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Saving your badly damaged tooth – the options

Tue, 17th Sep 2024

Patients often come to us looking for a second opinion on a badly damaged tooth. Another dentist might have advised them that it’s impossible to save their tooth, or perhaps they are unsure about the best course of treatment. At the Gentle Touch dental practice, we frequently recommend restoring your badly damaged tooth biomimetically. This is a different approach, and it can mean we can save teeth that others can’t. Biomimetic techniques are the gold standard of modern dentistry. What is biomimetic dentistry? And what makes these techniques different from traditional methods?

What are biomimetic restorations?

Biomimetic restorations mimic the natural structures of your tooth. They are more complex than a traditional filling so treatment takes longer, but your tooth will be healthier once restored.

Benefits of biomimetic restorations

Preservation: more of your tooth is saved compared to traditional procedures like crowns, which irreversibly remove healthy parts of your teeth.

Pain–free: biomimetic restorations are strongly bonded with your tooth, preventing bacteria from getting in. Traditional practices can result in failed bonds, leading to decay, cracks and sensitivity.

Long-lasting: A traditional crown lasts an average of 5–8 years and will likely become painful, decay or fracture. Based on current clinical data, biomimetic restorations repair the tooth from the bottom up and last over 15 years.

More natural function: saving your healthy tooth structure is our highest priority. After a biomimetic restoration, teeth chew and behave naturally, giving you a stronger bite and healthier smile.

Preparation

We begin by removing the existing fillings and fractures and checking and removing decay.

Using high magnification and specialised dye, we ensure all the decayed portions of your tooth are removed whilst preserving the healthy parts. Research shows, without this dye, decay is left in 69% of cavities.

Once the remaining tooth is healthy, we seal it with layers to form a ‘biobase.’ This biobase is permanent and prevents further decay and fractures.

Preparation for a traditional filling removes parts of the tooth regardless of their health and vitality.

Reconstruction

The tooth is then reconstructed gradually in layers of different materials. Each composite material mimics the strength and function of the layers in your tooth. Biomimetic restorations bond as strongly as the bonds within the layers of a natural tooth.

A traditional crown or filling might look like a secure cover for your damaged tooth but the material and preparation leave the tooth vulnerable to decay and cracks, often leading to a root canal or extraction.

Dental onlays or overlays for badly damaged teeth

Graphic illustrating an onlay which is created with biomimetic dental techniques
An overlay is a replacement for the whole biting surface of a back tooth.

If your tooth is extensively damaged, we recommend finishing your biomimetic restoration with a strong top cover. These replace the biting surface of a back tooth, mimicking your healthy tooth’s shape, size, bite and appearance.

An onlay helps preserve an individual cusp (if strong enough), while an overlay is used when the whole biting surface of the tooth needs to be restored.

Onlays and overlays can sometimes be made chairside in one appointment, using a strong composite material to create a good biting surface. More extensive overlays are made in a dental lab.

To allow the lab to achieve a precise fit to your tooth, we record an impression or 3D scan of your tooth after it has been prepared. There is often no need for a temporary onlay in between appointments because the tooth is so well protected.

Two weeks later, we bond this restoration to your tooth using a dental bonding material, which is cured with a light to harden it. This makes your tooth look, feel and function as good as new.



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