Bonding, Whitening & Inlays

Dental Bonding

Dental bonding is one of the most versatile and least invasive procedures in cosmetic dentistry. A tooth-colored composite resin is applied directly to the tooth surface, sculpted by hand to the desired shape, and hardened with a curing light. The entire process typically takes 30 to 60 minutes per tooth, requires little or no anesthesia, and preserves virtually all of the natural tooth structure.

The material used is a composite resin -- a mixture of acrylic monomer and finely ground glass or ceramic particles. It starts as a pliable paste that can be shaped and layered on the tooth surface, then polymerizes into a rigid solid when exposed to a blue LED curing light. Modern composites are available in dozens of shades and translucencies, allowing precise color matching to the surrounding natural teeth.

Common Uses for Bonding

Bonding is well suited to a range of cosmetic and minor restorative problems. Chipped or fractured front teeth are the most frequent indication -- a small chip on the biting edge of an incisor can be rebuilt in a single visit with no drilling and no anesthesia. Gaps between teeth that are too narrow for orthodontic correction can be closed by adding composite to the adjacent tooth surfaces. Teeth that appear too short, too narrow, or irregularly shaped can be recontoured to create better symmetry and proportion.

Bonding also works well to cover exposed root surfaces in patients with gum recession, reducing sensitivity and improving the appearance of the gumline. In some cases, bonding serves as a trial run for patients considering veneers -- the composite can simulate the shape and size changes that veneers would provide, giving the patient a preview before committing to a more permanent restoration.

The Bonding Process

The procedure begins with shade selection using a shade guide to identify the composite color that most closely matches your natural teeth. The enamel surface is etched with a mild phosphoric acid gel for about 15 seconds, creating a microscopically rough texture. A liquid bonding agent is applied and light-cured, forming an adhesive layer. Composite resin is then placed in small increments, each one shaped with hand instruments and cured before the next layer is added.

Once the final layer is cured, Dr. Rasmussen trims and contours the composite with fine diamond burs and finishing disks, checking the bite and making adjustments until the tooth feels natural when you close. The surface is polished to a smooth luster that blends with the surrounding enamel.

Longevity and Care

Composite resin is softer than porcelain and more susceptible to staining and wear. Coffee, tea, red wine, and tobacco can gradually discolor the bonded surface over months and years. Patients with bonded teeth should brush with a non-abrasive toothpaste and avoid habits that place concentrated force on the bonding -- biting fingernails, chewing ice, opening packages with the teeth. With attentive care, bonded restorations typically last five to ten years before requiring replacement or refinishing.

Teeth Whitening

Tooth discoloration is one of the most common cosmetic complaints patients bring to our office. Coffee, tea, red wine, tobacco, and simple aging gradually shift teeth from bright white toward yellow, brown, or gray. In many cases, professional whitening can reverse years of accumulated staining in a matter of days without altering tooth structure.

Not all discoloration responds equally to bleaching agents. Extrinsic stains that sit on or just below the enamel surface tend to respond well. Intrinsic stains caused by tetracycline exposure during tooth development, excessive fluoride intake, or trauma to the pulp may lighten but rarely disappear completely with whitening alone. Dr. Rasmussen will evaluate your discoloration and give you an honest assessment of what whitening can achieve for your teeth.

Professional vs. Over-the-Counter

Drugstore whitening strips and paint-on gels contain low concentrations of hydrogen peroxide -- typically between 3 and 10 percent. They can produce modest improvement over several weeks, but one-size-fits-all trays allow uneven contact with the tooth surface, and results tend to be inconsistent from tooth to tooth.

Professional whitening uses higher-concentration agents -- 15 to 40 percent hydrogen peroxide or 10 to 38 percent carbamide peroxide -- delivered in custom-fitted trays or applied directly by the clinician. The custom tray ensures full, even coverage of every tooth surface while keeping the bleaching gel away from the gum tissue. Before treatment begins, Dr. Rasmussen checks for untreated cavities, cracked teeth, and gum recession, because bleaching gel that contacts damaged surfaces causes significant sensitivity.

In-Office Whitening

In-office whitening is performed in a single appointment lasting approximately 60 to 90 minutes. A protective barrier is placed over the gums, and a high-concentration hydrogen peroxide gel is applied to the enamel surfaces in two or three 15- to 20-minute cycles. Patients walk out of the appointment with teeth that are noticeably lighter. Some transient sensitivity to cold temperatures is common for 24 to 48 hours following the procedure.

Take-Home Whitening

For patients who prefer a more gradual approach, Dr. Rasmussen provides custom take-home whitening trays fabricated from digital scans of your teeth. The trays hold a consistent layer of carbamide peroxide gel against every tooth surface. You wear the trays for 30 minutes to several hours per day, depending on the concentration prescribed and your sensitivity threshold. Most patients reach their desired shade within one to two weeks of daily use. The trays last for years, so you can purchase additional gel syringes for periodic touch-ups without needing new impressions.

Maintaining Whitening Results

Teeth will gradually re-accumulate stain after whitening. How quickly depends on diet, tobacco use, and oral hygiene habits. Limiting deeply pigmented beverages, rinsing with water after consuming coffee or red wine, and brushing twice daily will slow the process considerably. Most patients find that a brief touch-up with their take-home trays every six to twelve months is enough to maintain the shade they achieved during initial treatment.

Inlays & Onlays

Inlays and onlays are indirect restorations -- fabricated in a dental laboratory and bonded into the tooth at a subsequent appointment -- that fill the space between a simple filling and a full crown. They are used when a tooth has sustained too much damage for a direct composite filling to provide adequate strength, but not so much damage that a full crown is necessary.

When Inlays and Onlays Are Indicated

A large cavity or fracture on a back tooth often removes enough tooth structure that a filling, even a bonded composite, will not hold up under the heavy chewing forces concentrated on molars and premolars. The remaining walls of the tooth flex under load, which causes the filling to crack or the tooth to fracture further. An inlay or onlay distributes those forces more effectively because it is a rigid, precision-fitted piece of ceramic or composite that is bonded to the remaining tooth structure.

The distinction between the two is coverage. An inlay fits within the cusps of the tooth, filling the space between them. An onlay extends over one or more cusps, providing additional coverage and reinforcement where the tooth has lost structural support. Both preserve significantly more healthy tooth structure than a full crown, which requires reducing the entire outer surface of the tooth.

Materials

Dr. Rasmussen fabricates inlays and onlays from pressed or milled ceramics -- typically lithium disilicate (e.max) or zirconia -- depending on the functional and aesthetic demands of the tooth. Ceramic inlays and onlays are tooth-colored, stain-resistant, and wear at a rate similar to natural enamel. Their strength-to-thickness ratio is superior to direct composite, allowing thinner restorations that preserve more tooth structure.

The Process

At the first appointment, any decay or defective filling material is removed, and the tooth is shaped to receive the inlay or onlay. A digital scan captures the preparation and surrounding teeth, and the data is sent to the laboratory. A provisional restoration protects the tooth during the fabrication period, which typically runs seven to ten business days.

At the delivery appointment, the provisional is removed and the ceramic restoration is tried in. Dr. Rasmussen checks the fit under magnification, verifies the contacts with adjacent teeth, adjusts the bite, and then bonds the restoration in place using an adhesive resin cement. The bonding process creates a sealed, gap-free junction between the ceramic and the tooth, preventing bacteria from penetrating the margin and strengthening the overall tooth structure.

With proper oral hygiene and regular dental visits, ceramic inlays and onlays routinely last fifteen years or more -- comparable to the longevity of a full crown, but with the advantage of preserving substantially more of the natural tooth.