Pediatric and General Dentists See Bioactive Dental Materials Differently, Survey Finds

"Bioactive" is printed on more dental product boxes every year. A new survey asked how well dentists understand bioactive dental materials, and how often they reach for them. Pediatric dentists and general dentists gave noticeably different answers, and one question about fluoride revealed how fuzzy the label still is.

TL;DR

• A survey of 240 Costa Rican dentists found pediatric dentists more often defined bioactive materials correctly than general dentists

• About two in three dentists used bioactive materials, with no clear difference between the two groups

• Pediatric dentists were more likely to use these materials in at least a quarter of their cases

What Did the Bioactive Materials Survey Study?

The study was published on November 8, 2026, in BDJ Open. Researchers from the University of Costa Rica wanted to know whether dentists understand the bioactive label the same way, and whether that shows up in daily practice.

They sent a 25-item online questionnaire to practicing dentists in August and September 2025.

The questions covered familiarity with the term and how dentists defined it. They also asked which materials counted as bioactive, how often dentists used them, and whether training covered the topic.

How Did General and Pediatric Dentists Compare?

The two groups looked quite different in knowledge, while overall use was similar. Keeping those two ideas apart matters here.

Knowledge and Definitions

Most dentists had heard the term, with familiarity at 84.2% overall.

After adjusting for other factors, pediatric dentists had about five times the odds of picking the correct definition (aOR 4.98, 95% CI 1.57–15.74). The wide interval reflects the small pediatric group, so the exact size of the difference is uncertain.

Use Versus Frequency of Use

Overall, 65.3% of dentists said they used bioactive materials, and that share didn't differ meaningfully between groups. The difference appeared in how often. Pediatric dentists had about three times the odds of using them in at least 25% of cases (aOR 3.26, 95% CI 1.38–7.69).

Children's dentistry leans heavily on materials like glass ionomers and calcium silicates for small cavities, sealing, and pulp treatments in baby molars. General dentists may use the same products, just less often.

Which Materials Did Dentists Recognize as Bioactive?

Recognition was patchy, with roughly half the sample identifying the most established options.

• Glass ionomer was recognized by 52.5%

• MTA was recognized by 47.9%

• Resin-modified calcium silicates were recognized by 47.5%

The groups also differed on giomers and hydroxyapatite or calcium phosphate products. The researchers deliberately added topical fluoride to the list to see whether dentists would mix it up with bioactive materials. Fluoride helps teeth remineralize as a preventive agent. It doesn't work like a restorative material placed in a filling or on the pulp.

Why the Bioactive Label Causes Confusion

Here's the take some colleagues won't love. "Bioactive" has become a marketing word as much as a scientific one. Some products with the label release ions and form mineral at the tooth surface. Others release a little fluoride and little else, yet carry the same sticker.

That makes the survey results less surprising. When manufacturers stretch a term, clinicians naturally end up with different definitions. MTA and calcium silicate cements like Biodentine have years of pulp therapy research behind them. A flowable composite that releases a few ions is a different story, even if both appear in the same catalog section.

About 30.7% of dentists considered their training on the topic insufficient, and 16.8% said the term wasn't used during their education. The survey can't show that training caused the knowledge differences, though. It only shows that both appeared in the same answers.

What This Means for Patients

For patients, the label on the box matters less than the reason for choosing a material. A good dentist should be able to explain why a specific filling or liner suits your tooth. That applies to a child's molar and to a deep cavity close to the nerve alike.

A few questions are worth asking during a visit.

• What material are you using, and why this one for my tooth?

• How long does it usually last compared with other options?

• Is there research showing it works for this type of treatment?

Practices that lay out options clearly in a written dental treatment plan make those conversations much easier. For a wider look at the trade-offs, see this guide on how dentists choose dental materials.

What Are the Study's Limitations?

This was a snapshot with clear limits.

• The sample was a convenience sample, so it may not represent all Costa Rican dentists

• Most participants worked in the Central Valley region

• Use was self-reported, which can differ from what happens in practice

• The cross-sectional design can't show cause and effect

• No treatment outcomes were measured, so the study says nothing about which dentists get better results

• Dentists interested in the topic may have been more likely to respond

Bottom Line

Pediatric dentists in this survey knew the bioactive definition better and used these materials more often, while overall use was similar across both groups. No patient outcomes were measured, so neither group can claim better results. What stands out is how a popular label still means different things to different dentists. That alone is a good reason to ask what's going into your tooth and why.