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We Americans are fickle when it comes to health care. We boast that we have developed some of the most innovative treatments and therapies in the world, yet not all of our citizens have access to such treatments. Equally baffling is how segmented health care has become. Gone are the days when one went to her general family physician, a member of her community, and he took care of all her ills. Now it’s an allergist for allergies, a rheumatologist for joint aches, an endocrinologist for diabetes and a gastroenterologist for that churning in her belly (and all these providers can change if her insurance coverage changes). But it’s heartening to see that this trend toward micro-specialization is reversing itself and clinicians are recognizing how intricately intertwined and interdependent the human body’s systems are.
One area in which this trend is becoming more pronounced is in dentistry. More and more dentists are recognizing that they can no longer fully care for and maintain the oral health of their patients without careful consideration of how their treatments will affect the rest of their patients’ health.
“Biocompatible dentistry opens doors to lots of other areas of concern,” says Elizabeth Rayne, DDS. “Many of my patients are very sick, and working with their physicians and specialists, we try to get to and treat the root illnesses. There is a lot more to consider than just their teeth, so a lot more work is involved.”
In acknowledgement of the integral connection between oral health and systemic health, the editors of The American Journal of Cardiology and Journal of Periodontology came together and published a joint position paper on the association between oral health and atherosclerotic cardiovascular disease (hardening of the arteries). The publication begins with:
“The human organism is a single unit composed of a seemingly infinite number of biologic processes so intertwined that abnormalities of almost any of its parts or processes have profound effects on multiple other body areas … ”
These two medical journals have put into words what many physicians and dentists believe: that the human body is one complete organism and has to be treated as such.
E. Griffin Cole, DDS, FIAOMT describes biocompatible or holistic dentistry as whole body dentistry. “Your teeth are the one part of your skeleton that you can see. A good dentist can uncover many hidden, underlying, systemic problems such as heart disease and diabetes. He has to address those issues in his dental treatment plan.”
Cole has practiced biocompatible dentistry for his entire 17-year career. He first learned about biocompatible dentistry while in dental school. There was no biologic dental curriculum, so after graduation, he worked with a mercury-free dentist during the early part of his career and built his practice as a mercury-free, biocompatible practice. He believes that offering a biocompatible environment enhances his patient care.
Biocompatible dentistry involves considering not only how treatments will interact with patients’ overall health, but also how treatments interact with one another. At the center of the biocompatible dentistry controversy is mercury-containing amalgam used for fillings. The American Dental Association (ADA) maintains the position that amalgam fillings do not pose a threat to patients’ health, but opponents state that there is scientific evidence that mercury-containing fillings pose definitive health risks. The controversy has caused somewhat of a divide within the ADA. The ADA stands by its position that mercury-containing amalgam fillings are a safe and cost-effective dental treatment. The ADA refuses to change its position on the use of amalgam products, citing a lack of scientific evidence regarding toxicity. Amalgam is not banned or illegal and dentists who use amalgam fillings are practicing completely within the accepted dental practice guidelines as defined by the ADA.
In 2002, representatives from the ADA testified before the United States House of Representatives and made the following statement:
“If the Association believed that dental amalgam posed a threat to the health of dental patients, we would advise our members to stop using it. But the best and latest available scientific evidence indicates that it is safe. Banning amalgam would deprive patients and dentists of an essential treatment option that is clinically and scientifically substantiated to be safe and effective … The ultimate decision about what filling materials to use is best determined by the patient in consultation with his dentist.” (Statement made by the American Dental Association to the Government Reform Committee, United States House of Representatives on “Mercury in Dental Amalgams: An Examination of the Science,” November 14, 2002)
Those who are concerned about metal toxicity and mercury toxicity, in particular, believe that mercury-containing dental products cause chronic illnesses, autoimmune disorders, neurodegenerative diseases, birth defects, oral lesions and mental disorders. Likewise, they advocate that amalgam fillings be removed immediately and that replacement products be tested against the patient’s body chemistry to ensure they’re biocompatible with the patient’s system. In 1984, 13 dentists who were alarmed by the potential dangers of mercury-containing amalgams set out to find scientific evidence to substantiate the claims of toxicity. From that humble group, the International Academy of Oral Medicine and Toxicology (IAOMT) formed. The mission of IAOMT is to continually examine and compile scientific research relating to the biocompatibility of oral/dental materials, to inform the public about the potential dangers of mercury exposure and to offer safer alternatives. IAOMT IS NOT a branch of the ADA nor is it governed by the ADA. Many members of IAOMT are also members of the ADA.
Like many new paradigms without specific guidelines for practice, biocompatible dentistry runs the gamut in terms of how much a dentist does when considering his/her patient’s care. Griffin Cole, a Fellow of IAOMT, uses sophisticated filtering systems, negative ion generators and mercury-separating tanks in his office to lower exposure to mercury and mercury vapors. He performs comprehensive initial exams including digital x-rays, mercury vapor tests and compatibility screenings to be sure treatments and materials are compatible with his patient’s body chemistry and oral cancer screenings. Once he has compiled all of his findings, he has a follow-up appointment with the patient to propose his treatment plan.
Merrily Sandford, DDS, has been practicing dentistry for 21 years and learned about mercury toxicity 10 years into her career while attending an IAOMT conference. After the conference, Sandford, whose daughter has Autism Spectrum Disorder, wondered if her career exposure to mercury had had any effect on her child. Additionally, she had been given Rhogam during her pregnancy to prevent an autoimmune response to her baby (she is Rh negative and her husband is Rh positive). What Sandford learned at that conference nearly ended her career. But instead of quitting, she has dedicated her practice to educating her patients about oral health and practicing biocompatible dentistry.
“My philosophy centers around the mouth-body connection,” says Sandford. “After I examine a patient and assess what a patient needs, I present them with a comprehensive treatment plan and an explanation of why I am proposing the treatments. I tell my patients everything they need to know, and then I let them decide how they would like to proceed.” Sandford, like Cole, is very clear about how she practices and the equipment that she uses. It is up to patients to decide if they would like to proceed.
Rayne adds, “Patients have to decide what they want to do with their bodies. As dentists, we have to act in the patient’s best interest, but we can’t force them to change their habits or to use certain dental products. We offer them the best possible treatment options, in our opinion, and then they have to choose how much or how little they are willing to do. The final decision has to be theirs.”
Holistic/biocompatible/biologic dentistry – whatever you want to call it – remains controversial. Dentists who practice biocompatible dentistry sincerely believe, as do their more conventional counterparts, that they are acting in the best interest of their patients. Is one form of practice truly better than another? That remains to be seen. Ultimately, each individual patient will have to review the information available and decide what mode of treatment best suits her needs.
RESOURCES
If you are trying to see if biocompatible dentistry is for you, visit the following websites for more information:
The American Dental Association | ada.org
The International Academy of Oral Medicine and Toxicology | iaomt.org
The Holistic Dental Association holisticdental.org
Each of the experts in this article are also available for consultation:
E. Griffin Cole, DDS, FIAOMT
1301 W. 25th St., Ste. 402
Austin, TX 78705
512.472.3565 | griffincole.com
Elizabeth Rayne, DDS
1221 West Ben White Blvd.
Austin, TX 78704
512.443.5813
naturaltoothfairy.com
Merrily Sandford
D.D.S. & Associates
The Center for Healthy Dentistry
2303 Ranch Rd. 620 S. Ste. 14z0
Austin, TX 78734
512.263.8284
austinhealthydentist.com