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PERSPECTIVE
Year : 2023 | Volume
: 14
| Issue : 1 | Page : 39-41
Holistic Dentistry: A Brief Explanation and Overview of Modern Comprehensive Dental Care
Bernice Teplitsky
Private Practitioner, Ashland Ave, Chicago, IL, USA
Correspondence Address:
Bernice Teplitsky
3256 N. Ashland Ave, Chicago, IL 60657
USA
Source of Support: None, Conflict of Interest: None
CheckDOI: 10.4103/denthyp.denthyp_45_22
There has been an increase in worldwide curiosity regarding how people can become healthier through the intake of natural and organic foods, the reduction of toxins, and the use of natural medicine and dentistry. Holistic dentistry has been practiced for over 40 years in the United States, but it is not recognized as a standard of care by the American Dental Association yet. In fact, holistic dentistry carries a stigma and tends to daunt traditional dentists due to a lack of formal holistic dentistry education in dental school or continuing educational courses. Holistic dentistry is the most comprehensive modern form of dentistry that incorporates traditional teachings. It has numerous advantages and should be included into the field of dentistry both in education and as a standard form of practice.
Keywords: Biological, comprehensive, holistic dentist, holistic dentistry, modern dental care, natural
Holistic dentistry (HD) considers how oral health affects the whole body. The holistic dentist perceives the oral cavity as an ecosystem synergistically connected to the patient’s entire body. This field is not a recognized dental specialty, but it is rather a philosophy and may be known to patients and practitioners as biocompatible, conservative, biological, integrative, modern, biomimetic, or natural dentistry. Thus, the extent of its practice varies between practitioners. In recent years, HD has grown in popularity amongst dentists and patients who are attracted to a more natural approach and conservative methodology.
History
Holistic dentistry is not a new or revolutionary approach to dental treatment. It builds from evidence-based research and is an evolutionary form of medicine. It complements traditional dentistry and is considered a more comprehensive practice of general dentistry.
There are various organizations that support holistic dentists, including the Holistic Dental Association which was founded in 1978; the International Academy of Oral Medicine and Toxicology, which was established in 1984; the International Academy of Biological Dentistry and Medicine, established in 1985; and the American Academy for Oral Systemic Health, which was founded in 2010. These organizations support interdisciplinary healthcare by expanding awareness of the relationship between oral health and whole-body health.
Diagnostics by holistic dentistry
The scientifically proven treatments for dental diseases taught in dental schools, like brushing, flossing, and restorations, are used by both traditional and holistic dentists. Most holistic dentists, however, spend extra time educating their patients on dental prevention and any identified dental problems; they look for the fundamental cause with the longevity of the body in mind, as opposed to the individual tooth. Management of oral problems is the responsibility of both traditional and holistic dentists; the main difference is the patient’s participation in determining the most advantageous ways to prevent the recurrence of problems such as gingivitis and cavities.
In HD, a great emphasis is placed on the biocompatibility of the materials used in practice. Immunological testing helps determine the least reactive material to use for each individual patient; this is similar to having an allergy test performed. This service is extremely beneficial, especially for patients who may suffer from autoimmune issues, allergies, or environmental and chemical sensitivities.
In addition, holistic dentists incorporate other adjunctive services, such as the use of ozone, an antimicrobial product used in medicine since 1870 and in dentistry since at least 1930.[1] Holistic dentists also tend to use more natural remedies such as Homeopathy, which was introduced in 1796 by the German physician Samuel Hahnemann. Many Holistic dentists follow the research of Dr. Westin A. Price, Former Research Director for the American Dental Association, on nutrition, decay, and root canals. His book, Nutrition and Physical Degeneration, has been widely read by both practitioners and patients.
Holistic dentists feel that if they can work together with other healthcare practitioners to treat the fundamental cause of an oral issue, it will be a safer and more effective method of dental treatment. For this reason, they are more likely to refer patients to other healthcare practices such as functional medicine, cranial sacral therapy, chiropractic care, acupuncture, myofunctional therapy, breathing specialists, otorhinolaryngology, nutritional therapy, psychotherapy, and more.
Holistic dentists typically perform an extensive collection of tests for their patients as part of their initial diagnostic evaluation. A few examples include a salivary bacteria test, a biocompatibility test, a mercury “body burden” test, a root canal pathogen test, an electrical conductivity test, and a salivary pH test. From the results of these tests, the holistic dentist is able to discern which route of dental treatment will be best for the patients.
For example, if a patient with food, chemical, and/or environmental sensitivities needs a dental procedure such as implants, crowns, or fillings, a holistic dentist would consider it wise to complete a biocompatibility test. If patients tend to react to common, everyday materials, there is a higher likelihood that they may react to aluminum (can be found in some crowns and implants), bisphenols (found in some composites), and nickel (which can be found in some porcelain-fused-to-metal [PFM] crowns or ortho wires).[2],[3] A biocompatibility test allows the practitioner to choose the safest brand of implant, crown, and filling material which will be best suited for that particular patient.
Another common concern for patients seeking a holistic dentist is with amalgam (mercury) fillings. Many patients seek holistic or biological dentists to remove their silver fillings because of the controversy that surrounds the material and the negative health effects it may pose.[4]
Holistic dentists recognize that mercury constitutes 50% of filling material and is considered a neurotoxin. When a patient opts to remove silver fillings, there is a high level of mercury vapor emitted from the patient’s mouth during the removal.[5] Thus, when removing silver-mercury amalgam fillings, a specific protocol is needed to protect the dentist, assistant, patient, and environment. Many holistic dentists are certified to follow safe amalgam removal protocols. If safe protocols are not followed, it may affect the health of patients, dentists, and staff.[6]
The safe amalgam removal technique, often used by holistic practices, allows the practitioner to safely remove the mercury from a tooth with minimal exposure of mercury vapor to all present in the treatment room. Holistic dentists never place amalgams and rarely use metal materials in their practice to reduce the chance of oral galvanism.[7]
When performing procedures such as large fillings or crowns, many holistic dentists follow a biomimetic approach and use adhesive dentistry techniques for more conservative removal of tooth structure. The philosophy behind conserving tooth structure is to avoid the risk of compromising the nerve and increase the longevity of the tooth.
If a patient suffers from an auto-immune condition and is concerned with the amalgam removal, a holistic dentist can perform additional testing to measure systemic mercury levels. A successful test can also help measure the kidney and liver function, which can help both the dentist and the patient determine whether they can safely withstand the amalgam vapors during the removal. At times, a preoperative supplement is necessary to further protect the patient, by supporting kidney and liver function, the body’s main routes of mercury excretion. This mercury test can also be used by the patient’s medical practitioners to guide them through safe detoxification.
Many holistic dentists are mindful of a patient’s airway, often screening for sleep-disordered breathing, tongue ties, malocclusion, mallampati score, arch-width discrepancy, and other systemic risk factors. If any screening were to come back positive, a specialist referral would be provided for appropriate testing and care.[8] Some global problems have been linked to sleep disordered breathing, such as cardiovascular disease[9],[10] endocrine and metabolic interactions,[11] amongst other issues.
In HD, the importance of expansion rather than retraction in orthodontic treatment is stressed and there is a disapproval of removing premolars to align teeth.
Treatment by the HD
Dental treatment by a HD will vary based on a patient’s clinical symptoms. Holistic dentists do administer a lot of traditional treatments, but their methods differ based on their concern for the overall health of a person, material sensitivity, and the choice of the most viable organic or holistic option.
Holistic dentistry also includes patients’ involvement in their given treatment plan and gives them some autonomy over choices pertaining to their own oral health. If patients have dental caries, the holistic dentist will discuss the etiology and type of treatment that will best fit their needs, since each kind of cavity (interproximal, occlusal, or cervical) can have different etiologies. The HD would also expand the conversation past the current situation and discuss how to avoid future instances of decay.
These discussions are often regarding habits such as diet, oral pH, hygiene, brushing techniques, and brushing aids. The process of re-mineralizing incipient lesions may also be discussed. The holistic dentist may also suggest books, natural products, or other resources specifically designed for each patient.
For periodontitis, a traditional dentist may give verbal instructions after scaling, root planing, and possibly, a medicated mouthwash. A holistic dentist will also provide verbal instruction, but will then discuss diet, suggest a custom tray with medicated gel or laser therapy, perform a salivary test, use ozone therapy, or use other adjuncts aside from scaling, root planning, and a natural mouth rinse. This all comprehensive and holistic approach results in better long-term outcomes and lower overall pocket depths.[12],[13],[14]
Holistic dentists are also more conservative than what is traditionally taught in dental schools. When incipient lesions are noted, the philosophy is to educate the patient about the lesion, its location, and the probable course of action to avoid further progression. Frequent monitoring on recalls and radiographic follow-up is warranted. The practitioner compares previous intraoral pictures and X-rays and only treats when the lesion is in the dentin, posing a greater risk if left untreated. Notably, the patient is allowed to participate in their own oral care treatment decisions.
When performing procedures such as large fillings or crowns, many holistic dentists follow a biomimetic approach and use adhesive dentistry techniques for more conservative removal of tooth structure. The philosophy behind conserving tooth structure is to avoid compromising the nerve and increase the longevity of the tooth.
ConclusionThe practice of holistic dentistry is both complex and multifunctional. Due to its comprehensive nature, it takes more education and mentorship after dental school to understand a biologic approach to dentistry. A number of these philosophies and techniques are not addressed in US dental school curricula. Patients are now demanding more natural alternatives to traditional medical and dental models due to online information access, making these philosophies more pivotal than ever for traditional dentists to acknowledge and embrace modern dentistry.
Compliance with ethical standards
Ethical clearance from the ethical committee had been taken before proceeding with the study.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
References
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