Composite Bonding

Where it may be suitable

• Small chips or broken edges on front teeth
• Small and medium-sized gaps between teeth
• Teeth whose length or shape differs from their neighbours
• Front teeth with worn edges (the cause of the wear is assessed first)

Where another option should be considered first

• The overall colour of your teeth. If the concern is the colour of all your teeth, teeth whitening is done without adding anything to the tooth. Whitening does not lighten composite, crowns or veneers the way it lightens natural teeth², so whitening done after bonding can leave a colour mismatch.
• Crowded teeth, wide gaps or a bite problem. Bonding does not move teeth; it only changes their shape. Closing a wide gap with composite alone makes the teeth look wider than they are. In that case orthodontics or a combined plan is considered.
• Untreated decay or gum disease. These problems need to be treated¹ first.
• Extensive loss of tooth structure. If a large part of the tooth has been lost, composite may not be enough; a partial restoration or a crown is discussed.

Where extra care is needed

• Clenching or grinding, or a deep bite. In these cases a veneer, composite or porcelain, may not be a suitable option¹. A two-year randomised study comparing composite with ceramic did not include³ patients who clench their teeth, so its results cannot be applied to them. Your dentist may recommend a night guard.
• Worn teeth. Before composite is added, the cause of the wear is assessed, such as clenching or acidic drinks. For example, in a laboratory test every flavoured sparkling water examined showed an erosive effect similar to or greater than orange juice⁴.
• Root-filled teeth. At a university clinic, 196 direct composite veneers were followed for an average of 3.5 years. In this retrospective study, about 5 in every 100 veneers on living teeth failed each year, and about 10 in every 100 on root-filled teeth⁵. The main cause was fracture of the veneer. This does not mean that a root-filled tooth cannot be bonded.

The right option is decided at an examination, with X-rays assessed where needed.

• Doing nothing. If a small chipped edge or gap does not bother you and there is no underlying disease, leaving it alone is a valid option.
• Teeth whitening. If the only concern is colour, it is done without adding anything to the tooth surface. Its effect is not permanent⁶; the colour partly returns over time.
• Orthodontics. It does not change the shape of the teeth; it moves them to correct their position and the bite. It is used for gaps, crowding and bite problems; see our pages on braces and Invisalign clear aligners. It takes months, and afterwards retainers are needed for a long time to hold the teeth in place. A small retrospective study followed 30 patients whose gap between the two upper front teeth had been closed with orthodontics. On average 5 to 6 years after the patients stopped wearing retainers, the gap had reopened in 60% of patients⁷. This rate does not apply to every gap between teeth.
• Bonding or a composite veneer. The composite is shaped in the mouth, directly on the tooth. It can correct a chip, the shape and a gap at the same time.
• Porcelain (ceramic) veneer. It is made in a laboratory and usually needs more than one appointment. In most cases a thin layer of enamel is removed from the tooth for the veneer, and this cannot be undone⁸. See our porcelain veneers page for details.
• Laboratory-made (indirect) composite veneer. The composite is shaped in a laboratory rather than in the mouth and then bonded to the tooth. In a ten-year randomised study these veneers failed more often than ceramic ones: survival was 75% for indirect composite and 100% for ceramic⁹. The study was small: 24 veneers of each kind, and all 6 failures were composite. It does not show that ceramic veneers never fail, and its result does not apply to bonding done in the mouth.

The options can also be combined: for example, after the teeth have been aligned with orthodontics, bonding can refine their shape.

All of these options are also available from dentists in the UK, and a UK dentist can give you an independent opinion before you decide. You can say no, or ask to stop, at any stage. Once a tooth has been prepared, ask what would happen if treatment stopped at that point.

The steps below are for bonding done directly in the mouth. A small repair can be completed in one appointment¹; the more teeth are treated, the longer it takes. Your dentist decides whether a local anaesthetic is needed, depending on the extent of the work. How the appointments fit a trip is covered in "Treatment in Antalya when you live in the UK".

Shade selection is one of the steps that determine the result. Choosing a shade by eye is subjective. In two meta-analyses, selection with digital photography came closer to the target shade¹⁰ than selection by eye. For spectrophotometers (devices that measure tooth colour) the two disagreed: one found an advantage, the other did not¹¹; the studies are few and small.

Risks and disadvantages

• It is not fully reversible. The tooth surface is treated so the composite can hold, and sometimes a small amount of tissue is reshaped. Veneers, including composite veneers, are not designed to be removed¹. Composite may require less enamel to be removed⁸ than porcelain. Even so, tissue removed from the tooth does not grow back, and the procedure does not count as reversible without a trace.
• Staining and wear. Composite resists staining and wear less well⁸ than porcelain. Staining can appear at the edges over time.
• Chipping and debonding. Composite or porcelain, any veneer can chip, crack or come off¹² over time. It then needs to be rebonded, repaired or replaced. A review looked at 17 studies on composite restorations in front teeth. The most common reason for failure was fracture of the tooth or the restoration¹³. Nail biting and biting on hard objects increase the risk.
• Appearance problems. In the same review, failures due to colour, shape and surface staining were more common in restorations done for cosmetic reasons. The colour of a veneer cannot be changed¹ once it has been bonded. If the colour of the surrounding natural teeth changes over time, the match may be lost.
• Sensitivity. If enamel has been reshaped, the tooth may be more sensitive.
• Gums and decay. If the edge of the composite near the gum is not cleaned well, gum inflammation or new decay at the edge can develop.

Benefits

• It can be done with very little tissue removed from the tooth, or with no drilling at all.
• No laboratory is needed; small procedures are often finished in a single appointment.
• When damaged, it is easier to repair⁸ than porcelain. Small chips can be repaired; sometimes a new veneer is needed¹².

Bonding usually needs no recovery time. If you had a local anaesthetic, do not eat until it has worn off. If your bite feels high in the first few days, tell your dentist; it can be adjusted.

Day-to-day care

• Brush your teeth twice a day with a fluoride toothpaste; clean between your teeth every day with floss or an interdental brush.
• Do not bite hard things such as nails, pens or very hard foods with your front teeth; cut hard foods into small pieces.
• Tea, coffee and tobacco can increase staining of composite.
• If you clench or grind your teeth, tell your dentist; they may recommend a night guard.
• Keep up regular check-ups. Once you are back in the UK, these are usually with a dentist in the UK.

In short: most composite veneers stay in place for several years, but they need repair or replacement more often than porcelain. No single number of years can be given. The figures below come from published studies, not from the clinic's own results. Studies measure "lasting" in different ways; we state next to each rate what it counts. A rate of veneers staying in place does not mean that there were no problems or no repairs during that time. The research is mostly on composite veneers that cover the whole front surface of the tooth. Our sources give no separate rate for small edge repairs, so we do not give a figure for them.

Composite veneers. A meta-analysis looked at composite laminate veneers made both in the mouth and in the laboratory. It pooled the results of the randomised studies it included. Their average follow-up ranged from 2 to 8 years, and about 88 in every 100 veneers stayed in place¹⁴. The problems reported most often were surface roughness, colour mismatch and staining at the edges.

Composite or porcelain? A two-year randomised study included selected patients with gaps between several teeth. One assessment also counted chips as failures. In it, about 93 in every 100 composite veneers and 95 in every 100 ceramic veneers³ were counted as surviving at two years. The difference was not significant. In the composite group, 4 veneers needed repair³, and staining at the edges was more common with composite.

In a retrospective study of 1,459 veneers at a single dental practice, followed for up to 10 years, composite needed repair or replacement more often. Counting repaired and replaced veneers together, the estimated yearly rate over the ten years was about 10 in every 100 veneers for composite and about 3 for ceramic¹⁵. Counting replaced veneers only, the yearly rates were about 4 in every 100 for composite and about 1 for ceramic. These are average rates per year, not the share of veneers that failed over the whole ten years. Because this study was not randomised, it does not show that the difference comes from the material alone.

In both comparisons we have, the numbers favour porcelain. But in the two-year randomised study the difference was not significant, and the ten-year data come from a single non-randomised study. So it has been shown neither that composite lasts as long as porcelain nor that porcelain lasts longer for every patient. Porcelain veneers are not problem-free either. A meta-analysis pooled 29 studies of ceramic veneers. At an average follow-up of 10.4 years, 4.3% of ceramic veneers cracked, 3.5% chipped and 2.5% fractured completely¹⁶. In 2.2%, the veneer came off. The results varied widely between the studies.

Worn front teeth. A meta-analysis pooled 6 studies (141 patients, follow-up from 5 months to 10 years). They looked at repairing worn front teeth with composite placed in the mouth or made in the laboratory. Over 2 to 10 years of follow-up, 88 in every 100 restorations stayed in place, and 68 met the researchers' stricter success criterion¹⁷. The differences between the studies are very large. The authors recommend telling patients that these restorations will need monitoring, repair or replacement in the long term.

Repair or replace? Studies comparing the repair of defective direct fillings with their replacement found no significant difference¹⁸ in the risk of failure. However, there are only 3 studies on this, their reliability is low, and the result is not specific to veneers.

Contact a dentist if any of the following happens. While you are in Antalya, that is the clinic; once you are home, it is usually your own dentist in the UK.

• A chip or break in the composite, or a sharp edge that catches your tongue
• The composite coming off (keep the piece and do not try to stick it back yourself)
• Your bite feels high or uneven, or your jaw feels tired
• Sensitivity that does not settle, or keeps getting worse
• Staining or roughness at the edge of the composite, or bleeding from the gum around it
• Pain that starts on its own or wakes you at night

If you have had a knock to your front teeth, or a tooth has broken or moved, see a dentist without waiting.

Severe pain, facial swelling or a high temperature are not an expected result of bonding. See a dentist where you are the same day, without waiting for the clinic's reply. In England, if you do not have a dentist or cannot get an emergency appointment, the NHS says to call 111 or use 111 online¹⁹. Elsewhere in the UK, check the urgent dental care route where you live.

Emergencies. The following need urgent medical help¹⁹. Do not wait for a dental appointment or for the clinic's reply. In the UK, call 999 or go to A&E. In Turkey, the emergency number is 112.

• Swelling that makes it hard to breathe, speak or swallow
• Swelling around your eye or in your neck²⁰
• A painful eye, or sudden problems with your sight
• A lot of swelling inside your mouth
• Difficulty opening your mouth

Before you fly home

Make sure your bite has been checked and the composite polished. Make sure, too, that you have written care instructions, a written record of your treatment and a way to reach the clinic.

Once you are back in the UK

If a problem comes up that is not urgent, write to the clinic and send photographs, and see your own dentist in the UK. If you do not have a dentist, find one near you; for urgent problems, use NHS 111 as described above. In the emergencies above, do not wait for a reply.

Bonding done in the mouth needs no laboratory. A small repair is often finished in a single appointment; the more teeth are treated, the longer it takes. How many days you need in Antalya depends on how many teeth receive composite, and how much of each tooth. It also depends on whether decay or gum problems need treating first, and on whether whitening or other treatment is planned in the same trip. Whitening does not change the colour of composite. If you are thinking about whitening, raise it before the plan is made, and ask how it fits into the schedule. Laboratory-made composite veneers, like porcelain veneers, need a laboratory stage between appointments.

Before you book, you receive a written preliminary plan based on the photographs you send. It sets out the appointments and how many days they need. It is not a diagnosis or a final treatment plan. The General Dental Council says you should always be assessed by a qualified dentist before being given a treatment plan and cost estimate²¹. For bonding, that assessment is the examination in Antalya. It confirms or changes the preliminary plan, and with it the days and the cost. If it changes, you receive the revised plan in writing before treatment starts. You can say no, or ask to stop, at any stage. Ask before you book what you would pay if bonding turns out not to suit you, or if you decide not to go ahead.

Flying. A 2023 review of flying after dental treatment suggests waiting at least 24 hours after restorative treatment²², and longer after surgical procedures. These times assume there is no pain, swelling or bleeding where you were treated. The authors note that the research is limited and comes mainly from military aviation. Treat it as a starting point for your dentist's advice, not as a rule.

Your own dentist

The UK General Dental Council suggests talking to your own dentist²¹ before you go. They need to know the plan in case problems come up later. If you do not have a dentist in the UK, it helps to find one before you travel.

Composite needs regular check-ups for as long as it is on the tooth, and over time it may need polishing, repair or replacement. These visits are usually with a dentist in the UK, so plan them before you travel. National guidance in England (NICE) says the interval between check-ups should be set for each person according to their risk²³ and discussed with them.

Your records

Ask for a written record of the treatment to take back to your dentist. It should show which teeth received composite, and the material and shade used, so that a dentist in the UK can match a repair. The NHS lists exchanging medical records and arranging aftercare back home²⁴ among the things to consider before treatment abroad. In Turkey, the health tourism regulation entitles international patients to an itemised bill. On request, they also get free copies of the records of the materials used, the tests and the imaging²⁵.

If a problem appears after you are home

Problems that appear after you return are usually first seen by your own dentist in the UK. For a problem that is not urgent, you can also write to the clinic and send photographs. Before you start, ask for the clinic's written terms. Check what they say about composite that chips, stains or comes off after you are home. Ask whether a repair would be done in the UK or on another trip, and who pays for the repair and the travel.

What the NHS does and does not do

If you later need NHS dental care in England or Wales, having been treated abroad does not by itself shut you out of it. An NHS dental practice that accepts you for a course of treatment, not only an urgent appointment, provides clinically necessary treatment, with your consent²⁶. That may not be the same as the cosmetic work you had done. The free repair or replacement²⁶ an NHS practice can give for its own work does not apply to work done by another provider. The NHS also states that it is not liable for negligence or failure of treatment²⁴ when you have treatment abroad. On the NHS England routes that fund planned treatment abroad, you cannot get reimbursement for dental treatment²⁷. Ask any dentist about the cost before they repair or replace composite.

The NHS guidance quoted here is for England, and for England and Wales where stated. Scotland and Northern Ireland have their own NHS rules, which this page does not cover; if you live there, check the arrangements.

Travel insurance

The NHS says that most travel insurance policies will not cover you for planned treatment abroad²⁴, so you may need specialist cover. Tell your insurer about your plans.

The General Dental Council lists questions to ask before treatment abroad²¹. Below are its questions, some of them combined, with what this page can answer today and what to ask for in writing. Question 10 is one of our own.

1. Who will carry out my treatment, and what are their qualifications? The treatment is provided by our clinic in Antalya, Turkey, and carried out there by the clinic's dentists. Ask for the name of the dentist who will place your composite. Ask where they qualified and what their title is.
2. Will the dentist speak English, or will there be a translator? Ask before you book who will explain the plan, the consent form and the aftercare instructions to you.
3. Are you regulated by a professional body and registered with it? The GDC notes that it cannot guarantee that other countries have an equivalent regulator²¹. In Turkey, a health facility needs an authorisation certificate²⁵ from the Ministry of Health to treat international patients. Authorised facilities appear in a register the Ministry publishes²⁸, so you can check it yourself. The authorisation belongs to the facility, not to the dentist, and it says nothing about the result of your treatment. Ask for the treating dentist's own registration details as well. See health tourism authorisation.
4. How many times have you carried out this treatment, what are your rates of success and complications, and can you give references? The figures on this page come from published studies, not from the clinic's own results. We publish no figures of our own yet, and this page carries no patient reviews. Ask for the clinic's figures in writing, and how they were collected.
5. Is the work guaranteed, are the terms in writing, and for how long do they apply? This page makes no guarantee. Ask for the clinic's written terms for composite that chips, stains or comes off, and read them before you commit. Check how long they apply, what they exclude, and whether they cover a repair after you are back in the UK.
6. What aftercare do you provide, and who can I contact after the treatment? For a problem that is not urgent, you write to the clinic and send photographs. Check-ups, and problems that need someone to look in your mouth, are with a dentist in the UK. Ask which channel to use, in which language, and how quickly you can expect a reply.
7. If there are complications, or I am unhappy with the result, who pays for further treatment, extra flights and the hotel? Is further treatment included in the cost? Ask for the answer in writing before you commit.
8. Do you have insurance to cover this treatment? In Turkey a facility treating international patients must take out complication insurance for surgical and interventional procedures carried out in an operating theatre²⁵. That does not by itself tell you whether your treatment is covered, so ask which procedures in your plan, if any, fall under it. Ask too, in writing, whether the clinic or the treating dentist holds insurance for complications or errors, what it covers and whom it protects.
9. Do you have a complaints system, and can I see a copy? Ask for it before treatment. The GDC says it cannot resolve complaints or help with refunds²⁹; its investigations concern the dentists on its own register. Turkey's health tourism regulation makes the facility responsible for complications and medical malpractice arising after the health service it provided²⁵.
10. What happens if the examination shows that bonding is not right for me? You can say no, or ask to stop, at any stage. Ask before you book what you would pay in that case.

The NHS names warning signs to think about before booking any treatment abroad. They are a hard sell, a lack of information, pressure to make a quick decision, no discussion of possible complications, and no mention of aftercare²⁷. Apply them to this clinic too.

This page does not show prices. A treatment plan is prepared for you after an examination. The main factors that shape it are:

• How many teeth receive composite, and how much of each: a small edge repair or the whole front surface
• Any treatment needed first: decay, gum treatment, whitening or orthodontics
• A night guard, if needed
• Polishing, repair or replacement that may be needed over time
• The number of trips the appointments need

Ask for the plan in writing, including what is covered and how, and where, any future repairs will be handled. Ask too who pays for further treatment and extra travel if there is a complication.

Ask whether the examination and any X-rays are included. If you are comparing with a quote from a UK practice, compare what each one includes, item by item.