Biomimetic Dentistry & The Tooth Death Spiral

tooth death spiralCaring for teeth the old-fashioned way does as much harm as it does good. Fixing one problem contributes to another. Dentists who practice biomimetic dentistry call this “the tooth death spiral”. The word death here is an ode to what indeed happens: the tooth dies. Thankfully, over time, dentistry has evolved as new technologies have dawned on the horizon. Jim Erpenbach, DDS, is a biomimetic dentist who uses his years of training and experience to keep as much of the tooth intact as possible while treating other issues. Dr. Erpenbach’s skill set allows him to fix issues with the teeth without excessively damaging them, allowing his patients to permanently keep their natural teeth.

Old-Fashioned Dentistry: Crowns and Silver Amalgam Fillings

old dentistryIt’s easy to shudder upon hearing the word crown. It generally signals a painful operation for a hurting tooth that comes with an unpleasant recovery and reduced function in the long run. A lot is required of the tooth in order for a crown or silver amalgam filling to be successful. The tooth often has to be shaved down or filled in to make it fit. For example, 1.5 mm density is required for a silver filling for the tooth. Crown restorations can require even more density. 

Additionally, old-fashioned dentistry depends on the tooth to “hold onto” the restoration. If the tooth doesn’t hold on, the crown or silver amalgam filling won’t last. If the crown or filling doesn’t last, this requires even more dental work, further compromising the integrity of the natural tooth. A tooth must be shaved down to about 360 degrees to keep a crown on. 

The downsides don’t end there, either. Old-fashioned dentistry is not equal to biomimetic dentistry. The silver amalgam fillings are made from metal alloys. Teeth are made of pulp, dentin, enamel, and cementum. Fixing a natural tooth with metal doesn’t seem like the best solution. Granted, it was better than nothing when it became a part of dentistry, but in the twenty-first century, we have evolved past that. Biomimetics allow the tooth to be solidified until it is as solid as it was before it started having issues. For example, a tooth isn’t as robust as it was after a cavity is filled. The tiniest of cavities can take away close to half of a tooth’s strength. And cavities are just one example of how old-fashioned dentistry can temporarily fix a problem but won’t re-strengthen the tooth. Tooth preservation isn’t found in crown restorations, either. Crowns are comprised of porcelain and metal, making them very hard. A crown isn’t the right choice for natural tooth preservation based on this alone. The differences in density show exactly why crowns result in gum line fractures.

The Tooth Death Spiral in Dentistry

The Tooth Death Spiral explains the process that old-fashioned dentistry uses. 

  1. A tiny cavity is found. The dentist fills the cavity.
  2. The silver amalgam filling is used to fix the cavity, but part of the natural tooth has to be taken off to ensure that the filling stays in tact. This drastically decreases the tooth’s natural strength. 
  3. Because the tooth’s natural structure has been taken away from it, over time the tooth ultimately fractures. 
  4. After the tooth fractures, the only way to fix it is through performing a root canal, post, and core, so that the tooth won’t fracture again.
  5. The root canal is successful but the tooth is as good as dead. 
  6. After root canals are performed, the teeth are way too strong. They do not maintain any of their original composition. They are permanently damaged.
  7. Because teeth are too strong after root canals, their unnatural weight presses down even below the crown, ultimately resulting in the tooth dying. 
  8. The dentist removes damaged teeth and installs an implant where the tooth was. A dentist who uses biomimetics could have saved the tooth (or teeth!) from being killed by unnatural substances.

Dr. Erpenbach’s Practice Saves Teeth

erpenbachDr. Erpenbach’s training altogether bypasses the tooth death spiral. As dentistry has improved over the years, holistic dentistry has dawned on the same horizon as old-fashioned dentistry did. This evolution in dentistry comes as a result of adhesion and biomimetics. Together, these two forms of dentistry allow Dr. Erpenbach to maintain the health of the tooth as he fixes problems. Instead of removing the healthy parts of the tooth to fit a crown, he only removes the bad parts. By keeping the healthy parts, the tooth does not lose any more of its density than necessary.

Biomimetic Restoration completely bypasses the need for crowns and fillings.

The adhesion, a natural part of biomimetics, creates a natural bond with the tooth’s enamel and dentin. This allows the tooth to reform its natural bond and strength. Biomimetic/holistic dentistry comes as close to a natural tooth as possible.