TBU: #034 How to Start Doing Biomimetic DentistryJan 14, 2023
New Issue of The Biomimetic Uprising
Read Time: 3 min
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How do I get started doing biomimetic dentistry???
This is a super common questions. And frankly, the answer for it can be complicated depending on a few factors. A lot of the answer just depends on what kind of practice you are in, what materials are available to you, what kind of schedule you run, as well as many other things.
However, there are a few things that are easy to implement and start. From there, that will set you to make the transition easier into a more comprehensive treatment care as you grow.
Here's list of things that are easy to do for anyone getting started.
- Sounds obvious. Its harder than what it seems tho. Don't be afraid of failures. Failures are a great teaching tool. Analyzing the failure mode is a great way to tell you which areas to improve on. For example, if you have a crown that came off and needs to be recemented, take a look at the intaglio surface and also the crown prep. If you are seeing the adhesive in the crown, then you know you had a weak bond to the hybrid layer and the tooth. Some reasons for failure might have been: poor bonding agent, poor bonding technique, poor isolation, contamination, etc. IF the cement was on the tooth and not in the crown, then you can assume there was a problem with the ceramic adhesive steps. With more time and practice comes more successes. I've failed numerous times. I'd like to hope that I have learned something from them. But I promise, the more you try to do these techniques and push the limits to your understanding, the more you will see come back too you.
- Get some caries detecting dye
- It cost almost nothing. There are lots of different kinds. Using something will be better than nothing. Caries detector helps us to see what we are truly bonding to. We need to ensure that our foundation is solid and decay free. If we have that, then we have predictable bond strengths that will last. Its all about bond strengths. With time, you'll get more comfortable with your caries removal endpoints. Especially in the deep areas. Many think that caries dye leads to an over aggressive prep and removes too much tooth structure. While that maybe true, I'd rather have too much removed in my peripheral seal zone than too little. I'd rather be sure that we have a solid base that potentially not with just relying on a tactile sensation of the explorer.
- We need to be able to see. Plain and simple. We can't treat what we can't see. The amount of detail that is there with the higher magnification is amazing. It allows us to be so much more precise and direct. It takes some time getting used to higher power sure, but its well worth it. At the minimum, we recommend 4x with the ideal being between 6-8x. A lot of practitioners have gone with microscopes. Those are also a great way to practice if your situation allows. Ultimately working more precisely and with more attention to details is what will build our reputation and grow our practice.
- Start with IDS
- IDS = Immediate Dentin Sealing. I'm assuming that you're coming from the traditional style of dentistry where crowns are commonplace. Thats fine for now, just start sealing your dentin before you do your impression whether it be digital or traditional. The very quick and easy steps of it are, once you have finished your prep, just create your hybrid layer as you normally would for any restoration. So... Etch, prime, bond. If your bond layer is thin, you can even 'Resin Coat' it by placing a small, less than 1mm layer of flowable everywhere you prepped. After that, you just need to air block the newly formed layer (this is so you temp doesn't stick). These steps have numerous advantages for doing them. We will get into all those at a later time. But this will dramatically increase your bond potential while protecting the tooth from future decay.
If you're still wanting more questions answered or are looking for an introduction training, check out our Foundations of Biomimetic Dentistry course!
I'm excited about seeing your progress. We are truly raising the standard of care in our profession and delivering a higher quality to our patients!
Whenever you're ready, here are the ways I can help you:
- If you're looking for better application in your practice, take a look at our online courses and guides
- The Foundations Of Biomimetic Dentistry
- How To Do Biomimetic Posterior Direct Composites.
- Get our 53 page biomimetic protocols guide for posterior direct restorations.
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- Work with me 1:1 to grow your biomimetic dental practice, with our Biomimetic Business Coaching.