Composite build-ups for tooth wear

Information about composite build-ups for tooth wear and your treatment with Bristol Dental School.

Composite build-ups (also known as composite bonding) refers to using tooth coloured filling material to build up several teeth. This type of treatment is often used to restore worn teeth to improve appearance, restore function and protect the remaining tooth underneath. 

Why do I need composite build-ups for tooth wear

Composite build-ups are usually recommended for treating tooth wear that is localised (affecting some but not all teeth). If tooth wear is generalised (affects all teeth) more complex treatment is often required. 

Only teeth with enough remaining tooth tissue can be restored using composite build-ups. Teeth with severe wear cannot be built up using this method. 

Treatment

Planning 

Moulds of your teeth are taken using a putty-like substance. A measuring device (called a Facebow) is used to record the position of your jaws. The moulds and Facebow are used in the dental lab to plan how much the teeth need to be built up. 

Wax-up 

In the dental lab, models of your teeth are made and wax is used to build them up to the right shape and size. A stent (guide) is made so the wax-up plan can be transferred onto your teeth. 

Try-in

You can review the wax up and it can be tried in your mouth using temporary filling material. This allows you to see how it will look before treatment. 

Tooth build-ups

Your teeth will be built up with white filling material using the stent to help. This part of treatment is often done under rubber dam – a rubber sheet that is placed over your teeth to keep them dry during treatment. This phase of treatment is either completed in one long appointment, or split over two appointments.

Advantages

No tooth preparation

Composite filling material sticks directly to teeth without needing to drill them. This preserves the underlying tooth tissue from any further damage. 

Appearance

Excellent aesthetic results can be achieved using composite filling materials.

Filling loss

If a filling is lost, the bond breaks between the tooth-filling junction. This means that its very unlikely for the underlying tooth to be damaged if a filling breaks off. 

Repair

Composite material can be repaired and added to if fillings are fractured or lost. 

Risks 

Bite changes  
  • Only worn teeth will be built-up, which means some teeth (usually the back teeth) will temporarily not meet after treatment.  
  • This can feel strange at first, but most patients become accustomed to it in 1-2 weeks.
  • This bite change is temporary and your untreated teeth will erupt (move downwards/upwards) until they are meeting in the bite again.  
  • It usually takes 6-7 months for the bite to stabilise again, however it can take up to 24 months in some patients. 
  • Sometimes some of the teeth may not meet again – this has not shown to affect long-term appearance or function. 
Survival
  • Composite build-ups for worn teeth last on average for 5-6 years. However, they are at risk of fracture, discolouration and chipping therefore long term maintenance is required. 

 

What happens after treatment has finished

A review appointment will be arranged to check your bite settles following treatment.  

When all of your dental treatment is complete, you will be discharged from the dental school. We advise that you find a dentist outside the dental school to continue to look after your teeth and restorations. 

Questions you may want to ask

  • Which of my teeth need to be built up? 
  • How can I clean my composite build-ups? 
  • What should I do if a filling breaks? 
  • What can I do to prevent further tooth wear? 

Maintaining good oral hygiene at home

Maintaining good oral hygiene is crucial for healthy teeth and gums, and will help reduce the risk of decay and gum disease. Brush your teeth twice daily for 2 minutes with fluoride toothpaste and clean between your teeth with floss or interdental brushes.

Smoking and alcohol increase the risk of oral disease. If you want to quit smoking or reduce your alcohol intake, please talk to the clinician you see for further advice.

It is important to attend dental check-ups regularly, as this will help your dentist to identify any dental disease early.