Biological Dentistry is a concept of modern dentistry that focuses primarily on strengthening overall health. There is no other medical discipline in which so many different materials are brought into the human body as in dentistry. No other medical field works with so many chemical materials. Various synthetic substances, metals and paints are used by and put into the patient’s mouth by the dentist and enter the body via the oral mucosa and the digestive tract.

The proportion of people with chronic diseases is constantly increasing. There are now very few people who can be described as medically healthy. The graph below shows the exponential increase in some chronic inflammatory diseases.

The graph ends in the year 2000. It can be assumed that today, in 2022, the incidence is much higher. 

Biological Dentistry Winterthur Switzerland
Biological dentistry is focused on the interactions of dental materials on the body, taking toxicity and its effect on the immune system into account.

The following chart shows the development cycle of chronic diseases. Please note that many influencing factors mainly originate in the oral cavity (underlined in red).

Biological dentistry emphasizes the interactions of dental materials on the body, taking toxicity and its effect on the immune system into account.

The concept of biological dentistry is based on reducing the harmful load of the oral cavity to a minimum and strengthening one’s health in the best possible way.

he materials, equipment and treatment techniques used are selected and adjusted accordingly. The holistic view of these interactions allows the dentist to reduce the burden of the oral cavity to a minimum and improve the patients overall health.

Biological Dentistry vs. Classical Dentistry


Biological dentistry originates from the teaching of classical dentistry and has many parallels. For example, the measures to preserve vital/living teeth are very similar and are based on fillings and crowns.

However, what distinguishes biological dentistry from classical dentistry is the holistic selection of materials and the treatment techniques. All materials are selected with health and biology in mind. Other important criteria, such as longevity and aesthetics, must not be neglected.

Examples of the choice of materials are:

  • Ceramic implants instead of titanium implants
  • Ceramic crowns instead of metal crowns
  • Composites without plasticizers instead of composites with plasticizers

There are also differences in treatment techniques. Here are some examples: Here are some examples:

  • Metals and amalgam are removed with the highest protective measures. This is done in the interest of both the patients and staff.
  • When treating tooth decay, everything is done to ensure that the tooth does not die.
  • Surgical treatments are performed as atraumatic as possible. The use of ozone and A-PRF membranes support wound and bone healing.
  • Wherever possible antibiotics are not used.
Difference between Environmental Dentistry and Holistic Dentistry

The concept of environmental dentistry and holistic dentistry also consider the mouth and the body as one interconnected unit. For example, an inflammation in the jaw, a diseased tooth or a toxic dental material in the mouth can lead to chronic inflammation in a joint.

Biological dentistry, as well as holistic dentistry and environmental dentistry, aim to reduce the triggers and irritants that affect the body. The biological organism should be strengthened as best as possible.

In our practice we combine all proven and effective methods of these dental disciplines, in order to offer you the most ideal concept.

Exposure to metals in the mouth

Metallic dental restorations and problematic from a toxicological and immunological point of view. Through abrasion during chewing and oxidation processes (corrosion), the metals get into the surrounding tissue and the entire organism.

Exposure to metals in the mouth

The metallic ions and metal particles emitted can cause local inflammation of the gums in the oral cavity.

The metallic substances that are swallowed can cause chronic inflammation of the intestinal mucosa. As a result, the permeability of the intestinal walls (leaky gut) increases, which means that undigested food, intestinal bacteria and intestinal toxins can enter the organism.

Biological dentistry helps with exposure to metals

This increased intestinal permeability then has a systemic effect on the entire body and can cause a wide range of non-specific symptoms.

Toxicology:

Many metals are capable of causing oxidative and nitrosative cellular stress, resulting in the body being flooded with free radicals. These are very reactive and can severely damage various body building blocks, enzymes and cells.

Furthermore, metals can compete/react with vital minerals and trace elements and displace them from their function, which can negatively affect metabolic processes.

Immune system:

The body reacts to the invasive metal ions or metal particles by ramping up the immune system. Various immune cells, such as lymphocytes or macrophages, begin to fight the metallic invaders. This, in turn, causes even more oxidative and nitrosative cell stress and robs the body of a lot of energy. The activation of the macrophages upon contact with titanium can be determined, for example, by the titanium stimulation test. The activation of the lymphocytes when they come into contact with different metals is demonstrated by the lymphocyte transformation test (LTT).

Since such constant stress takes a toll on the health of the body, chronic diseases can manifest themselves. The aim of biological dentistry is to recognize and eliminate these influences on the body.

Ceramic is the material of choice


Dental ceramics show the best biological compatibility and are clearly preferable to metallic alloys. Bacteria show a significantly lower attachment to ceramics, resulting in less biofilm and plaque buildup. As a result, the adjacent soft tissue in the mouth is less likely to be affected by inflammation and forms a stable bond with the ceramic.

Ceramic is the material of choice

In the concept of Biological Dentistry, no metals are used, but ceramics are clearly the material of choice.

Ceramics are non-toxic and have a neutral effect on the immune system and the body.

By using ceramic implant, ceramic implant superstructures and ceramic crowns, even edentulous patients can be provided with fixed dentures quickly and tolerably in our practice.

Ceramic inlays and partials crowns are ideal alternatives to composite fillings and can be prepared by the dental technician and integrated by the dentist in one session (chairside). The attachment is made with a high-quality and non-toxic cement.

Safe amalgam removal under protection


In the past, amalgam was the most common material used for dental fillings. Today, the use of amalgam is steadily declining, although there are still many dentists who swear by it. The reason for this is the simple processing, the low costs and the durability of this material.

In Germany, amalgam is still covered by health insurance and anyone who wants a filling made of composites pays the surcharge themselves. 

Amalgam consists mainly of mercury, which is one of the most toxic elements on earth. As soon as amalgam fillings are no longer in the mouth, they are declared as hazardous waste and must be separated carefully and be disposed of professionally. 

Many studies also prove the toxicity of amalgam. In 1983, M. Wolff’s research team showed that mercury was constantly evaporating from amalgam fillings in the mouth. The team’s opinion was that amalgam would not receive FDA (Food & Drug Administration) approval if it were launched today.

During the amalgam removal, very high concentrations of mercury can be released into the oral cavity and surrounding air which is breathed, which can put a massive strain on the body. Therefore, when removing amalgam, care should be taken to ensure maximum protection for the patient, assistant and dentist:  

  • The amalgam filling should be removed in one piece using the appropriate technique. This means that exposure to mercury can be reduced to a minimum.
  • Powerful extraoral suction system with an effective filter system for heavy metals.
  • Suction cup that is placed around the tooth and encloses it from all sides. This greatly improves the extraction of possible metal particles.
  • Gold-plated nose guard for the patient and gold-plated mouth guard for the assistant and dentist.
  • A cofferdam, a rubber band around the tooth, is used depending on the situation, since the application can have advantages as well as disadvantages.
Biological dentistry safe amalgam removal

Composites with high compatibility


Composites are mainly used in dentistry for fillings and have largely replaced amalgam.

Composites are also foreign materials and can have a toxic effect and cause activation of the immune system. As with metal, a lymphocyte transformation test can be used to determined how the immune system reacts to composite molecules.

When it comes to the biological compatibility of composites, two aspects are of particular importance: the choice of material and the degree of molecular cross-linking (polymerization) in the composite.

In our practice we use the Swiss quality product Saremco Green Line, which contains no BisphenolA, BisGMA, GEMA, TEGDMA and fluoride.

Admira Fusion from COVO, a composite that has a high ceramic content, is also used.

Biological dentistry Resins with high compatibility

For optimal cross-linking of the composite molecules, each layer is thoroughly cured with a powerful UV lamp. Finally, the filling is additionally polymerized several times.

The biocompatibility of the material is ideally improved through the use of proven, high-quality composites as well a deep and thorough polymerisation.

As a healthier alternative to composite fillings, laboratory-made ceramic fillings can be placed/integrated easily. These have a longer durability and show less strain than common fillings made of composites.

Jaw Inflammation – a Chronic Burden


There are various forms of inflammation in the jaw.

In X-ray images, for example in the digital volume tomography (DVT), they are shown as dark areas that can be easily distinguished from healthy bone.

  • Inflammation of shifted or partially erupted wisdom teeth
  • Inflammation of damaged or root canal treated teeth
  • Inflammation of foreign bodies remaining in the bone, such as metal splinters, overpressed root filling material, tooth fragments, etc.
  • Other forms of jaw osteitis

Such inflammatory processes in the jawbone can represent a permanent burden on one’s health. The immune system is put into a continuously active state, which means that it requires more energy. This energy is then missing for daily activities – the affected person feels tired and exhausted.

Due to the proximity to the brain and the good blood circulation in the head, the negative influence of jaw inflammation on the body is quite pronounced.

In biological dentistry, areas of inflammation in the jaw are completely removed. The wound healing is ideally supported by minimally invasive surgical techniques using A-PRF and ozone. If teeth are removed, compatible ceramic implants can be placed immediately – bone resorption and the need for a bone graft later on are avoided.

Ozone in Biological Dentistry


Ozone is a gaseous molecule composed of three oxygen atoms (O3). The main property is an effective disinfection.

Ozone is very important in biological dentistry. It can be used effectively in various pathological processes such as caries or periodontitis.

Ozone on the Biological Dentistry

Developing caries can be treated without breaking into the surface of the tooth. The ozone molecules penetrate deep into the softened tooth structure and eliminate the bacteria cousin the caries.

Even with gingivitis, the ozone can penetrate into the deep pockets of the gum and eliminate the periodontitis bacteria there. Bleeding gums and bad breath can also be greatly improved.

During operations in the oral cavity, the wound can be effectively disinfected with ozone, which improves wound healing and reduces postoperative complications.

Adjusting the Bite to the Correct Height and Position


The bite height indicates how the upper and lower jaw are aligned with each other vertically. Improper vertical alignment of the jaws can lead to various problems. For example, this results in compression and improper loading on the jaw joints, compression of blood vessels to the brain and tension in the chewing and facial muscles.

The alignment of the horizontal bite position is also important and should be taken into account.

Especially in patients with few teeth and in the case of complex restorations, the jaw relation should be adjusted as ideally as possible. For this we use the exact evaluation of the three-dimensional dental volume tomography (DVT) as well as a digital intraoral scan.

The digital volume tomography provides clear reference points of the patient’s skull, whereby the correct skull axes and planes can be determined. Using this, the ideal position of the jaws to one another and the correct position of the jaw joints can be determined exactly.

Additional intraoral scans of the upper and lower jaw, and of the bite, presents the individual situation of the teeth and gums.

Biological dentistry with adjustments of bite height and bite position

The information obtained of the skull from the DVT and the information on the teeth and gums from an intraoral scan are combined digitally and result in a complete, uniform picture. This clear and repeatable information flows into the treatment planning. Thus, the ideal position of the ceramic implants and the exactly shape of the tooth crowns can be individually and precisely determined.

In the case of complex functional disorders of the masticatory system, we use dentokinetics and the MAGO splint. Please see the TMD/TMJD article for more information.

The holistic view should always take into account the bite position and bite height. The correct alignment of the jaws to one another is of great importance for health and quality of life.

Biological Impression


Before a denture can be made, an impression of the teeth is made. The type of impression and the material used determine how compatible it is.

Impressions are often made with silicone or polyether, which provide good results but also have disadvantages in terms of biocompatibility. Polyether in particular shows increased toxicity in various studies and should be avoided.

Hydrocolloid, which is obtained from algae, offers the best compatibility and has the most precise impression properties at the same time. Therefore, from a biological point of view, hydrocolloid is clearly preferable to silicone and polyether.

Another modern and harmless solution is the digital intraoral scan. With a small camera, many photos are taken in rapid succession and combined to form a complete, three-dimensional representation of the mouth. This intraoral scan can completely replace impressions made with impression compounds.

Biological dentistry and biological impressions

The use of hydrocolloid impression material or the latest generation of intraoral scanners have a clear advantage in terms of biology. Depending on the situation, we choose one of the two methods in our practice.

Biological Bleaching


If a patient finds their teeth too yellow or dark, they can be whitened quickly and easily with the help of bleaching.

Normally, a high-percentage hydrogen peroxide gel is used in teeth whitening. This gel also contains acids such as phosphoric acid or acetic acid, which not only has a bleaching but also a caustic effect. This can lead to oversensitive teeth and irritated gums.

In our dental practice we use a mild method based on plasma medicine and ozone, with no side effects.

Before this biological bleaching, the teeth are carefully cleaned and plaque/tartar buildup are removed.

Since the oral cavity is flooded with oxygen molecules during the procedure, the pathological bacteria are eliminated at the same time.

Long Lasting Prophylaxis in Biological Dentistry


Many patients wonder why problems in the oral cavity remain and nothing changes. Year after year, more and more caries form and the inflammation of the gums only subsides for a short time.

The reason for the progressive, destructive process in the oral cavity depends on the oral bacterial flora. If the flora has a large number of pathological bacteria, e.g. bacteria that cause tooth decay, periodontitis or bad breath, the corresponding symptoms will appear.

In order to prevent this progressive destruction in the oral cavity, the oral bacterial flora should be improved.

In our practice we have a holistic prophylaxis concept, which effectively addresses the flora in the mouth. By optimizing the bacterial composition, there are fewer oral problems (e.g. caries, periodontitis, bad breath) and therefore a huge improvement in quality of life.

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