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What is Biomimetic Dentistry?
Biomimetic dentistry is tooth-conserving dentistry. It restores a damaged tooth to mimic its natural strength, function, and appearance, while preserving as much of your healthy tooth structure as possible.
Instead of drilling away healthy tooth to place a traditional filling or crown, a biomimetic dentist bonds advanced materials that work like your natural tooth.
In practice, that usually means one of three restorations: a bonded filling, an inlay, or an onlay. An onlay is the one most people arrive here asking about, because it is the conservative alternative to a crown. If a dentist has told you that you need a crown, this chapter will show you what else is possible and how to tell which option fits your tooth.
So if mercury fillings and root canals are options you would rather avoid, what should you do instead?
That is where the power of biomimetic dentistry comes in.
What is Biomimetic Dentistry?
Biomimetic Dentistry is the tool to use when considering your dental options.
Let’s take a closer look at the word “biomimetic” itself.
The first part of the word, “bio”, refers to our natural body.
The other root of the word is “mimic”.
Biomimetic dentistry mimics natural teeth and replaces tooth structure with something as close to natural tooth structure as possible. The goal is to return the tooth to its original strength, function, and esthetics.
What Happens to a Tooth After a Traditional Filling or Crown
Traditional methods of restorative dentistry focus on the strength of the filling or the crown. The typical rule in this line of work is ‘the stronger the better because you want to prevent the dental material from breaking.
Unfortunately, this leaves out what is best for the tooth and creates a cycle that isn’t too pretty.
Below is the sad but very real life cycle of a tooth that occurs once it has been traditionally restored.
Here’s how the process starts in a traditional dentist’s office practicing traditional restorative dentistry:
A tooth gets a small cavity and is restored with a strong filling. If it’s a mercury filling, it will eventually get a new cavity underneath, which leads to a larger filling. Even new resin fillings often have to be replaced within 10 years of original placement, with the fillings getting larger each time.
That larger filling weakens the tooth, and sometimes that weakened tooth fractures.
The larger filling is also more difficult to place and may not be completely sealed at the edge. The filling then leaks, creating a cavity underneath again.
Not only can the cycle continue, but things typically get worse after the second cavity forms. Another filling may not be possible at this point because of the extent of the tooth structure that has been lost to cavities and breaking.
The tooth will now need a crown or an onlay which is a restoration that covers a portion of the tooth rather than the entire tooth like a crown.
Preparing the tooth for the crown or onlay is stressful on the tooth and requires the removal of healthy tooth structure. It is possible for the tooth to eventually die from the stress of the filling or the cavity being so close to the nerve.
Traditionally, a root canal would then be prescribed to “save” the tooth. If you’ve already read Chapter 5, you know why many patients would rather explore other options first.
A tooth with a root canal can become reinfected, which may lead to the tooth being lost and replaced with a dental implant, or the person choosing to live without the tooth.
Not only is this a sad life cycle for a tooth, resulting in the loss of most of the remaining tooth structure, but it is also very costly.
Biomimetic dentistry does its best to stop this life cycle early in the process and help prevent tooth loss and the cost associated with this dental tragedy.
What are Biomimetic Restorations and How Do They Differ From Traditional Dental Materials?
Your tooth needs something that can strengthen the part of your tooth that needs to be stronger, and support and protect the part that is weak.
Biomimetic dentistry does just that. Biomimetic dentistry is tooth-conserving dentistry.
Done correctly, this approach can help many patients avoid traditional crowns and root canals altogether.
Through these restorative techniques, more intact tooth structure can be saved and healthy tooth structure preserved.
What is the secret? These techniques use a glass and resin mixture called composite, or porcelain, to seal and bond to the tooth. In addition, a holistic dentist will use ozone when placing these restorations to address bacteria that may still be living in the tooth.
This helps protect the tooth from further decay, may reduce tooth sensitivity, and reduces stress in the tooth.
You may have heard of composite fillings and porcelain crowns or onlays.
Don’t be fooled into thinking they are all alike.
There are different ways to use these materials, and hundreds of different brands that have very different properties.
Fish sticks and a beautifully cooked piece of fish at a fine restaurant are both technically fish. But the handling, the quality, and the preparation are very different.
Make sure you are getting the right kind of restoration, performed with a biomimetic approach.
I’ve seen many composite restorations function for less time than the mercury fillings they replaced.
Don’t make that mistake. The restorative material used will ultimately determine the success of the restoration.
There are, unfortunately, no dental materials that are the exact replacement for tooth structure. However, if you find a dentist who performs Biomimetic Dentistry and aims to preserve the intact tooth structure you can feel as confident as possible that you are getting a restoration similar to your natural tooth.
Biomimetic Onlay vs. Crown: What Is the Difference?
If your dentist has told you that you need a crown, there is a good chance you were given one option and one price. A crown is not the only way to restore a badly damaged tooth, and it is rarely the most conservative one.
Here is the difference in plain terms.
A crown covers the entire tooth. To place one, the dentist reduces the tooth on every side, shaping what is left into a peg so the crown can slide over it. That means healthy enamel and dentin come off along with the damaged part, simply because the crown needs room. The tooth is made smaller in order to be covered.
A biomimetic onlay covers only the part that is actually damaged. If one or two cusps are broken or decayed, that is what gets replaced. The healthy walls of your tooth stay exactly where they are. The onlay is then bonded to the remaining structure so the restoration and the tooth flex and function together, rather than the restoration sitting on top of a stump.
| Traditional Crown | Biomimetic Onlay | |
|---|---|---|
| Healthy tooth removed | Substantial. The tooth is reduced on all surfaces to make room for the crown. | Minimal. Only damaged structure is removed. Sound walls and cusps are kept. |
| How it holds on | Largely by shape and fit. The crown grips the prepared tooth. | By adhesive bonding. The material is chemically bonded to enamel and dentin. |
| Coverage | The entire visible tooth. | Only the cusps and surfaces that need it. |
| Proximity to the nerve | Deeper reduction brings the preparation closer to the pulp, which is one reason some crowned teeth later need a root canal. | Shallower preparation is designed to leave more dentin between the restoration and the nerve. |
| If it ever needs redoing | Little tooth structure is left to work with, so options narrow. | More original tooth remains, which keeps more options open later. |
| Chair time | Shorter. It is the faster procedure. | Longer. Bonding is technique-sensitive and takes more time. |
When a crown is still the right call
I am not going to tell you crowns are never appropriate. They are. When a tooth has lost most of its structure, when a fracture runs below the gum line, or when there simply is not enough sound enamel left to bond to, a crown may be the restoration that keeps that tooth in your mouth.
The problem is not that crowns exist. The problem is that crowns are often the first option offered when a more conservative one would have worked.
The honest answer for any individual tooth depends on how much healthy structure is left, and that takes an exam and images to determine. No article can tell you which one your tooth needs.
Biomimetic Fillings, Inlays, and Onlays: Which One Does Your Tooth Need?
Biomimetic dentistry is not a single procedure. It is an approach, and it shows up as three restorations that scale with how much of the tooth is damaged. The goal in every one of them is the same: replace what is broken, keep what is not.
Biomimetic fillings
For small to moderate decay. A layered composite is bonded directly to the tooth in a single visit. People often assume a biomimetic filling is just a white filling, and that is the most common misunderstanding on this page. The material matters, but the technique matters more: how the tooth is prepared, how decay is removed, how the composite is layered and cured, and whether the bond at the margin actually seals. A composite placed quickly and a composite placed biomimetically can look identical on the day and behave very differently five years later.
Biomimetic inlays
For damage too large for a direct filling but still contained within the cusps of the tooth. An inlay is fabricated outside the mouth, usually from porcelain or a high-grade composite, then bonded into the prepared space. Because it is made outside the mouth, it can be shaped and cured under conditions you cannot achieve while it sits in a tooth, which gives better strength and a more precise fit at the margins.
Biomimetic onlays
For teeth where one or more cusps are broken, cracked, or heavily decayed. An onlay does everything an inlay does and also caps the damaged cusps, which is the job a crown is usually recruited for. This is the restoration that replaces most crowns in a biomimetic practice, and it does it while leaving your healthy walls standing.
A simple way to think about it
- Small cavity: bonded filling.
- Larger cavity, cusps intact: inlay.
- One or more cusps damaged: onlay.
- Very little sound tooth left: a crown may genuinely be the right restoration.
Every one of these is bonded rather than simply seated, and ozone is used when placing them to address bacteria that may remain in the tooth.
How Can You Find a Dentist That Performs Biomimetic Dentistry?
The materials and techniques used in the biomimetic method have been researched for more than 25 years and have a long clinical track record. But it is important to understand that not every dentist performs biomimetic restorations. It takes longer than a traditional restoration, it requires specific training, and relatively few dentists have pursued it.
That means the search matters. A practice that places white fillings is not necessarily a biomimetic practice.
What to ask before you book
- Do you place bonded onlays as an alternative to full crowns, and roughly how often?
- What training have you completed in adhesive or biomimetic restorative technique?
- Do you use magnification, and do you use ozone when placing restorations?
- How do you decide between an onlay and a crown for a specific tooth?
Biomimetic restorations at Total Care Dental & Wellness
Our doctors in American Fork, Utah practice biomimetic restorative dentistry as part of a whole-body, biological approach, and we regularly see patients who travel from out of state. Your first step is a comprehensive new patient exam, which includes a low-dose cone beam scan and a full evaluation, so you leave knowing what your tooth actually needs before anything is scheduled.
Schedule Your New Patient Exam
Finding A Holistic Balance
One word of caution with biomimetic dentistry:
Biomimetic Dentistry organizations are not entirely holistic in nature.
They are instead focused on replacing dental structures, not necessarily on whole-body health.
Biomimetic dentistry, performed along with Holistic and Biologic Dental practices, is the best of all worlds.
The focus of this chapter was to teach you a better alternative to traditional treatment. I don’t want to tell you everything that is wrong with something without giving you a better alternative!
In this chapter, you learned some alternatives to traditional fillings, crowns, and root canals.
In chapter 8 you’ll learn about how you can have beautiful, bio-compatible teeth even if you have had a tooth removed!
Biomimetic Dentistry: Common Questions
Is a biomimetic onlay better than a crown?
For the right tooth, an onlay lets you keep healthy structure a crown would have removed, and that is a meaningful long-term advantage. But better depends on the tooth. When too little sound structure remains to bond to, a crown may be the restoration that saves it. The comparison above walks through where each one fits.
Are biomimetic fillings just white fillings?
No. Tooth-colored composite is the material, not the method. A biomimetic filling refers to how the tooth is prepared, how decay is removed, how the composite is layered and cured, and how well the margin is sealed and bonded. Two fillings that look the same on the day of placement can behave very differently over time.
How long do biomimetic restorations last?
Longevity depends on how much healthy tooth remained, where the tooth sits in your bite, whether you grind, and your day-to-day oral health. Well-placed bonded restorations are designed to last many years, and the biomimetic goal is to break the cycle where each replacement is larger than the last. Any dentist who quotes you a guaranteed lifespan is guessing.
How much does biomimetic dentistry cost?
It varies with the restoration and how much of the tooth is involved, and a bonded onlay generally sits in a similar range to a crown. It takes longer to place, which is reflected in the fee. The more useful comparison is not one restoration against another but the full cycle: a tooth that keeps its structure avoids the sequence of larger filling, crown, root canal, implant that follows a tooth that does not. We give you specific numbers at your exam, before anything is scheduled.
Do I need to be in Utah to see a biomimetic dentist?
Our practice is in American Fork, Utah, and a meaningful share of our patients travel from out of state for this kind of restorative work. If travel is not practical, the Living Well Directory is a reasonable place to start looking closer to home.
Can biomimetic dentistry help me avoid a root canal?
Sometimes. The approach is designed to keep the preparation farther from the nerve and to seal the tooth well, which is part of why fewer crowns and root canals are needed in a biomimetic practice. It is not a guarantee for any individual tooth, and a tooth that is already infected needs different treatment.
Schedule Your New Patient Exam With Total Care Dental & Wellness
With a comprehensive exam, you’ll receive:
- A low dose cone beam 3d Dental Xray (CBCT)
- Tooth Xrays
- Dental photographs
- A comprehensive gum exam with an intraoral scan
- A comprehensive oral exam by a Total Care Doctor
- Jaw joint exam
- Oxygen, Sleep, and Airway Evaluation
You will leave the appointment with a report of findings and treatment recommendations from your doctor and care coordinator. Finances, scheduling, and other instructions will also be provided.
