Beware "Holistic" Dentists

[sirwired]

The well-respected website ScienceBasedMedicine.org recently went over the claims of a so-called "Holistic" dentist. (Amazingly, they asked to be interviewed by this band of committed and qualified skeptics.) The results were not pretty.

I bring this up because "Holistic" dentistry extends to some orthodontists (especially among those who style themselves "Functional" orthodontists.)

Among the claims of this particular group:
- Their practice is primarily built on removing Amalgam fillings from patients. This is a bad idea on several fronts, the most obvious being that it is both counter-productive and useless. Removing a functioning filling releases more mercury than simply leaving it in place. That, and the fact that fillings while sitting in your mouth, are quite stable, and release far less mercury into your body than you'll absorb from air (most commonly from air pollution) or common food sources. (Tuna fish is the most common dietary source of the stuff, but other foods have it.) Of note that when performing this needless operation, they'll have a "naturopath" standing by to give you an IV line of Vitamin C; a "treatment" that is supposed to somehow remove the mercury from your body, despite the fact that Vitamin C certainly is not on the list of treatments for heavy-metal poisoning. (The actual treatments for heavy-metal poisoning have serious side effects... I suppose if you are going to be treated for heavy-metal poisoning you don't have, giving you Vitamin C you don't need makes some sort of twisted sense.)

- They claim to treat "whole-body" health problems through dentistry, proudly supplying a "dental meridian" chart showing how various teeth correspond to the health of various organs. (And implying that doing some dental treatment to a particular tooth or set of teeth could do things like cure liver problems.) Of course, anybody with any knowledge of medicine, dentistry, or having successfully passed high school biology can figure out that this is implausible, at best. When pressed on this (and presented with a collection of "dental meridian" charts that all conflicted with each other), they admitted that the chart was not, in fact, the least bit scientific, and not actually useful for dental or medical treatment.

- Like many such quacks, they have their very own line of "natural" products, in this case "natural toothpaste". While I have not personally dug into it, you can guess it is a toothpaste without Fluoride, which of course makes it no more useful than 19th-century tooth powder in the prevention of decay (which is to say, not at all.)

So, when you are checking out orthodontists, and one of them takes a full medical history and gives you some bizzaro claims like they can help your diabetes or knee pain by straightening your teeth, back slowly out the door and get out of there as fast as you can, as you have been lured into crazy-town...

[djspeece]

I'm nominating this for promotion to "stickie" status!

[daveq]

Excellent post. Thanks.

[bbsadmin]

I'm nominating this for promotion to "stickie" status!

Agreed, and done!

[EWUgal15]

- Like many such quacks, they have their very own line of "natural" products, in this case "natural toothpaste". While I have not personally dug into it, you can guess it is a toothpaste without Fluoride, which of course makes it no more useful than 19th-century tooth powder in the prevention of decay (which is to say, not at all.)

This is my favorite part. Because fluoride is derived from naturally occuring fluorine...so yea

[anitahansen]

Hollistic dentistry is pretty much the worst thing that has happened to dentistry. Their treatment and their advice ruins peoples teeth in the long term.

Fluoride does a fantastic job of reducing the occurance of caries (cavities) in the population. However, for a hollistic dentist, more cavities might be a good thing...

Silver fillings are still the best choice for most people. They last longer, there is a lower risk of getting new cavities along the fillings, and they do not lead to root canals and crowns as often as composite (white) fillings do. However, for a hollistic dentist, replacing them with short lived composite fillings might make a lot of sense.

Not to mention the fact that hollistic dentistry has no basis in real peer reviewed research. In my opintion quaks are a much better name for hollistic dentists.

[jfriend33]

I do think that oil pulling is a neat idea, although I have never tried it. And I also think it is scary to see studies posted that many people with crowns have health problems.

I do think that the dentists that are willing to isolate a cavity to a very small portion of the tooth and use something like an inlay or an onlay, they are the good guys.

[sirwired]

I do think that oil pulling is a neat idea, although I have never tried it.

"Oil pulling" really isn't any different from simply doing a very thorough job cleaning your teeth. It just takes longer. The other supposed benefits like "detoxifying you" are pure woo...

And I also think it is scary to see studies posted that many people with crowns have health problems.

Everybody eventually develops "health problems", given how we are mortal. A properly-done crown is pretty darn inert. It's a chunk of porcelain or very stable and non-reactive metal. Of course, if it doesn't fit properly, there are going to be issues, but that's an issue of skill, not an indictment of the idea of crowns.

I do think that the dentists that are willing to isolate a cavity to a very small portion of the tooth and use something like an inlay or an onlay, they are the good guys.

Which is exactly what a filling does. An inlay is a filling fabricated outside of the mouth, and an onlay is kind of a "crown-lite". If an ordinary filling will work for a given case, that's the best solution for most people, as it's inexpensive, not particularly difficult, and quick.

[newbite]

I always thought amalgam fillings were better for molars since I was always told they're stronger and longer wearing, however my ortho tech recently told me I should always get composite fillings no matter which tooth because they completely seal the site and prevent the leakage that eventually occurs around an amalgam filling. I have a problem molar with a large amalgam filling that she thinks is "leaking" around the edges so food and stuff is going in there and irritating it. But she's not a dentist so I don't know. I do know I'm going to need a crown at some point! Ugh. Thanks, bruxism!

Oh, yeah, and thanks to the freaking idiots who convinced naive me not to use flouride for three years of my late teens/early twenties. All of my adult fillings are thanks to them! And now I use Rx fluoride toothpaste and haven't had a filling in about ten years-- go figure...

[anitahansen]

Your orthodontist got it the wrong way around. You can get cavities around both kinds of fillings, but you are much more likely to get cavities around composite fillings. Composite fillings shrink after being placed, which means they are much more likely to leak than amalgams. If an amalgam filling is leaking a tiny bit, they actually kind of self heal because the exposed surface of the amalgam filling will corrode a little bit, sealing the gap. Bacteria also doesn't grow as well on amalgam fillings, as they do on composite fillings. In addition to this, composite fillings doesn't take anywhere near the same chewing forces as amalgam fillings, so they are more likely to crack and chip.

Stick with amalgam, and get fillings that last as long as possible!

[Pooka94]

Hi I'm new here!

I just want to say, I just started going to a new dental office, one that offers a more "holistic" approach. And, they offer braces! I have been needing braces since like the 5th grade, and could never afford them until now. But i want to mention two things that concerns me:

The dentist did remove my amalgam fillings, but that because new caries developed around them. They don't believe in "silver fillings" at that office. What are the pros and cons to this?

Also, the fact that this office (which is not an orthodontic office) offers braces made me a bit happy until I did some research. Did anyone ever get braces done at a general or cosmetic's office and gotten good results? I just have an overjet/overbite... I'm just a new, curious member. Hope to start my ortho treatment by the end of the month!

[sirwired]

Well, it certainly is rather common for previously-filled teeth to develop additional decay. And it is true that many dentists no longer use amalgam filling material. (Composite fillings don't require as much drilling as amalgam, and they are better looking, although they generally do not last as long.)

As long as your dentist removed the old fillings for good reasons, like decay (as opposed to telling you that they needed to come out because they were poisoning you), there's no particular reason to suspect a problem.

There are general dentists that can do a good job with braces, but you owe it to yourself to at least consult with a board-certified orthodontist before commencing treatment with a general dentist. Often the ortho will be no more expensive, and you have the benefit of his/her specialized training and experience.

[anitahansen]

The problem is that you most likely didn't have cavities around all your fillings. I've seen over and over that holistic dentists tell patients they need fillings replaced for different reasons, cavities, worn fillings, "leakning" fillings and so on. Patients often figure out something is wrong because everything was fine at their last appiontent to a regular dentist. I've had some of these patients come in for a second opinion, and many times I've seen no need to replace any fillings at all.

The white fillings does not last as long, and you are more likely to get cavities around them.

Holisitic dentists do not believe in silver fillings, because they last too long, and do not lead to more extensive dental work later on. What they do believe in is to fill their pockets by doing dental work that is not needed, and by doing dental work that leads to more extensive dental work.

[gglass]

Theodent is a Fluoride free toothpaste that uses theobromine, a derivative of chocolate. They have some amazing studies. I believe in Fluoride just letting everyone know there is a Fluoride free option and its researched backed.

[sirwired]

FYI, Under the "too good to be true" alarm bells, I just looked up that toothpaste.

I wouldn't necessarily throw out your fluoride yet (and I'm glad you aren't!), for a few reasons:

- The research, while double-blinded, has been rather small, and short. (Total number of subjects, 80, allowing only 20 subjects per product in their clinical trial, which only lasted a few weeks.)

- Their product appears to be illegally marketed. It is being sold for the express purpose of cavity prevention. This means that they need to receive FDA approval under the New Drug Application (NDA) process. Theobromine is FDA-approved as a food additive (under the "Generally Recognized As Safe" designation, which does NOT involve actual toxicology testing), but it is NOT approved as a drug. As such, it is illegal for Theodent to market it as a cavity-preventive. (They can market it using vague terms like "improves dental health", but they CANNOT market it as a cavity-preventive. In practice the FDA would NEVER approve an NDA based on a single trial with only 80 subjects.)

- It should be no surprise the product has not received ADA approval either.

- Even their own trial showed it to be no superior than Rx toothpaste.

- Their marketing talks about Fluoride being toxic if swallowed. In the concentrations used in OTC toothpaste, fluoride is NOT toxic. Since you don't swallow toothpaste unless you are a child that doesn't know better, even the dose in Rx toothpaste isn't a problem either.

- Unlike fluoride, which is NEVER toxic in OTC doses, (and utterly harmless in Rx doses as long as you do not, in fact, actually eat it), theobromine IS toxic to some sensitive populations. (It is also highly toxic to many animals; theobromine is the reason you cannot give chocolate to dogs; it is highly toxic to them. It's actually used as a pesticide to control coyote populations. "A cavity preventive in humans, and deadly poison to canines!" doesn't make for good ad copy.) It's not likely that theobromine is toxic to humans in the concentrations used in this toothpaste, but neither is fluoride. Remember, just because something is "natural" does not mean it's non-toxic. (The most deadly poisons outside of certain radioactive isotopes occur in nature, and, as I just mentioned, this compound is hardly inert.)

In summary: Based on the highly-deceptive (and illegal) marketing and sparse research alone, I would never purchase this product, especially given how there's no good reason to avoid fluoride toothpaste outside of general paranoia.