Introduction to Dental Materials Chapter 1

What Is “Dental Materials”? “Dental Materials” is defined as the study and science of the development, properties, manipulation, care, evolution, and evaluation of materials used in the treatment and prevention of dental disease. It specifically includes the principles of engineering, chemistry, physics, and biology.

Our Role in Dental Materials Until 1970, only dental hygienists were allowed to work in the intraoral environment. Advanced dental care procedures for dental assistants have become more popular and continue to be developed. Dental assistants and hygienists must know not only how to manipulate materials but why we do what we do. Laws vary from state to state regarding intraoral functions that dental assistants are allowed to perform. Currently several states allow the placement and care of restorative and therapeutic agents in the patient’s mouth

Our Role in Dental Materials The role of the RDH frequently include caring for restorative material once placed and applying some therapeutic or preventive agent. All oral health practitioners need a complete understanding of potential hazards in the manipulation and disposal of materials and must be trained to handle them safely. In many cases you must advise the patient why the dentist recommended a particular procedure

Why Study Dental Materials? Dental materials receive multiple classifications depending on the type of material utilized, and it is up to the person who manipulates each material to understand its properties and effects.  Safety: handling, disposal, patient safety  Maintenance: cleaning, polishing, instrumentation  Delivery: behavior of material, manipulation of material, assistance in the delivery of material  Patient education: options of material choices, maintenance

Evidence-Based Dentistry The American Dental Association (ADA) defines evidence-based dentistry as an approach to oral health care that requires judicious integration of the systemic assessment of clinically relevant scientific evidence related to the patient’s oral medical history with the dentist’s clinical expertise and the patient’s treatment needs and preferences. The dentist routinely searches scientific information when making clinical decisions regarding techniques, technology, and products. Evidence does not replace clinical expertise or input from the patient.

Dental Hygiene Journals

History of Dental Materials The concept of using materials for restoration, replacement, or beautification was introduced as long ago as 600 BC. In the Christian era, the Romans were known to use gold to restore teeth.  Materials included gold shells, fixed bridges, and partial and full dentures. In the mid-18th century, casts were constructed from wax impressions.

Wax Impression Plaster Model

History of Dental Materials (cont’d) Hippopotamus ivory bases with human and animal teeth replacements were popular. Retention was accomplished by hingeing the top and bottom together by using a spring- like device. In France, King Louis XVI awarded a patent to a French dentist for his technique in which fired porcelain was used for prosthetic teeth.

History of Dental Materials (cont’d) Amalgam has a long and somewhat controversial history. Silver paste was first mentioned by the Chinese in 659 AD. In the year 1800, in France, silver shavings from coins were mixed with mercury to form a sloppy paste.  Health problems arose from the high mercury content in early amalgam.  In 1846, the American Society of Dental Surgeons passed a resolution to not use amalgam.  In 1895, G.V. Black developed the first viable amalgam formula.

Amalgam Alloy

History of Dental Materials (cont’d) The use of gold to restore teeth dates back to the Christian era, when the Romans used gold shells as restorations. Cohesive gold foil was introduced in Cements were also introduced being patterned after a technique for cementing tile floors (1855) Dr. William Taggart demonstrated a casting method for inlays in 1907.

History of Prevention in Dental Materials The first mention of the use of fluoride for the prevention of caries occurred in England in Dr. Fredrick McKay is credited with noting fluorosis in  He and G.V. Black determined that the drinking water in Colorado Springs was a contributing factor.  First community water fluoridation program in 1945

Agencies Responsible for Standards American Dental Association (ADA)  Established in 1859  ADA Seal of Approval  Established guidelines for testing of products  Since 2005 seal is only awarded for consumer products  The Professional Products Review  Newsletter mailed to ADA members that provides extensive lab data and clinical feedback Food and Drug Administration (FDA)  Ensures that products meet certain standards of safety and efficacy  Medical Device Amendment  Was signed in 1976 to give the FDA authority over medical and dental devices  Evaluate dental materials and OTC products

Agencies Responsible for Standards International Agencies  International Dental Federation  Put forth standards used to develop specifications and testing on international level  International Standards Organization  Put forth standards used to develop specifications and testing on international level  Developed through ISO’s technical committee for dentistry

Summary Dental Materials continues to evolve as a science. Materials and techniques are improved continually. Standardizing agencies (ADA, FDA, ISO) are committed to the evaluation, testing, monitoring, assessing, reviewing, and labeling of the materials used in dentistry. Current research is focused on the topics of composites, adhesives, and ceramics, and on the use of associated technologies.