeth. I make this crystal clear, in writing, any time I am placing an anterior restoration. In another example, if an all-on-4 prosthesis is made of solid zirconia, any grinding/clinching pressure will be placed on the bone around the implants because the zirconia prosthesis and titanium implants will not fracture, so the bone around the implants becomes the "weakest point." For that reason, the teeth on the all-on-4 prosthesis are often processed acrylic vs. zirconia if the patient is a big bruxer/clincher so the "weak point" is the teeth in the prosthesis and not the bone around the implants. Many dentists do not understand building in a most favorable "break point." You would rather have a tooth break off the prosthesis than an implant loosen. I hope this makes sense. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513

[@Overdrivepony]

That makes complete sense. Thank you very much for the explanation!

[@Nehakumari-in9wh]

What is treatment plan for the posterior teeth bruxism ?

[@centerforard]

Nightguard for sure to stop the damage, then decide if the teeth need to be restored. If they do need restoration due to severe wear, then you are probably looking at a full mouth restoration and increasing the vertical dimension (opening the bite). I have several full mouth restoration increasing vertical dimension cases in the library of DMC.com on complete comprehensive cases. These cases are not for the novice! They are very complicated and the maintenance is serious. Severe wear cases are like restoring a race car due to the extreme pressure placed on the teeth because the patient will probably continue to brux and grind their teeth. A night guard worn every time the patient sleeps is mandatory. Do not get into the restoration of a severe wear case casually. You must be very proficient in occlusion. Very technically demanding cases and the post op maintenance is extreme. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513

[@redpoppy3569]

What about cracks in a tooth? Straight vertical line like one tooth in this video?

[@centerforard]

Go see a good dentist and get it fixed.

[@Overdrivepony]

Hello Dr. Cutbirth. Your videos are amazingly informative for someone going through what I am. Bad TMJ disorder for years, sinus congestion, apnea, fullness behind right eye and ear, tinnitus, headaches, clenching and grinding. Got a nightguard but the damage has been done. I’ve been looking into LVI treatment to make more room for my tongue, widen arch and correct my bite. I’ve been looking at possible restorations once the braces are off. Can more profoundly chipped teeth be properly lengthened using this bonding technique if the teeth have been made perfectly straight from ortho? The hope is grinding pattern would be different and hopefully wouldn’t happen as much with a corrected TMJD and bite.

[@centerforard]

Sorry, I cannot diagnose your condition without examining you.

[@Overdrivepony]

I would love for that to happen. I’m in Canada and it would be a bit of trek, but possible. I love how informative these videos are and they answer so many questions. Anxiety still exists but less so because of them. Thank you, again.

[@centerforard]

You are welcome.

[@johnpearson6087]

so this process isnt revericible mine have chiped all up and i hate it been 6 months and would like my old bite back

[@centerforard]

Are you wearing a night guard? If you do not wear a night guard and you continue to grind your teeth (bruxism), of course you are going to do the same thing to the composite bonding you did to your teeth. Wear a night guard every night.

[@redpoppy3569]

Where do we find dentists who'll do the work using this method? I'm in NYC.

[@centerforard]

I do not know.

[@redpoppy3569]

@@centerforard ok thanks

[@KatrinaDancer]

Amen! I'm lucky to be easily numbed but several of my friends have never had a dentist get them successfully numbed. One of them even suffered through a root canal that way!

[@centerforard]

Wow! Sorry. Watch my videos on "Painless and Profound Local Anesthesia."

[@alymohamedalygamaleldin4966]

Hallo dr , I have read before that flowable composite shouldn’t be placed more than 1mm is that right ? Can we depend only on flowable In case of attrition or should we place highly filled composite also . Thanks for these informative videos 🙌🏼

[@centerforard]

Flowable has almost as much filler as highly filled and it flows into the space better with class 5 restorations. I place all composites in 1-2mm increments, then cure. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513

[@artistheart5272]

Why do dentists claim to lengthen incisors with dental bonding and widen teeth or make teeth larger to fix gaps?

[@centerforard]

I don't know. I fix chips on anterior teeth with composite bonding, but never make the overall tooth longer with bonding because, with my capabilities, it doesn't hold up and I don't want to be constantly repairing the broken bonding. If I am lengthening the entire anterior tooth, I do it with veneers. Even then, the patient must wear a Nightguard while sleeping to protect from bruxism. Just like natural teeth, any tooth colored restoration can fracture, but veneers and crowns on anterior teeth are very durable if the patient is not like "a bull in a china shop" and is careful with biting, does not bite hard things with their front teeth and wears the Nightguard.

[@redpoppy3569]

Can patient wear nightguard if has loose teeth? What about daytime?

[@iddicted]

Loose??

[@centerforard]

It's complicated. I suggest you go see a good dentist for an exam and consultation.

[@MyGabriella21]

Hello! I might be wrong, but isn’t composite placing based on adhesive conseption and no macro retention areas are needed no matter what situation? Thank you for yor answer!

[@centerforard]

If you place the composite directly on top of the worn area, the patient will quickly wear the composite restorations off again, just like they wore away the tooth structure. This is common sense. You must protect the composite by placing it it a shallow digit in the incisal edge of the tooth, along with a nightguard, if you wish for the composite to last. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month.

[@mustafaalkotobe7741]

3rd thank you

[@centerforard]

Welcome!

[@ToanNguyen-kk1rs]

2nd. Thank you

[@centerforard]

Welcome!

[@redpoppy3569]

Some people sleep with mouth open and on their back. Some have hard bite. Some have misaligned jaw. Poor nutrition and poor hygiene weakens teeth as does sugar. Gum chewing wears away teeth. Some people grind teeth on food, including candy, etc.

[@centerforard]

Correct. What is your point.