Natural teeth have the optimal properties & structure to withstand the many challenges of the oral environment. Conservative dentistry preserves this natural tooth structure with minimally invasive restorations and procedures. A biomimetic dentist practices a special type of conservative dentistry that restores the function, strength, and biomechanics of natural intact teeth.
Traditional approaches require unnessary removal of tooth structure and fail to replicate the properties of natural teeth, leading to major complications including root canals, fractures, and extractions.
Traditional VS Conservative Dentistry VS Biomimetic Dentistry
Traditional procedures in dentistry rely on shaving or drilling away extra tooth structure in order to strengthen teeth with the restoration (filling, inlay, onlay or crown). While traditional dentistry has been relatively successful, it still introduces many complications and problems that can be avoided with a more conservative approach. A conservative dentist values the importance of preserving tooth structure and avoiding extra shaving and drilling of teeth. Conserving the tooth structure is important, but it is useless if the restored tooth is weak or likely to experience complications. A Biomimetic dentist practices a specific type of conservative dentistry that restores teeth with restorations that mimic the properties of natural teeth and strengthens badly damaged teeth with the science of Biomimetic Dentistry.
Why is Tooth Conserving Dentistry Important?
It is essential to appreciate the properties and structure of natural teeth in order to understand how and why conservative dentistry is beneficial. The natural tooth is a layered structure consisting of a strong outer shell of enamel, strongly connected (“adhered”) to a more flexible inner core of dentin. The function and strength of natural teeth is the direct result of this structure and the properties of the combined layers. The structure of each individual layer is lacking but combined together, the resulting complex makes the anatomy of the tooth perfectly designed. Conservative dentists and biomimetic dentists recognize tooth structure must be conserved to avoid many of the complications faced from traditional dentistry and excessive tooth shaving and drilling. Watch the video below or read on to learn more about the structure and anatomy of teeth.
Enamel is the Strong Outer Layer of the tooth
Enamel makes up the outermost layer of the tooth. It is comprised of 96% minerals, the primary one being hydroxyapatite (a crystalline calcium phosphate). The remaining percentage is water and organic material. As a result of the highly mineralized structure, the enamel is the hardest substance in the human body. Enamel is responsible for the strength, hardness, and protection of the teeth. However, the enamel is extremely brittle! If the tooth was made entirely of enamel, catastrophic fractures would be very common. Fortunately, the properties of Enamel are enhanced by the underlying dentin layer and a strong adhesive junction known as the DEJ.
Dentin Supports Enamel
While the enamel provides the strong outer shell, its brittle nature is unsuitable for the oral environment without a stress relief mechanism. Fortunately, the inner dentin core of the tooth provides this necessary flexibility and prevents enamel from fractures. Dentin is composed of about 45% hydroxyapatite and 33% organic material and the rest is water. The increased organic content of dentin provides the flexibility and support that enamel needs.
The Dentin Enamel Junction (DEJ) Unites the Enamel and Dentin
Enamel and dentin are two distinctly separate layers with drastically different properties. They are formed independently, and their properties are uniquely different. These two materials with diverging properties do not benefit from each other unless they are strongly united with a durable adhesion. This extremely strong connection is formed naturally by the dentin enamel junction (DEJ). This strong connection makes enamel and dentin function together as a hybrid material which has the benefits of both materials, and this would be impossible with a weak connection.
The Pulp Provides the Vitality of the Tooth
The pulp is the nerve center of the tooth. It consists of nerves, blood vessels, lymphatic vessels, and connective tissue. The blood vessels and nerves here are connected to the larger blood vessels and nerves running along the jaw. The pulp gives life to the tooth by supplying nutrients and circulation. When this vitality is lost, the biology of the tooth is disrupted and various infections result.
Loss of vitality can result from:
- Trauma
- Periodontal disease
- Cavities
- Inadequate & failing restorations
- Excessive tooth shaving and drilling
Preserving pulp vitality is one of the major objectives for a conservative dentist and biomimetic dentistry. A vital pulp drastically reduces the incidence of future complications and problems. Traditional restorative techniques do not adequately prioritize the importance of maintaining pulp vitality.
Biomimetic protocols and techniques prevent the conditions which lead to root canals. As a result, the occurrence of root canals can be drastically reduced.
Biomimetic dentistry preserves pulp vitality by:
- Providing high-quality restorations
- Treating teeth conservatively
- Minimizing tooth shaving and drilling
- Preserving healthy portions of the tooth
- Early & definitive intervention
- Achieving a strong durable seal
- Selectively removing only areas affected by cavities
A Conservative Dentist Saves Teeth Trom Unnecessary Shaving and Drilling.
Cavities damage the structure of enamel and dentin. If they are not treated in time, the cavity will reach the pulp and lead to irreversible damage. Once this has occurred, there is no way to reverse the damage and maintain the vitality of the pulp. For this reason, the pulp tissue will have to be removed or the tooth will need to be extracted. A root canal procedure removes the pulp tissue, disinfects the tooth, and seals the pulp area. A better approach is to prevent conditions that lead to loss of vitality.
One major way pulp vitality is maintained is through treating problems and cavities with conservative dentistry. Specifically, the biomimetic approach conserves tooth structure AND restores back the structure and strength of teeth. A biomimetically restored tooth is considered a permanent restoration. A permanent restoration doesn’t mean that it will last forever. It means it is designed to have results similar to other permanent natural teeth in the same environment, which varies from patient to patient.
In contrast, traditional dentistry requires lots of additional tooth shaving to make the filling stronger or to place a crown on the tooth. The more tooth structure that is removed, the weaker the tooth becomes, and the higher the chance of major complications (fractures, root canals, and cracks). Biomimetic dentistry addresses the problems in the most conservative manner possible.
How does Biomimetic Dentistry Mimic Natural Teeth?
Biomimetic dentistry replicates natural teeth by using materials, protocols, and techniques that best mimics and preserve the various layers of the teeth. Teeth restored with biomimetic dentistry have similar properties, structure, and biology to that of natural teeth. Biomimetic dentistry is a healthier, better, and safer alternative to traditional dentistry. Conservative dentistry is not enough, and the properties of teeth must be replicated for restorations to last long-term and avoid complications.
The table below summarizes the ways that biomimetic dentistry mimics natural teeth.
| Tooth Layer | How its Replicated or Preserved |
|---|---|
| ENAMEL | Strong ceramic materials mimic the properties and strength of enamel. |
| DENTIN | Composite materials provide the flexibility and optimal properties to replace the dentin portions of the tooth. |
| DEJ | Strong adhesives applied with optimal conditions and protocols unite the enamel and dentin layers with a strong bond. This strong bond provides an optimal seal, and biomechanical properties comparable to natural teeth. |
| PULP | The vitality of the pulp is conserved by minimizing shaving and drilling, and selectively removing cavities and damaged areas of the tooth. High-quality restorations provide a strong biological seal that prevents leakage and recurrent problems. |
Learn More About Biomimetic Dentistry
Biomimetic dentistry is scientifically supported and backed by decades of clinical practice. I have been practicing Biomimetic dentistry since 2010, and training dentists on how to implement this approach in their practices. To learn more about biomimetic dentistry, sign up for my free biomimetic dental course designed especially for patients.
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