Composite Bonding Compared With Amalgam Fillings for Crooked Teeth

Where Composite Bonding Fits

Composite bonding uses a tooth-coloured resin that is formed directly onto the tooth. Your dentist can use this to repair a minor chip or build up a slightly uneven edge, which can make a mildly crooked tooth appear more balanced without physically repositioning the tooth.

A Small Change Can Look Different

Imagine one front tooth is a little tucked back behind the other, with the discrepancy being on the lesser side. Adding composite to the right area can make the smile look more even from the front, although the tooth hasn’t technically moved.

This is where I prefer composite bonding over amalgam for visible dental work, since amalgam has that unappealing silver-greige colour and using it in an area where people would see it doesn’t make much sense, unless there’s a strong clinical reason for it.

What Amalgam Can and Can’t Do

Amalgam fillings have been used for decades, and have long been associated with restoring teeth that have decayed. They’re designed to replace lost tooth material and hold up to the forces put on them during chewing. They’re not meant for reshaping crooked teeth for cosmetic reasons, however.

So if a patient has a crooked molar with decay, an amalgam filling might replace the decayed material and restore the tooth without attempting to change the position of the tooth. If the same issue occurs but with a front tooth and cosmetic concerns are an issue, composite bonding would be the more suitable option.

What Actually Changes the Position?

Orthodontic treatment is what changes the position of the teeth. Bonding simply changes the visible shape.

• Minor unevenness can sometimes be disguised with composite bonding, especially if the tooth only requires a modest change in shape.

• A severely crooked tooth requires more than a cosmetic build-up and attempting to force the shape onto it with bonding could be a poor decision.

• Amalgam fillings are aimed at restoring lost tooth structure and are not designed for improving the alignment of the teeth, making them not the best option for reshaping.

What About Enamel Removal?

One of the reasons some people prefer composite bonding is that it often requires little or no removal of healthy enamel. The dentist prepares the area so that the composite can adhere to it, then shapes and polishes the bonding material.

With crooked teeth, however, there has to be a degree of space created to accommodate the added material. So if a tooth is already sitting snugly next to another one, simply adding composite material to it could cause a lumpy appearance and/or interfere with the occlusion of the two teeth.

So, Which Makes More Sense?

If a crooked tooth also needs to have a filling and the tooth is visible, composite bonding is generally a more sensible cosmetic choice. It blends well with natural enamel and gives the dentist much more control over the final shape.

But don’t count on bonding as a substitute for orthodontics when the tooth is genuinely out of position, as that’s asking the filling to do a job that it wasn’t made to do.

Sometimes the smallest change is enough, and sometimes you really do need to move the tooth. The ability to tell the difference is the part that makes all the difference.