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experiencelifemag.com
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A Different Kind of Dentistry
Holistic dentists take a whole-body approach to dental care - an approach enthusiastically embraced by a growing clientele, and largely rejected by the
conventional dental establishment.
By Kristin Ohlson |
September 2009 |
The Whole-Body Connection
Biting Criticism
Different Takes on Orthodontia
Root-Canal Concerns
Disagreements About Amalgams
How to Find a Holistic Dentist
The Domino Effect
If the idea of a holistic dentist is new to you, you’re not alone. But if
holistic dentistry follows the same path that the rest of medicine has been
traveling, the concept probably won’t remain unfamiliar to you and other health
seekers for long.
It used to be that when someone said they were
going to the doctor, it meant only one thing: They were going to see a physician
trained in allopathic (conventional) medicine. While there were other
professionals who treated problems of the body — alternative practitioners like
chiropractors, acupuncturists, osteopaths, naturopaths and even medical doctors
who practiced integrative care — many people either hadn’t heard of them or
hesitated to seek their help. The medical establishment scoffed at them. Health
insurance wouldn’t cover their services.
But things changed, in large part
because of growing patient demand and a growing body of evidence that such
alternative treatments were not only sought after, but had good clinical
outcomes. For the most part, these alternative practitioners are now accepted as
part of our spectrum of healthcare. It’s not unheard of for conventional doctors
to refer clients to them, and insurance often covers at least some of their
treatment costs.
This level of acceptance has not yet reached dentists who
offer an alternative approach to conventional dental care. But their profession
seems to be following a path not unlike those that other alternative-care models
have already tread, and their methods may be destined for a similar measure of
public acceptance and success.
Like alternative medical practitioners,
holistic dentists approach care in ways that depart from conventional treatment,
employ methods culled from other complementary approaches and reject some
traditional procedures — especially root canals and the installation of amalgam
“silver” fillings — they perceive as being potentially harmful or downright
dangerous.
And as it was with the chiropractors and acupuncturists who
preceded them, their progressive perspectives are not looked upon kindly by the
establishment.
The American Dental Association (ADA) declined to comment for
this story, instead pointing to a policy statement on its Web site:
“‘Unconventional dentistry’ is defined as encompassing scientifically unproven
practices and products that do not ... conform to generally accepted dental
practices or ‘conventional’ methods of evaluation, diagnosis, prevention and/or
treatment of diseases, conditions and/or dysfunctions relating to the oral
cavity and its associated structures ... The dental profession advocates an
evidence-based approach to oral health care that requires the judicious
integration of systematic assessments of clinically relevant scientific evidence
...”
But alternative practitioners insist that there’s scant science behind
some of the standard procedures of conventional dentistry, as well as a long
history of problems and health complications caused by some conventional dental
treatments. They can also point to plenty of research that supports their own
pioneering work and articulate the need for progress in a profession that they
suggest has been mired in traditions that have not always served the best health
interests of its patients.
“All dentistry should be evidence based,” says
David Kennedy, DDS, past president of the International Academy of Oral Medicine
and Toxicology, which promotes scientific research on biocompatible dentistry
(basically, the avoidance of toxic compounds in dental materials). “Dentists
think they are doing evidence-based work when they get out of dental school. But
unfortunately, dental schools just teach ADA dogma.”
The Whole-Body Connection
The basic tenets of holistic dentistry are
simple: Dentistry should do no harm, and dentists must look at the mouth, teeth,
gums and jaws as integral parts of a larger, whole-body system. Holistic
dentists see the mouth as more than just a receptacle and processing station for
food. Indeed, the health and structural integrity of the mouth both influence
and are influenced by everything else going on in the body — from skeletal
mechanics to nutritional biochemistry.
Beyond those basic tenets, there is
great diversity in how holistic dentists practice their craft. They may employ a
wide variety of approaches to support and improve their patient’s overall health
— and they may define health as comprising many aspects of physical, emotional
and even spiritual well-being.
First visits with a holistic dentist
generally involve comprehensive examinations and inquiry sessions that may
last two hours or more. The intake forms might ask what other healthcare
providers the patient is seeing, including herbalists and acupuncturists. They
might ask the patient about health issues that are seemingly unrelated to the
mouth: for instance, whether the patient has had disorders of the nervous
system — from epilepsy to chronic nerve pain — or suffers from depression,
digestive trouble, skin irritation or difficulties breathing. They might ask if
the patient is sleeping well, has any phobias or has been dealing with an
unusual amount of stress.
All these questions originate from the core belief
that the health of the mouth and the overall body are connected. “Disease is
always multi-factorial,” says Steve Green, DDS, a second-generation dentist who
practices in Miami, Fla. “When someone comes to me with a toothache, I see two
problems. One, there’s a sick tooth. And two, the patient is rundown. A healthy
person can carry a sick tooth for years, but if they go through a divorce or
lose a job, their immune system suffers, and the tooth quickly becomes
intolerable.”
Recent studies support the connection between oral and overall
health. Researchers at the State University of New York at Buffalo — funded by
the National Institute of Dental and Craniofacial Research — showed that people
with periodontal disease have a two- to four-times greater risk of suffering a
heart attack.
This tie is acknowledged by even conventional dentists, many
of whom employ the heart-disease angle to encourage their patients to floss. But
even though the health profession overall is moving toward a greater
appreciation of the connection between the mouth and the body, the attention
holistic dentists pay to medical issues discomfits the conventional dental
industry.
Biting Criticism
All holistic dentists have completed the same
professional training that conventional dentists undergo to earn their Doctor of
Dental Surgery (DDS) degrees. Many also practiced as conventional dentists long
before they decided to shift their practices in a more holistic direction and
complete additional training to support what they saw as more promising and
productive methods.
The criticism or even outright betrayal implied by
holistic dentists’ rejection of certain aspects of their early conventional
training — which many of them later come to see as incomplete or just plain
wrong — may have something to do with the professional animosity that brews
between the two camps.
To the ADA (and the state licensing boards closely
tied to the organization), holistic dentists inappropriately blur the line
between medicine and dentistry. Conventional dentists resent the aspersions
holistic dentists cast
upon certain conventional methods, and they are
highly skeptical of the companion therapies their holistic
colleagues
recommend or employ. These may include immune-building and detoxifying
nutritional programs, chiropractic, hypnosis, and acupressure or craniosacral
therapy (a very gentle form of massage intended to ease tension in the tissue
around the head and spine).
This integrated treatment approach attracts
holistic-minded clients and produces many glowing and grateful patient
testimonials, but it can also open holistic dentistry practitioners to a host of
professional liabilities. Often, all it takes is one patient complaint to the
state dental board to create trouble. Some holistic dentists have had their
licenses revoked based on a board’s conviction that dentists simply shouldn’t be
talking about — much less treating — anything but teeth and gums.
“Aggressive dental boards try hard to find something wrong [with what we
do],” says Ron King, DDS, a former president of the Holistic Dental Association
who practices in Minneapolis. He recently served on Minnesota’s state dental
board, including a stint on its complaint committee, and says that a
license-endangering dispute can ensue over issues as minor as the use of certain
clinical terms. “Using the wrong word in a patient’s file can be enough” to put
a holistic dentist on the wrong side of a review board, says Mac Lee, DDS,
author of Nothin’ Personal, Doc, But I Hate Dentists! (IHD Publishing, 1999).
Underlying such technical quarrels over vocabulary, however, are some
important material disagreements about protocol and some important philosophical
arguments about what types of dental treatments are best for patients.
Perhaps the best way to understand such differences is to look at a few
representative areas where conventional and holistic dentists part ways.
Different Takes on Orthodontia
In conventional dentistry, otherwise
healthy teeth are often removed to make space for straightening crooked front
teeth. Most frequently removed are permanent side teeth (bicuspids) and baby
teeth that serve important functions in the mouth.
Holistic dentists
tend to take a more conservative and patient approach, preferring to keep
removal of teeth to a minimum because they see them as an important structural
component within the jaw and cranium, and may feel that removal of healthy teeth
presents unnecessary risks to the patient. Some holistic dentists avoid
extraction entirely and employ a range of expansion and realignment techniques
to create space in an overcrowded mouth and promote proper development of the
teeth and jaws. Others give cautious approval to limited tooth extraction when
they feel it is merited.
Many employ a variety of dental appliances,
including braces and retainers, to realign the teeth for healthy jaw
positioning, but they may recommend unconventional designs and materials and
employ a wider range of devices over a longer period of time to achieve an ideal
cosmetic and structural result. Some prefer “invisible” braces or metal
appliances that contain the least amount of nickel possible; they want to avoid
the potentially carcinogenic properties of the nickel in most conventional metal
braces.
“We try to preserve the mouth in as natural a condition as
possible,” says John Laughlin, DDS, a past president of the Holistic Dental
Association who has been practicing what’s called orthopedic or nonextraction
orthodontia for more than 20 years in River Falls, Wis. “And we do our best not
to amputate teeth.” (For more on Laughlin’s approach and the logic behind
extraction avoidance, see “The Domino Effect,” below.)
Laughlin practiced
as a conventional dentist for several years after he graduated from dental
school, but he started rethinking this approach when a patient came in
after an oral surgeon had removed four bicuspids. The patient’s facial structure
was so collapsed that he “looked as if he’d been hit in the face with a baseball
bat,” he recalls. It was clear to Laughlin that a more sensitive, conservative
approach would have served the client better. So he began to explore other
approaches.
At around the same time, he became interested in the work of
cranial osteopaths Viola Frymann, D.O., and John Upledger, D.O., who teach
that the bones of the skull never fuse, an opinion consistent with current
science, but counter to most conventional dentists’ training. “Even though the
bones look fused in an X-ray or MRI scan, they actually allow for minute
movement that is difficult to see with today’s technology,” says Upledger,
adding that the flow of cerebrospinal fluid that nourishes the brain and spinal
cord can be blocked by stiffness among the skull bones. As a result of his
exposure to the foundational teachings and research of Frymann, as well as
William Sutherland, D.O., and M. B. DeJarnette, D.O., D.C., Upledger developed
craniosacral therapy to eliminate these blockages.
Rigid wire braces and
other standard orthodontic devices can limit the flexibility among cranial
bones, Laughlin learned. In looking for better options, he discovered the
Alternative Lightwire Functional (ALF) appliance. Invented by Darick Nordstrom,
DDS, the ALF appliance encourages the jaw to develop properly so that it can
better accommodate all of its original teeth. Laughlin now uses the device on
patients as young as 3 or 4 years old, gradually expanding the jaws as children
grow, preventing overcrowding of incoming teeth.
The ALF appliance snaps
around the molars and fits along the inside of the teeth, like the inner tube
inside a tire. The appliance moves when the patient swallows and works in accord
with the natural movement of the skull. Many holistic dentists who use the
appliance — about 400 worldwide have been trained — will later use light,
flexible braces to straighten the teeth after the jaw has properly developed.
But they consider this more-cosmetic work to be the completion of a task that
must begin with foundational, functional work on the jaw. “For years,
orthodontists thought their job was only to straighten teeth,” says Nordstrom.
“But we know it’s not just about making teeth straight and attractive. It’s
about helping the patient swallow and breathe properly and about the long-term
stability of the face and body. Just straightening the teeth doesn’t always make
a healthy patient.”
Root-Canal Concerns
Many holistic dentists won’t do root canals, a process
by which a decayed or infected tooth is stripped of its nerve and pulp, cleaned
and sealed. They feel it’s impossible to sterilize the interior of the affected
tooth and that it becomes an incubator of bacteria that cause problems
throughout the body.
Concerns about root canals date back to studies
conducted in the 1920s by a former National Dental Association (which preceded
the ADA) research director named Weston Price. He implanted teeth from the root
canals of people with heart and kidney disease in healthy rabbits and found that
the rabbits contracted the same diseases. Price’s ideas were later ridiculed,
but even some conventional dentists voice concern about the practice.
“I
have sometimes had to remove a patient’s root-canal tooth that’s gotten cracked
or reinfected,” says Lee. “When you look at the hole where the tooth came from,
it often doesn’t look right. There seems to be more debris and infection. That’s
why I give [Price’s] whole line of thought some credibility.”
Biochemist Boyd
Haley, PhD, professor emeritus at the University of Kentucky, shares Lee’s
concern. “Root canals harbor toxic bacteria,” Haley says. “No blood flows to
that tooth, no antibodies can get to it, and the bacteria morph into more toxic
forms. And every day, bacteria come out of that root canal and you swallow them.
If the gums bleed, the bacteria go into the capillaries.”
Kathrine Aaberg,
44, had a root canal three years ago and began suffering unceasing pain in the
area of the affected tooth. Her conventional dentist told her it could take up
to a year for a root canal to heal properly. When the pain didn’t abate after a
year, she saw an ear, nose and throat specialist who decided that the problem
was a blocked parotid (saliva) duct and operated. When the pain persisted, her
dentist decided she had a TMJ (temporomandibular joint) problem and sent her to
a physical therapist. Still in pain, she consulted a renowned parotid duct
specialist who told her she was in perfect health.
“You think,
‘seek and ye shall find,’ but I kept seeking and no one could find what was
wrong,” Aaberg recalls. “No one would listen to me. They just kept telling me
I’d be fine, because they couldn’t find the source of the pain with their
technology.”
Finally, an alternative health practitioner told her that he
thought the root-canal tooth was poisoning her and recommended she go to a
holistic dentist. She found Ron King, who diagnosed a chronic bone infection
around a normal-appearing root canal and recommended extraction. When the tooth
was removed, her pain disappeared. “I was so happy and grateful,” Aaberg says.
“I fill up with tears every time I think of it. It’s been a long road.”
Disagreements About Amalgams
Perhaps no issue in the dental world has
been more ran-corous than amalgams, the “silver” cavity fillings that contain up
to 50 percent mercury. As far back as the 1800s, some dentists have argued that
it was dangerous to put mercury, a known neurotoxin, into the mouth. This
tends to be the position taken by holistic dentists, many of whom advise against
the use of amalgams and also specialize in the safe removal of amalgams placed
by other dentists.
The ADA, conversely, has steadfastly asserted its belief
in the safety and stability of these fillings, noting on its Web site that
“Dental amalgam (silver filling) is considered a safe, affordable and durable
material
that has been used to restore the teeth of more than 100 million
Americans.”
The ADA cites studies that bolster this position. But a growing
number of studies suggest that the mercury in these fillings leaches into our
bodies as we chew, and when we brush or grind our teeth. There is no scientific
consensus about the effect of these small bursts of mercury over a lifetime, but
some researchers believe it’s a significant health issue.
In the 1980s,
University of Calgary researchers placed amalgam fillings compounded with
radioactive mercury to track its dispersal in the bodies of pregnant sheep
(chosen for their frequent chewing). After a month, they discovered the mercury
had leached into the sheep’s vital organs.
More recently, University of
Georgia microbiologist Anne Summers, PhD, conducted a similar study using
monkeys, which have chewing patterns more like that of humans. Summers not only
found that the mercury leached out, but that the bacteria in the monkeys’
intestinal tracts had become resistant to both mercury and antibiotics.
Bacterial genes that resist mercury, she explains, are in the same DNA package
as the ones that resist antibiotics. In other words, if your bacteria become
mercury resistant because of your fillings, they’re likely to become antibiotic
resistant, too.
“Frankly, I think the use of amalgam fillings in the
developed countries is the public health sleeper of the century,” says Summers,
who notes that mercury’s complex and varied toxicology make it “an
epidemiological nightmare.”
Holistic dentists and others who argue for
eliminat-ing mercury amalgams compare the shifting weight of research and
opinion about them to public health battles of the past regarding smoking and
asbestos, which were once considered safe and are now known to pose serious
health threats. And they predict that the amalgam controversy may be the first
of many protracted battles ultimately destined to go holistic dentistry’s
way.
The most recent shift in their favor: In June 2008 the U.S. Food and
Drug Administration (FDA) changed
the information on its Web site about
amalgam fillings. It is widely thought that the agency is likely to reclassify
dental amalgams later this year.
The FDA had previously stated that amalgams
were safe and listed them in the same category of medical devices as Band-Aids.
Today, the agency takes a far more measured stance. Its carefully worded
statement now reads: “Dental amalgams contain mercury, which may have neurotoxic
effects on the nervous systems of developing children and fetuses. When
amalgam fillings are placed in teeth or removed from teeth, they release mercury
vapor. Mercury vapor is also released during chewing ... Pregnant women ...
should not avoid seeking dental care, but should discuss options with their
health practitioner.”
This shift in position came two years after the FDA’s
Dental Products Panel voted to reject the agency’s conclusion on the safety of
mercury amalgams and demanded further research and public testimony. Panel
members were especially concerned that dentists did not even tell patients that
amalgam fillings contained mercury.
“The physicians and PhDs on the panel
were incredulous,” says Michael Fleming, DDS, who is serving a four-year term on
the panel (and stressed that he was speaking for himself and not as a
representative of the FDA). “Prior to 2006, dentistry managed to escape scrutiny
on informed consent for the products installed in patient mouths. In the case of
amalgam, patients had no idea their dentists were putting mercury in their
mouths. They were never told.”
This shift in the tide on mercury is an
important victory for holistic dentists, who for decades endured ridicule and
even fury from their colleagues on this issue. They hope it will prompt critical
examination of other issues important to dental health and boost the holistic
philosophy into the mainstream. Some already see this happening.
“If you live
long enough, the old guard retires and goes out of power,” says Craig Zunka,
DDS, a past president of the Holistic Dental Association who practices in Front
Royal, Va. He notes that demand for holistic dentists far outstrips the supply
of practitioners, many of whom maintain lengthy waiting lists and book
appointments months in advance.
Meanwhile, even some conventional dentists
are expressing interest in the methodologies and philosophies with which their
holistic counterparts seem to be having the most success, from treating TMJ to
saving broken or badly decayed teeth.
“Twenty years ago,” says Zunka, “I
considered closing up my practice and going to osteopathic medical school — I’d
get to do some of the things I wanted without getting rocks thrown at me. But
now, some of the people who used to throw rocks are coming around and asking me
how the holistic approach works.”
Kristin Ohlson is a writer in Cleveland Heights, Ohio.
How to Find a Holistic Dentist
“People are unaware that
there is a choice in dentistry,” says Jessica Saepoff,
DDS,
who has a
practice near Seattle. “I think the holistic patient
community is
terribly underserved.”
Yet, it takes a
little work to find a
holistic
dentist. Since American dental
schools don’t teach holistic
dentistry,
practitioners who want
to offer their patients alternative
approaches spend
thousands
of hours taking classes at various centers
around the country. As a
result, “holistic” means different things to
different
dentists — and there
isn’t one definitive list of
practitioners with a holistic approach.
If
you want
to find a
holistic dentist in your area, study the Web sites of the
four major
organizations that address their concerns. All have
a list of active
members, but you’ll have to interview
individual practitioners to
determine
their philosophy and
array of services.
The Domino Effect
Traditional
orthodontia often involves the
removal
of up to four
bicuspids, the
double-pointed teeth
between the
six
teeth
at
the front of our
mouths and our
molars.
These extractions
provide room for the
orthodontist to
straighten the
teeth with
relative
ease. But
many holistic
dentists
believe that patients wind
up
sacrificing long-term
health in pursuit of a
perfect
smile.
“We
were
meant to
have
those
teeth in our
mouths,” says John Laughlin, a
holistic dentist
practicing in River Falls,
Wis. “Anytime you
take out
teeth or affect the
structure of
the jaw, you’re
affecting
something
much
larger.”
When these
teeth
are
removed, the jaw
shrinks back
into
the face, Laughlin
explains. This
not only creates a
less
flattering profile, but
also
increases
stress on the
temporomandibular
joint
(TMJ)
and may cause it
to degenerate. This can lead to
imbalances
in the entire body.
The
head and neck try
to
compensate for the
aberration in the
jaw’s
position,
the spine tries to compensate for
misalignments in
the
head and neck, and the
dislocation ripples through
the
body.
This may often
lead to headaches, earaches and
tension in
the
neck
—
and even
problems
in the
back and hips.
In addition to
triggering
this
accumulation of
assaults on the
structure of
the
body,
extraction can
also
affect other processes. As the
jaw shrinks back,
it
can cause a reduced level of
function in
several glands, including the
pituitary
and
pineal gland; negative
results can
include depression and
poor digestion.
There
is
also less room
in this
smaller oral
cavity
for the
tongue,
which is forced to the
back of the
throat,
causing both
to
function less
efficiently.
In this
scenario,
a person
may become, or
continue to be, a
mouth-breather. Then the nose is
deprived of
its
function of
both warming the breath
before it enters
the
body and cleansing
it of potentially
harmful
airborne
substances.
Without this crucial
filtration
system,
people face an array
of new problems, from
aggravated
allergies
to
pneumonia.
It’s a classic example,
says
Laughlin, of how
holistic dentistry
sees
complex, yet
logical, health
connections
that their
conventional
counterparts minimize or
reject.
“Conventional
dentistry and medicine are
often
not
open to these
possibilities and
may not consider them
at all. I don’t
understand why,
because it makes so
much sense.”
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A Different Kind of Dentistry
Holistic dentists take a whole-body approach to dental care - an approach enthusiastically embraced by a growing clientele, and largely rejected by the
conventional dental establishment.
By Kristin Ohlson | Features,
September 2009 |
The Whole-Body Connection
Biting Criticism
Different Takes on Orthodontia
Root-Canal Concerns
Disagreements About Amalgams
How to Find a Holistic Dentist
The Domino Effect
If the idea of a holistic dentist is new to you, you’re not alone. But if
holistic dentistry follows the same path that the rest of medicine has been
traveling, the concept probably won’t remain unfamiliar to you and other health
seekers for long.
It used to be that when someone said they were
going to the doctor, it meant only one thing: They were going to see a physician
trained in allopathic (conventional) medicine. While there were other
professionals who treated problems of the body — alternative practitioners like
chiropractors, acupuncturists, osteopaths, naturopaths and even medical doctors
who practiced integrative care — many people either hadn’t heard of them or
hesitated to seek their help. The medical establishment scoffed at them. Health
insurance wouldn’t cover their services.
But things changed, in large part
because of growing patient demand and a growing body of evidence that such
alternative treatments were not only sought after, but had good clinical
outcomes. For the most part, these alternative practitioners are now accepted as
part of our spectrum of healthcare. It’s not unheard of for conventional doctors
to refer clients to them, and insurance often covers at least some of their
treatment costs.
This level of acceptance has not yet reached dentists who
offer an alternative approach to conventional dental care. But their profession
seems to be following a path not unlike those that other alternative-care models
have already tread, and their methods may be destined for a similar measure of
public acceptance and success.
Like alternative medical practitioners,
holistic dentists approach care in ways that depart from conventional treatment,
employ methods culled from other complementary approaches and reject some
traditional procedures — especially root canals and the installation of amalgam
“silver” fillings — they perceive as being potentially harmful or downright
dangerous.
And as it was with the chiropractors and acupuncturists who
preceded them, their progressive perspectives are not looked upon kindly by the
establishment.
The American Dental Association (ADA) declined to comment for
this story, instead pointing to a policy statement on its Web site:
“‘Unconventional dentistry’ is defined as encompassing scientifically unproven
practices and products that do not ... conform to generally accepted dental
practices or ‘conventional’ methods of evaluation, diagnosis, prevention and/or
treatment of diseases, conditions and/or dysfunctions relating to the oral
cavity and its associated structures ... The dental profession advocates an
evidence-based approach to oral health care that requires the judicious
integration of systematic assessments of clinically relevant scientific evidence
...”
But alternative practitioners insist that there’s scant science behind
some of the standard procedures of conventional dentistry, as well as a long
history of problems and health complications caused by some conventional dental
treatments. They can also point to plenty of research that supports their own
pioneering work and articulate the need for progress in a profession that they
suggest has been mired in traditions that have not always served the best health
interests of its patients.
“All dentistry should be evidence based,” says
David Kennedy, DDS, past president of the International Academy of Oral Medicine
and Toxicology, which promotes scientific research on biocompatible dentistry
(basically, the avoidance of toxic compounds in dental materials). “Dentists
think they are doing evidence-based work when they get out of dental school. But
unfortunately, dental schools just teach ADA dogma.”
The Whole-Body Connection
The basic tenets of holistic dentistry are
simple: Dentistry should do no harm, and dentists must look at the mouth, teeth,
gums and jaws as integral parts of a larger, whole-body system. Holistic
dentists see the mouth as more than just a receptacle and processing station for
food. Indeed, the health and structural integrity of the mouth both influence
and are influenced by everything else going on in the body — from skeletal
mechanics to nutritional biochemistry.
Beyond those basic tenets, there is
great diversity in how holistic dentists practice their craft. They may employ a
wide variety of approaches to support and improve their patient’s overall health
— and they may define health as comprising many aspects of physical, emotional
and even spiritual well-being.
First visits with a holistic dentist
generally involve comprehensive examinations and inquiry sessions that may
last two hours or more. The intake forms might ask what other healthcare
providers the patient is seeing, including herbalists and acupuncturists. They
might ask the patient about health issues that are seemingly unrelated to the
mouth: for instance, whether the patient has had disorders of the nervous
system — from epilepsy to chronic nerve pain — or suffers from depression,
digestive trouble, skin irritation or difficulties breathing. They might ask if
the patient is sleeping well, has any phobias or has been dealing with an
unusual amount of stress.
All these questions originate from the core belief
that the health of the mouth and the overall body are connected. “Disease is
always multi-factorial,” says Steve Green, DDS, a second-generation dentist who
practices in Miami, Fla. “When someone comes to me with a toothache, I see two
problems. One, there’s a sick tooth. And two, the patient is rundown. A healthy
person can carry a sick tooth for years, but if they go through a divorce or
lose a job, their immune system suffers, and the tooth quickly becomes
intolerable.”
Recent studies support the connection between oral and overall
health. Researchers at the State University of New York at Buffalo — funded by
the National Institute of Dental and Craniofacial Research — showed that people
with periodontal disease have a two- to four-times greater risk of suffering a
heart attack.
This tie is acknowledged by even conventional dentists, many
of whom employ the heart-disease angle to encourage their patients to floss. But
even though the health profession overall is moving toward a greater
appreciation of the connection between the mouth and the body, the attention
holistic dentists pay to medical issues discomfits the conventional dental
industry.
Biting Criticism
All holistic dentists have completed the same
professional training that conventional dentists undergo to earn their Doctor of
Dental Surgery (DDS) degrees. Many also practiced as conventional dentists long
before they decided to shift their practices in a more holistic direction and
complete additional training to support what they saw as more promising and
productive methods.
The criticism or even outright betrayal implied by
holistic dentists’ rejection of certain aspects of their early conventional
training — which many of them later come to see as incomplete or just plain
wrong — may have something to do with the professional animosity that brews
between the two camps.
To the ADA (and the state licensing boards closely
tied to the organization), holistic dentists inappropriately blur the line
between medicine and dentistry. Conventional dentists resent the aspersions
holistic dentists cast
upon certain conventional methods, and they are
highly skeptical of the companion therapies their holistic
colleagues
recommend or employ. These may include immune-building and detoxifying
nutritional programs, chiropractic, hypnosis, and acupressure or craniosacral
therapy (a very gentle form of massage intended to ease tension in the tissue
around the head and spine).
This integrated treatment approach attracts
holistic-minded clients and produces many glowing and grateful patient
testimonials, but it can also open holistic dentistry practitioners to a host of
professional liabilities. Often, all it takes is one patient complaint to the
state dental board to create trouble. Some holistic dentists have had their
licenses revoked based on a board’s conviction that dentists simply shouldn’t be
talking about — much less treating — anything but teeth and gums.
“Aggressive dental boards try hard to find something wrong [with what we
do],” says Ron King, DDS, a former president of the Holistic Dental Association
who practices in Minneapolis. He recently served on Minnesota’s state dental
board, including a stint on its complaint committee, and says that a
license-endangering dispute can ensue over issues as minor as the use of certain
clinical terms. “Using the wrong word in a patient’s file can be enough” to put
a holistic dentist on the wrong side of a review board, says Mac Lee, DDS,
author of Nothin’ Personal, Doc, But I Hate Dentists! (IHD Publishing, 1999).
Underlying such technical quarrels over vocabulary, however, are some
important material disagreements about protocol and some important philosophical
arguments about what types of dental treatments are best for patients.
Perhaps the best way to understand such differences is to look at a few
representative areas where conventional and holistic dentists part ways.
Different Takes on Orthodontia
In conventional dentistry, otherwise
healthy teeth are often removed to make space for straightening crooked front
teeth. Most frequently removed are permanent side teeth (bicuspids) and baby
teeth that serve important functions in the mouth.
Holistic dentists
tend to take a more conservative and patient approach, preferring to keep
removal of teeth to a minimum because they see them as an important structural
component within the jaw and cranium, and may feel that removal of healthy teeth
presents unnecessary risks to the patient. Some holistic dentists avoid
extraction entirely and employ a range of expansion and realignment techniques
to create space in an overcrowded mouth and promote proper development of the
teeth and jaws. Others give cautious approval to limited tooth extraction when
they feel it is merited.
Many employ a variety of dental appliances,
including braces and retainers, to realign the teeth for healthy jaw
positioning, but they may recommend unconventional designs and materials and
employ a wider range of devices over a longer period of time to achieve an ideal
cosmetic and structural result. Some prefer “invisible” braces or metal
appliances that contain the least amount of nickel possible; they want to avoid
the potentially carcinogenic properties of the nickel in most conventional metal
braces.
“We try to preserve the mouth in as natural a condition as
possible,” says John Laughlin, DDS, a past president of the Holistic Dental
Association who has been practicing what’s called orthopedic or nonextraction
orthodontia for more than 20 years in River Falls, Wis. “And we do our best not
to amputate teeth.” (For more on Laughlin’s approach and the logic behind
extraction avoidance, see “The Domino Effect,” below.)
Laughlin practiced
as a conventional dentist for several years after he graduated from dental
school, but he started rethinking this approach when a patient came in
after an oral surgeon had removed four bicuspids. The patient’s facial structure
was so collapsed that he “looked as if he’d been hit in the face with a baseball
bat,” he recalls. It was clear to Laughlin that a more sensitive, conservative
approach would have served the client better. So he began to explore other
approaches.
At around the same time, he became interested in the work of
cranial osteopaths Viola Frymann, D.O., and John Upledger, D.O., who teach
that the bones of the skull never fuse, an opinion consistent with current
science, but counter to most conventional dentists’ training. “Even though the
bones look fused in an X-ray or MRI scan, they actually allow for minute
movement that is difficult to see with today’s technology,” says Upledger,
adding that the flow of cerebrospinal fluid that nourishes the brain and spinal
cord can be blocked by stiffness among the skull bones. As a result of his
exposure to the foundational teachings and research of Frymann, as well as
William Sutherland, D.O., and M. B. DeJarnette, D.O., D.C., Upledger developed
craniosacral therapy to eliminate these blockages.
Rigid wire braces and
other standard orthodontic devices can limit the flexibility among cranial
bones, Laughlin learned. In looking for better options, he discovered the
Alternative Lightwire Functional (ALF) appliance. Invented by Darick Nordstrom,
DDS, the ALF appliance encourages the jaw to develop properly so that it can
better accommodate all of its original teeth. Laughlin now uses the device on
patients as young as 3 or 4 years old, gradually expanding the jaws as children
grow, preventing overcrowding of incoming teeth.
The ALF appliance snaps
around the molars and fits along the inside of the teeth, like the inner tube
inside a tire. The appliance moves when the patient swallows and works in accord
with the natural movement of the skull. Many holistic dentists who use the
appliance — about 400 worldwide have been trained — will later use light,
flexible braces to straighten the teeth after the jaw has properly developed.
But they consider this more-cosmetic work to be the completion of a task that
must begin with foundational, functional work on the jaw. “For years,
orthodontists thought their job was only to straighten teeth,” says Nordstrom.
“But we know it’s not just about making teeth straight and attractive. It’s
about helping the patient swallow and breathe properly and about the long-term
stability of the face and body. Just straightening the teeth doesn’t always make
a healthy patient.”
Root-Canal Concerns
Many holistic dentists won’t do root canals, a process
by which a decayed or infected tooth is stripped of its nerve and pulp, cleaned
and sealed. They feel it’s impossible to sterilize the interior of the affected
tooth and that it becomes an incubator of bacteria that cause problems
throughout the body.
Concerns about root canals date back to studies
conducted in the 1920s by a former National Dental Association (which preceded
the ADA) research director named Weston Price. He implanted teeth from the root
canals of people with heart and kidney disease in healthy rabbits and found that
the rabbits contracted the same diseases. Price’s ideas were later ridiculed,
but even some conventional dentists voice concern about the practice.
“I
have sometimes had to remove a patient’s root-canal tooth that’s gotten cracked
or reinfected,” says Lee. “When you look at the hole where the tooth came from,
it often doesn’t look right. There seems to be more debris and infection. That’s
why I give [Price’s] whole line of thought some credibility.”
Biochemist Boyd
Haley, PhD, professor emeritus at the University of Kentucky, shares Lee’s
concern. “Root canals harbor toxic bacteria,” Haley says. “No blood flows to
that tooth, no antibodies can get to it, and the bacteria morph into more toxic
forms. And every day, bacteria come out of that root canal and you swallow them.
If the gums bleed, the bacteria go into the capillaries.”
Kathrine Aaberg,
44, had a root canal three years ago and began suffering unceasing pain in the
area of the affected tooth. Her conventional dentist told her it could take up
to a year for a root canal to heal properly. When the pain didn’t abate after a
year, she saw an ear, nose and throat specialist who decided that the problem
was a blocked parotid (saliva) duct and operated. When the pain persisted, her
dentist decided she had a TMJ (temporomandibular joint) problem and sent her to
a physical therapist. Still in pain, she consulted a renowned parotid duct
specialist who told her she was in perfect health.
“You think,
‘seek and ye shall find,’ but I kept seeking and no one could find what was
wrong,” Aaberg recalls. “No one would listen to me. They just kept telling me
I’d be fine, because they couldn’t find the source of the pain with their
technology.”
Finally, an alternative health practitioner told her that he
thought the root-canal tooth was poisoning her and recommended she go to a
holistic dentist. She found Ron King, who diagnosed a chronic bone infection
around a normal-appearing root canal and recommended extraction. When the tooth
was removed, her pain disappeared. “I was so happy and grateful,” Aaberg says.
“I fill up with tears every time I think of it. It’s been a long road.”
Disagreements About Amalgams
Perhaps no issue in the dental world has
been more ran-corous than amalgams, the “silver” cavity fillings that contain up
to 50 percent mercury. As far back as the 1800s, some dentists have argued that
it was dangerous to put mercury, a known neurotoxin, into the mouth. This
tends to be the position taken by holistic dentists, many of whom advise against
the use of amalgams and also specialize in the safe removal of amalgams placed
by other dentists.
The ADA, conversely, has steadfastly asserted its belief
in the safety and stability of these fillings, noting on its Web site that
“Dental amalgam (silver filling) is considered a safe, affordable and durable
material
that has been used to restore the teeth of more than 100 million
Americans.”
The ADA cites studies that bolster this position. But a growing
number of studies suggest that the mercury in these fillings leaches into our
bodies as we chew, and when we brush or grind our teeth. There is no scientific
consensus about the effect of these small bursts of mercury over a lifetime, but
some researchers believe it’s a significant health issue.
In the 1980s,
University of Calgary researchers placed amalgam fillings compounded with
radioactive mercury to track its dispersal in the bodies of pregnant sheep
(chosen for their frequent chewing). After a month, they discovered the mercury
had leached into the sheep’s vital organs.
More recently, University of
Georgia microbiologist Anne Summers, PhD, conducted a similar study using
monkeys, which have chewing patterns more like that of humans. Summers not only
found that the mercury leached out, but that the bacteria in the monkeys’
intestinal tracts had become resistant to both mercury and antibiotics.
Bacterial genes that resist mercury, she explains, are in the same DNA package
as the ones that resist antibiotics. In other words, if your bacteria become
mercury resistant because of your fillings, they’re likely to become antibiotic
resistant, too.
“Frankly, I think the use of amalgam fillings in the
developed countries is the public health sleeper of the century,” says Summers,
who notes that mercury’s complex and varied toxicology make it “an
epidemiological nightmare.”
Holistic dentists and others who argue for
eliminat-ing mercury amalgams compare the shifting weight of research and
opinion about them to public health battles of the past regarding smoking and
asbestos, which were once considered safe and are now known to pose serious
health threats. And they predict that the amalgam controversy may be the first
of many protracted battles ultimately destined to go holistic dentistry’s
way.
The most recent shift in their favor: In June 2008 the U.S. Food and
Drug Administration (FDA) changed
the information on its Web site about
amalgam fillings. It is widely thought that the agency is likely to reclassify
dental amalgams later this year.
The FDA had previously stated that amalgams
were safe and listed them in the same category of medical devices as Band-Aids.
Today, the agency takes a far more measured stance. Its carefully worded
statement now reads: “Dental amalgams contain mercury, which may have neurotoxic
effects on the nervous systems of developing children and fetuses. When
amalgam fillings are placed in teeth or removed from teeth, they release mercury
vapor. Mercury vapor is also released during chewing ... Pregnant women ...
should not avoid seeking dental care, but should discuss options with their
health practitioner.”
This shift in position came two years after the FDA’s
Dental Products Panel voted to reject the agency’s conclusion on the safety of
mercury amalgams and demanded further research and public testimony. Panel
members were especially concerned that dentists did not even tell patients that
amalgam fillings contained mercury.
“The physicians and PhDs on the panel
were incredulous,” says Michael Fleming, DDS, who is serving a four-year term on
the panel (and stressed that he was speaking for himself and not as a
representative of the FDA). “Prior to 2006, dentistry managed to escape scrutiny
on informed consent for the products installed in patient mouths. In the case of
amalgam, patients had no idea their dentists were putting mercury in their
mouths. They were never told.”
This shift in the tide on mercury is an
important victory for holistic dentists, who for decades endured ridicule and
even fury from their colleagues on this issue. They hope it will prompt critical
examination of other issues important to dental health and boost the holistic
philosophy into the mainstream. Some already see this happening.
“If you live
long enough, the old guard retires and goes out of power,” says Craig Zunka,
DDS, a past president of the Holistic Dental Association who practices in Front
Royal, Va. He notes that demand for holistic dentists far outstrips the supply
of practitioners, many of whom maintain lengthy waiting lists and book
appointments months in advance.
Meanwhile, even some conventional dentists
are expressing interest in the methodologies and philosophies with which their
holistic counterparts seem to be having the most success, from treating TMJ to
saving broken or badly decayed teeth.
“Twenty years ago,” says Zunka, “I
considered closing up my practice and going to osteopathic medical school — I’d
get to do some of the things I wanted without getting rocks thrown at me. But
now, some of the people who used to throw rocks are coming around and asking me
how the holistic approach works.”
Kristin Ohlson is a writer in Cleveland Heights, Ohio.
How to Find a Holistic Dentist
“People are unaware that
there is a choice in dentistry,” says Jessica Saepoff,
DDS,
who has a
practice near Seattle. “I think the holistic patient
community is
terribly underserved.”
Yet, it takes a
little work to find a
holistic
dentist. Since American dental
schools don’t teach holistic
dentistry,
practitioners who want
to offer their patients alternative
approaches spend
thousands
of hours taking classes at various centers
around the country. As a
result, “holistic” means different things to
different
dentists — and there
isn’t one definitive list of
practitioners with a holistic approach.
If
you want
to find a
holistic dentist in your area, study the Web sites of the
four major
organizations that address their concerns. All have
a list of active
members, but you’ll have to interview
individual practitioners to
determine
their philosophy and
array of services.
The Domino Effect
Traditional
orthodontia often involves the
removal
of up to four
bicuspids, the
double-pointed teeth
between the
six
teeth
at
the front of our
mouths and our
molars.
These extractions
provide room for the
orthodontist to
straighten the
teeth with
relative
ease. But
many holistic
dentists
believe that patients wind
up
sacrificing long-term
health in pursuit of a
perfect
smile.
“We
were
meant to
have
those
teeth in our
mouths,” says John Laughlin, a
holistic dentist
practicing in River Falls,
Wis. “Anytime you
take out
teeth or affect the
structure of
the jaw, you’re
affecting
something
much
larger.”
When these
teeth
are
removed, the jaw
shrinks back
into
the face, Laughlin
explains. This
not only creates a
less
flattering profile, but
also
increases
stress on the
temporomandibular
joint
(TMJ)
and may cause it
to degenerate. This can lead to
imbalances
in the entire body.
The
head and neck try
to
compensate for the
aberration in the
jaw’s
position,
the spine tries to compensate for
misalignments in
the
head and neck, and the
dislocation ripples through
the
body.
This may often
lead to headaches, earaches and
tension in
the
neck
—
and even
problems
in the
back and hips.
In addition to
triggering
this
accumulation of
assaults on the
structure of
the
body,
extraction can
also
affect other processes. As the
jaw shrinks back,
it
can cause a reduced level of
function in
several glands, including the
pituitary
and
pineal gland; negative
results can
include depression and
poor digestion.
There
is
also less room
in this
smaller oral
cavity
for the
tongue,
which is forced to the
back of the
throat,
causing both
to
function less
efficiently.
In this
scenario,
a person
may become, or
continue to be, a
mouth-breather. Then the nose is
deprived of
its
function of
both warming the breath
before it enters
the
body and cleansing
it of potentially
harmful
airborne
substances.
Without this crucial
filtration
system,
people face an array
of new problems, from
aggravated
allergies
to
pneumonia.
It’s a classic example,
says
Laughlin, of how
holistic dentistry
sees
complex, yet
logical, health
connections
that their
conventional
counterparts minimize or
reject.
“Conventional
dentistry and medicine are
often
not
open to these
possibilities and
may not consider them
at all. I don’t
understand why,
because it makes so
much sense.”
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September 6, 2009
Bonnie Johnson says:
I totally agree we need to be more informed on how generally accepted medicine, dentistry as well as everyday products like laundry detergent and toothpaste with formaldehyde are affecting our health. I have found a way to save money while getting better, safer products. You may also go to my website: www.thesecretoffeelingyounger.com. It goes into more detail on toxins in our home and how they are affecting our health, our energy, our immune system.
August 26, 2009
Laureen says:
I think this is an excellent article, and I think that it would be great if many of the conventional dentists would read it. In fact, it should be a must read for students of dental colleges. I believe I've had my own experience with the amalgam issue -- about 12 years ago some old fillings started falling out of my teeth and my dentist suggested seeing an Endodontist to get a root canal for one of those teeth, which I did. Several years later, I ended up with hypothyroidism. I went to a naturopath who put me on a detoxification program and asked me to get some urine samples while (and after) I was detoxifying. The results showed that I had an excessive amount of mercury in my system -- likely due to the mercury from the amalgams leaching into my system. I do believe that the root canal also has also affected my health somewhat direly. When I need fillings these days, I ask the dentist not to use an amalgam. Notably, the dentist I'm seeing now told me that the amount of mercury in the amalgams is very small and that I'd get more mercury in my system from eating tuna. (I believe this is a point that is taught in 'conventional' dental colleges.) It is quite obvious that a lot of work still needs to be done.
August 21, 2009
Susan Barendregt, MNT says:
I want to thank you for for this article. As a nutrition therapist, I regularly tell my clients of the importance of non-toxic dentistry and now I'll have an article to refer them to for more information. Susan Barendregt, MNT, Holistic Health Center, www.hhcviroqua.com, 608.637.7272
August 20, 2009
C.S. Helfer says:
I would like to extend my gratitude to Experience Life for researching and publishing such a fabulous, well written article. I have had the pleasure of witnessing some of the remarkable changes possible through whole-person dentistry, and was very moved to see this information brought to the public's eye. I would like to encourage the "skeptics" out there to keep an open mind while learning about holistic approaches to dentistry. Scientific evidence isn't the only factor that is helping to revolutionize the dental community; patients' testimonials on how their lives have changed for the better are leading the charge, and are even more powerful. I would like to inspire you to keep reading, learning, and listening...
August 20, 2009
Christy says:
I absolutely loved this article! I recently searched our area for a dentist that wouldn't look at me like a child abuser because i don't use fluoride toothpaste, which lead me to discover holistic dentists. It is wonderful having your magazine support many of the non conventional approaches to life that we take as a family.
August 20, 2009
J.D. Hartsough says:
I would like to know if Donna Rohrer's husband (an orthodontist in the Minneapolis / St. Paul area) asked her to write the comments below. I also wonder if Ms. Rohrer actually looked at any of the websites offered for additional information or did any independent research that brought her to the conclusion that the article contains "so much false information"? I have personally experienced the benefits of Holistic Dentistry covered in the article. I also found the article to be very well researched, though I must admit that I am not a board certified dentist - but then again, is Ms. Rohrer? In the end we must all depend on ourselves to make educated health decisions that are right for us. Ultimately, it is our responsibility to learn about other points of view and evaluate the science behind differing therapeutic philosophies. I appreciate that Experience Life magazine made the effort to get this vital information into the hands of the public. Also, I can't help but wonder: If the ADA has admitted that mercury is emitted from silver/amalgam/mercury fillings (which they have) and mercury is more toxic than lead (which it is), then why on earth would I ever want a dentist putting it in my mouth? -J.D. Hartsough
August 19, 2009
Donna Rohrer says:
I would like to know if Kristin Ohlson is a board certified dentist and from what institution she got her doctor of dental surgery degree. If not, what background does she have to write such a damaging article? There is so much false information in that article, it can do much more harm than good for the American public. There are benefits to treating the whole body and I know many dentists who take that in to consideration. To have that article printed in the Lifetime fitness magazine is a travesty. donna rohrer