Biomimetics: advanced techniques to mimic your natural tooth structure

Did you know that a filling at the Gentle Touch is designed to last longer than a traditional filling? That’s because our approach to the repair and restoration of teeth uses the techniques and materials of “biomimetic dentistry“. This is something we are hugely passionate about! “Biomimetic” is not a word familiar to many, but it simply means to mimic nature.

Why is a biomimetic approach best for your teeth?

As biomimetic dental practitioners, we aim to mimic nature when working with your teeth. We want to conserve as much of the natural tooth as possible, protect it, and restore it close to its natural strength and appearance. Biomimetic materials are in direct comparison to those used in traditional metal and white fillings:

• Traditional amalgam filling (“silver” filling) uses an excellent filling material and can last for many years. However, as well as being unsightly, amalgam is too strong for the tooth, so over the years, as a tooth flexes during chewing, the tooth starts to crack and cusps can break off. The risk is even higher for teeth grinders!
• Traditional white composite fillings are typically done quickly, use a rigid material, and are generally not bonded properly to the tooth. The result is a greater chance of gaps between the filling and the natural tooth, which can lead to future cavities. Evidence suggests that traditional white composite fillings often fail after 3-5 years.
• Biomimetic white composite fillings, done at The Gentle Touch, are not simple and the do take time. We carefully add biomimetic materials which mirror the tooth structure, including the natural flex of the tooth. As we add the material in layers, a long-lasting seal with the tooth is achieved which minimises the risk of future problems.

Overall, the main benefits of a biomimetic approach are reduced sensitivity, teeth fracturing, and the need for a root canal. In fact, we hardly ever need to carry out root canal treatment at The Gentle Touch! The result is symptom-free teeth that can last for decades. 

What else makes our biomimetic treatment so successful?

Early treatment is best for protecting and reinforcing badly damaged back teeth. This means that your Gentle Touch dentist will recommend early intervention for teeth that are symptom-free but have big fillings and display signs of weakness, such as cracks and fractures. (However, it can sometimes be challenging to prevent root canals or save teeth if treatment occurs after teeth have broken or become painful.) 

One of the best things about biomimetic restoration, is that we can sometimes save teeth that other dentists have recommended be removed. The treatment is not offered on the NHS, and it can be time-consuming, but we feel it’s worth every minute in the chair!  

A rubber dam (see photos) is always used to treat teeth biomimetically because we must ensure the tooth remains isolated from saliva and kept dry. This is necessary for the bond to be strong and the treatment to be predictable. A rubber dam might seem unusual, but patients tell us that it’s far more comfortable than treatment without. Some patients even fall asleep during treatment!

Before treatment

Old amalgam fillings – restoration is needed for cracks and decay.

During treatment

Rubber dam in place, biomimetic restoration in progress. The restoration includes many layers including, in this case, a mesh layer.

After treatment

Biomimetic restoration complete! The biomimetic material mimics the real tooth in structure, look and feel.

Our Biomimetic Treatment Process

• First, we remove the existing fillings/restorations, as well as decay and any cracks while preserving the healthy parts of the tooth. We use a special decay dye to remove the decay in the gentlest and minimally invasive way. Research states that if this detector dye isn’t used, decay is left in the tooth 69% of the time. We always use this dye at The Gentle Touch.
• The tooth is then sealed to protect the nerve, and this foundation is called a ‘biobase.’ This biobased is what sets biomimetic dentistry apart from traditional fillings; it prevents symptoms like pain & sensitivity and preserves the tooth’s long-term health.
• The tooth is then restored with one of (a) a composite ‘white’ filling, (b) a lab-made composite/ceramic onlay (depending on the tooth’s damage) or (c) a chair-side composite onlay (made by the dentist which means same-day repairs for badly damaged teeth). In each case, the restoration mimics the tooth’s strength and flexibility and has the added advantage of looking like a natural and healthy tooth again!
• We use the very best materials and techniques to ensure the tooth’s long-term protection. One example is a mesh called Ribbond, which reinforces the internal aspect of the tooth. We use different composites for the other tooth layers so that once finished, the restoration matches the tooth functionally as well.

Traditional techniques vs biomimetic restoration

There are many reasons behind our preference for biomimetic restoration of teeth compared with the traditional dental approach. There is no doubt that it takes a little bit longer to complete a biomimetic procedure, of course, but we are passionate that it’s the right approach for the long term health of your teeth.

Diagnosis

Traditional diagnosis starts with asking about your symptoms and taking x-rays. Biomimetic diagnosis starts similarly but with a clearer understanding of what causes a long-term health concern. Biomimetic dentists use high magnification and knowledge of research studies to offer treatment options tailored to a particular tooth’s needs.

Treatment of decay and cracks

Traditional fillings do not support your tooth’s natural structure or seal it from further decay, allowing decay and cracks to spread. As a result, this tooth will likely require increasingly invasive treatments over time.

Biomimetic treatments allow us to better treat the causes of symptoms rather than recommending overly invasive treatments. Cracks are removed under high magnification, and the active decay is identified using caries-detector dye to prevent needless drilling. The tooth is then sealed with what biomimetic dentists call the Biobase. This protects the tooth’s nerve against decay and fractures.

Risk of decay and cracks

Traditional techniques leave your teeth at risk of decay and cracks, which can lead to tooth death. While studies exist to protect teeth from these outcomes, traditional practices have yet to adopt them. Biomimetically restored teeth function just like natural teeth, and as such, they remain well sealed, preventing decay or cracks from developing.

Root Canal Cases

Painful teeth have deep cracks or decay, and these teeth are traditionally recommended for a root canal and then a crown. Crowns are highly destructive to teeth. Biomimetic techniques, on the other hand, avoid the need for a root canal. Onlays are usually recommended to restore and reinforce badly damaged teeth. We consider crowns to be old-fashioned because they are highly destructive to teeth.

Longevity

Traditional fillings and crowns last an average of 5-8 years and are often symptomatic. Biomimetically restored teeth have been shown to last many years (some over 20 years).