By Krissy Dail, DA
Working as a dental assistant means serving as the right hand to the dentist, and anticipating his or her next move before it’s made. It’s important to be well versed in the dentist’s preferred materials and techniques to fully understand when and why a particular material is used. With 14 years in dental assisting and experience training new assistants at my current practice, I have truly realized firsthand the value of gaining practical experience using a variety of materials. Depending on state law, dental assistants may not commonly place restorations or directly use composite materials. However, a thorough knowledge of the materials and experience with preparing them is paramount to offering the best possible assistance.
Not all restorative materials are created equal. For a restorative to be effective, it must have ideal handling properties, along with the esthetics and strength to provide a long-term, beautiful restoration for the patient.
For me, the best restorative material to achieve all of these characteristics is 3M ESPE Filtek™ Supreme Ultra Flowable Restorative. The handling properties and consistency are excellent. With this material in particular, I’ve noticed that it consistently exhibits the flow-on-demand behavior that dentists prefer. Under pressure of being dispensed or manipulated with instruments, the material becomes more liquid and flows easily and quickly where it’s needed. After placement when flow stops, it returns to a higher viscosity and holds its shape without slumping or running. Of course it’s all about timing when I’m supporting the dentist, and with the capsule dispensing system I simply place the capsule in the applicator, hand it to him, and he uses what he needs with no mess or waste. The syringe dispenser is a great tool as well and provides precise, easy application.
We see a lot of children come through our practice with chipped or cracked teeth from rough playing or falling. In these cases, Filtek Supreme Ultra Flowable restorative is ideal because it’s easy to work with and esthetically a great match to the natural tooth. This material in particular exhibits excellent fluorescence for a more life-like appearance, and very high polish retention. Because the material is also strong, it is likely that the restoration will serve the child well into the future.
Children are not the only patients that benefit from highly esthetic restorative materials that create an almost identical match to natural dentition. We often see patients who have had work done in the anterior who are very unhappy with the look, and they feel like people notice their mismatched restorations. It’s important to work with a material that not only offers good opacity, but also has shades that will be a good fit universally, and that make it possible to match stains or discolorations on surrounding teeth.
Once the dentist removes all decay or old restorative material and the primer and bonding agents have been placed, it's also possible to place a small amount of flowable restorative followed by composite material in a capsule. The combination allows the flowable to reach hard-to-access areas or use as a liner, while also benefitting from the composite material’s different body, enamel, and dentin shades to build a close match to the natural color variances of the tooth. With a combination of the flowable material and composite, you would be hard pressed to know whether patients have had any work done.
In addition to lending themselves to class III and class V restorations and simple occlusal composites, flowable restoratives also work particularly well as a liner for direct restorations, or under a crown as pulpal protection when the dentin is thin over the pulp, thus avoiding post-operative tooth sensitivity.
Flowable restorative material is also useful when working with patients that have a difficult time keeping their mouths open, or for those who have considerable saliva in the mandible. It allows the dentist to get in and complete the restoration in less time. For restorations that are harder to reach, for example, the distal of tooth No. 2, Filtek Supreme Ultra Flowable restorative is ideal because of its easy handling and flow-on-demand dispensing. This easy access, even in difficult-to-reach restoration sites, is essential, and your dentist will appreciate a material that makes this simple and efficient.
A restorative material that allows for ease of handling in a variety of situations while offering lasting esthetics and strength is essential. Furthermore, getting to know your dentist's preferred restorative materials inside and out helps you to not only be as useful as possible to the dentist you support, but allows you to offer the best treatment solution to the most important people in your practice — your patients. While you may not be the one placing the restoration, knowing the potential strengths and weaknesses of materials and techniques makes you a valuable asset to any dental team.
Krissy Dail is a dental assistant for Drs. Robert G. Ritter and Christopher D. Ramsey in Jupiter, Fla. She received her diploma in dental assisting from the University of Florida, and has been working in dentistry for over 14 years. She takes pride in helping patients create beautiful smiles they can be proud of.