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    Why better adhesion means happier patients

    Ensuring bond strength and avoiding post-op sensitivity are key for dentists.

    Adhesive dentistry has many benefits to the patient, from preserving more tooth structure to less cutting for a dental filling and even in some cases to reinforcing the tooth structure. Dentists have more options to restore or repair teeth thanks to advances in adhesive dentistry. However, these options all rely on bond strength. Without it, your restoration will fail, and your patient could come unglued.

    “Adhesive dentistry is a significant improvement in dentistry, both cosmetically and restoratively,” says Dr. Richmond Chung, DMD, a private practice general dentist in Orange County, Calif. “But when the adhesive fails, the restoration will become displaced. Another big challenge with adhesive dentistry is post-op sensitivity, where the restoration is satisfactory, but maybe it wasn't isolated as nicely as you would like and there was some contamination, and now there’s some sensitivity.”

    Related reading: How self-etch adhesives can help prevent sensititvity

    Dr. Leah Capozzi, DDS, who practices in Buffalo, N.Y., explains that if a filling partially de-bonds, it can allow leakage, recurrent decay and exposed dentin. Unfortunately, the dentist and patient may not realize there is a problem with the bond in these cases until they replace the filling. On the other hand, a fully de-bonded filling can lodge in an uncomfortable position against the gum tissue and expose the tooth to the oral environment.

    “Either situation will cause patients to return to the office to have the treatment redone," she said, which can infringe on the patient's time and erode their confidence in the dentist. 

    For all of these reasons, excellent adhesion leads to happier patients.

    “Better adhesion can prevent de-bonding and leakage, saving both the patient and dentist from spending time on replacing fillings. Better adhesion can also reduce post-op sensitivity for patients,” Dr. Capozzi says.

    What makes a patient happy?

    Dr. Ford Gatgens, DDS, who practices just outside Nashville in Dickson, Tenn., said patients want everything to function like it is supposed to and look natural as well. Most of all, they want to avoid postoperative problems after their dental visit.

    “Obviously, if the patient had work done and he or she says, ‘Man! When I left, I couldn’t even tell I had been at the office. Everything feels just like it belongs,’ I would say that’s a happy patient,” he said.

    Dr. Kalmanovich agrees that happy patients are those who feel comfortable in your chair and confident they are in good hands. He ensures he is doing the right steps, so his patients don’t have post-operative sensitivity.

    “They can see that you are doing things in a step-by-step strategic manner and not fumbling around not knowing what you are doing,” he says.

    More from the author: 3 ways mishandling adhesives contributes to restorative failure

    Dr. Kalmanovich, who usually etches and then applies Gluma to prevent sensitivity before using the adhesive, compared his bonding procedure with his dental assistant to watching an orchestra perform -- precise and systematic while working together to achieve a result.

    “We do the same thing every time. I get the etch. I get the Gluma. I get the primer. I get the bonding. She light cures it for the same time every time. I put in my liner and I put in my composite. Everything flows well. The patients appreciate that,” Dr. Kalmanovich explains.

    “Whenever they don’t have to come back after dental work has been done, they feel comfortable and confident, everything functions the way it is supposed to and they look good as well -- that’s a happy patient,” Dr. Gatgens says.

    Up next: Adhesives recommended by dentists ...


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