A Different Kind of Dentistry
By Kristin Ohlson, Experience Life
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.
Holistic dentists approach care in ways that depart from conventional treatment. They employ holistic practices to the mouth, seeing the mouth as an integral part of a larger system. Holistic dentists generally reject some traditional procedures, especially root canals and the installation of amalgam “silver” fillings, which they perceive as being potentially harmful or downright dangerous.
And as it was with the alternative practitioners, like 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.
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.
Next: Different Takes on Orthodontia and Root Canal Concerns
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,” page 3.)
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.
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.”
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.
“Root canals harbor toxic bacteria,” says Biochemist Boyd Haley, PhD, professor emeritus at the University of Kentucky. “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.
“No one would listen to me,” Aaberg recalls. “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. “It’s been a long road.”
Kristin Ohlson is a writer in Cleveland Heights, Ohio.
Next: How to Find a Holistic Dentist
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 Holistic Dental Association: www.holisticdental.org
• The International Academy of Oral Medicine and Toxicology: www.iaomt.org
• The International Academy of Biological Dentistry and Medicine: www.iabdm.org
• American Academy of Gnathologic Orthopedics: www.aago.com
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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