Julian Perry discusses the benefits, limitations and legal considerations for composite bonding, and how to communicate them to patients.
Composite bonding is a popular cosmetic dental procedure where tooth-coloured resin is applied and shaped to enhance the appearance of teeth. It’s commonly used to repair chips, close gaps, reshape teeth, or improve discolouration. What are the advantages and disadvantages of these procedures, and how should this be communicated?
Advantages of composite bonding
Minimally invasive
Usually requires little or no removal of natural tooth structure and no drilling or anaesthetic is needed in most cases.
Cost-effective, quick and reversible
Typically less expensive than veneers or crowns and often completed in a single visit. Since minimal tooth is removed, the treatment is may be reversible (but not always!).
Aesthetic improvement
Provides immediate cosmetic results: improves shape, size, and colour of teeth and the composite material can be colour-matched and sculpted for a natural appearance.
Disadvantages of composite bonding
Less durable than alternatives
More prone to chipping, wear, and staining than porcelain veneers or crowns. Typically lasts three to seven years, whereas veneers can last more than a decade.
Not ideal for major corrections
Better suited for minor cosmetic changes rather than large structural repairs and may need regular polishing or touch-ups to maintain appearance.
Staining over time
Composite resin is more porous than enamel and can stain from coffee, wine, or smoking. Results are heavily dependent on the dentist’s artistic ability and experience with shaping and finishing the material.
Digital wax-up and stend driven outcomes are really a must. Freehand runs the significant risk of not meeting the clients/patients expectations.
What are the legal implications of consent?
Informed and valid consent is a legal and ethical necessity. If a patient is not properly informed, even if they agree to treatment, it could still be deemed invalid in the eyes of the law.
- Voluntary: Consent must be given freely
- Informed: The patient must understand the nature, risks, benefits, and alternatives of the treatment
- Capacity: The patient must be mentally capable of making the decision
- Documented: If it’s not written down, it didn’t happen (from a medico-legal standpoint).
Implications in composite bonding:
Patients must be clearly told about limitations: likely lifespan (eg three to seven years), potential for staining or chipping, and that bonding is not a permanent solution. Failure to explain these risks can and often do result in negligence claims.
Guarantees and warranties – what you should never say
Legally, dentists should avoid offering guarantees. But why? Dentistry is healthcare, not consumer goods. Outcomes depend on patient behaviour, biology, and long-term maintenance. Dentists cannot influence the patient’s behaviour.
A ‘guarantee’ creates an implied contract. If the restoration fails – even for reasons out of your control – you may be legally liable.
So what’s the alternative? Use phrases like: ‘Expected lifespan under normal conditions is around X years’ or ‘Longevity varies depending on patient maintenance, diet, and habits like grinding or smoking’.
Make it clear that no dental treatment is permanent, and patients are responsible for upkeep (eg hygiene, avoiding trauma, attending reviews).
Longevity – managing expectations
As the treating clinician, you are legally required to:
- Give realistic expectations of how long treatments are likely to last
- Discuss alternatives, including no treatment
- Document the conversation in the clinical notes.
For composite bonding specifically, if the patient believes it will last 10+ years like a crown or veneer and it fails after three, and you didn’t clarify expectations, they may pursue a claim. If you cannot demonstrate the above, it’s likely that the claim will be upheld.
Densura was created by dentists, for dentists. This approach means our insurance package truly understands the risks and exposures you and your practice might face. Our approach is centred on early engagement (typically within two hours of your first call), thorough investigation, robust defence where no fault exists, and early resolution where liability is established. Because claims don’t need to be stressful.
This article is sponsored by Densura.
