I’m going to expand further on the five Pillars of Bioclear beginning with the Pillar number  one, which is biofilm removal.

Now, in talking about biofilm, we know that we all have it on our teeth and that it is composed of bacteria and their byproducts. There are glycoproteins, polysaccharides mixed with oral debris, and other components. Biofilm can have a healthy role in the oral cavity, but when it comes to bonding composite to our patients’ teeth, biofilm is never a good thing.

In reality, this negativity about biofilm related to poor adhesion is talked about frequently. It is written about in articles and textbooks with the usual suggestion to remove biofilm prior to performing the adhesion process.

Yet how much effort—consistent effort—do dentists make to be sure our patients’ teeth are completely cleaned of all biofilm before we attempt to place a restoration? If you look at instructions on a product label, it might mention that you should remove all biofilm from the tooth prior to using their product, and that’s about it. The instructions usually start with etching the tooth.

Well, we tested that method out. We took a tooth, disclosed it so you could see the biofilm, and then applied 37% phosphoric acid to it and found that it did absolutely nothing in regards to removing that layer of biofilm. Bioclear Pillar number one ensures complete removal, and it’s rather easy, as you will see later in this course.

Okay, so we know that we need to remove all biofilm from the tooth we are just about to bond to. But let’s discuss other reasons why this is so important to do, and even critical to the long-term success of our patients’ restorations.

All adhesives require a high surface energy to attract itself to the tooth. Biofilm produces low surface energy and doesn’t allow the adhesive to bond well at all. It might appear to do so, but we know what happens later on, don’t we? We start to see staining at the edges of our composite.

We see Class V restorations that fall out. Sensitivity issues arise and we don’t even know why because we thought we did everything right.

And this doesn’t make patients very happy does it? Listen, we have all been guilty of it so don’t feel badly. Rather, get excited that all of this is about to change for you.

How about this reason: it’s just an ethical thing to do. It’s a matter of good practice that we consider our patients’ reasons for coming to see us. They expect that we know this. They expect that we would do to their tooth exactly what we would want done to ours. Ask yourself, wouldn’t you want me to remove the biofilm completely before I restored your own tooth?

Let’s return for a few moments to the issue of stained margins. How about this word: flash. Remember how this is a bad word in dentistry? Flash is terrible because it’s an area of leakage and stain, and let’s face it; we hate seeing it. As a dentist, it makes me feel bad.

That happens because biofilm was present and you thought the surface was cleaned. You may have even used a quick pumice and rubber cup prophy and yet, the stain was still there.

But in the Bioclear world, we don’t mind extra composite going out beyond our preparation. In fact, we want it and we need it!

But there is a difference between flash, which is composite over biofilm and what is called “the infinity edge”. The infinity edge is good! It’s where you have a well-bonded composite that will not stain, because the biofilm was removed.

The method is simple:

After choosing your shade of composite, you disclose the tooth or teeth you are working on with our Bioclear Disclosing Solution. Then you go through the necessary tooth preparation, if needed, and blast away all remaining biofilm that has been disclosed with our Bioclear Blaster.

The Bioclear Blaster is an instrument you will snap on to your unit. It has a powder receptacle that is filled with Bioclear Blasting powder—a mild aluminum tri-hydroxide powder that is much safer than the aluminum tri-oxide found in most sandblasting units—and it is forty times softer as well, so it will not harm the tooth, or lead to scratches on your loupes like sandblasting powder can do. It is meant to do one major thing well: remove Biofilm and the invisible protein pellicle.

There you have it. You already know the reasons for being diligent about giving your patients the best restoration possible; now you understand why it begins with a perfectly clean tooth free of all biofilm. Exactly like you would want it.