Unmasking the risks and reality of direct composite bonding with a clinical and ethical imperative

The technique of direct composite resin bonding has experienced a marked increase in its clinical application. This has largely been propelled by patient demand for rapid, minimally invasive and ostensibly reversible aesthetic treatments. This review moves beyond the commercial narratives, critically examining the longer-term aesthetic and functional performance of composite bonding, its inherent technical challenges, and the fundamental interplay between clinical durability and informed patient consent. It also evaluates the current literature relating to the indications, longevity, and failure mechanisms with the prescription of this treatment, including colour stability and material wear. Additionally, it provides a structured, risk management approach and proposes an ethical consent framework designed to address nuanced patient expectations regarding maintenance, material degradation, and the (often-underappreciated) risks associated with this seemingly straightforward additive procedure. CPD/Clinical Relevance: Critical assessment of the functional and aesthetic risks of direct composite bonding is essential for facilitating appropriate long-term maintenance planning and emphasizing the importance of ethical consent to align patient expectations with treatment limitations.