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What is Holistic Dentistry?
TMJ (Jaw Treatment)
Biocompatible Materials (Cerec, BPA free composites)
Gum Disease - non surgical and laser treatment
Safe Removal of Amalgam Fillings
Materials Reactivity Testing
What is Holistic Dentistry?
Holistic Dentistry is also called alternative dentistry, biologic dentistry, or biocompatible dentistry. It emphasizes approaches to dental care which consider the patient's dental health in the context of their entire physical as well as emotional or spiritual health. We avoid material such as silver-mercury-amalgam, latex, BPA's, and metal crowns. The focus is on eliminating infection from the body, and preventing further disease from occurring. This is more a "wellness" approach to your health, and is individualized according to the patient's philosophy, needs, and risk for disease.
This approach to dentistry encompasses both modern science and knowledge drawn from the world's great traditions on natural healing. Holistic Dentistry acknowledges and deals with the mind, body, and spirit of the patient, not just his or her "teeth". It lays out the following basic principles:
• Prevention and treatment of dental malocclusion (bite problems = physical imbalance)
• Avoidance and elimination of toxins from dental materials
• Prevention and treatment of gum disease at its biological basis
• Proper nutrition for the prevention and reversal of degenerative dental disease
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What are biocompatible materials?
Biocompatible materials that are used in the mouth agree with your immune system. A serum test can establish this. A hair test can determine the presence of various heavy metals including mercury from past exposure that alter your immune system.
What is biological microscopic monitoring?
Biological microscopic monitoring can be performed at the dental chair. A sample of dental plaque is used to determine if harmful bacteria are present in your mouth.
What is the significance of heavy metals?
Heavy metals are an emerging factor in environmental health. They can affect the immune systems of some individuals. They include lead, mercury, nickel, cadmium, beryllium, and aluminum.
What is the problem with mercury?
Mercury is in the news constantly now with warnings about fish taken from the ocean, lakes, and streams containing unacceptably high levels of mercury. This may become a possible health problem, particularly for pregnant women, if consumed more than twice a month. A zero tolerance level has been established for mercury whether in pure form, mixed as in amalgam, or vapor as when subject to hot liquids such as soup, tea, and coffee. Its effects have been noted particularly on hemoglobin, nerve cells and certain yeasts in the digestive tract. Amalgam fillings at first contain 51% mercury which decreases over time. Various recommended procedures have been used to remove these fillings in order to respect the immune system and affect improved health changes.
Who are alternative complimentary or integrative physicians?
Licensed medical doctors who practice a multidisciplinary approach to wellness or illness using a mix of allopathic, homeopathic, osteopathic, chiropractic, naturopathic, acupuncture, herbal, and oriental therapy according to their best understanding of the patients' needs.
Who are holistic dentists?
Holistic dentists practice a whole body approach to dental care and are alert to avoiding materials that may cause health problems in restoring teeth. We restore a functional masticatory system and also address aesthetic concerns.
What is balance?
That's the secret of health. Mind, spirit, body, diet, and environment are oft times imbalanced by very minute changes over a long period of time. Such is the case with mercury and other heavy metals available from multiple sources. Some people are little effected while others manifest symptoms that defy conventional diagnosis and treatment. From hair dyes to frequent eating of fish, to smoke stack emissions, to mercury based fillings, to vaccines with thimerosol, to broken thermometers, to broken fluorescent bulbs, to playing with liquid mercury, we are all exposed in various ways to this most toxic of elements whether in its methyl form, its vapor farm, its liquid form or combined form in amalgam. Often it is a matter of small exposure that puts the patient's health over the line.
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TMJ Jaw Treatment
Holistic Dentistry recognizes the fact that there is a very delicate harmonious relationship between the teeth, facial muscles, and the temporamandibular joint. When this relationship is altered by injury or an improper bite relationship the resulting painful syndrome known as TMJ (Temporamandibular Joint Dysfunction) arises.
Early Diagnosis and treatment is essential for avoiding more serious consequences. The following questions are useful in identifying jaw joint disorders.
• Do you have difficulty or pain when opening your mouth?
• Does your jaw feel stiff, tight, or tired?
• Do you have difficulty or pain when chewing?
• Does your jaw shift when you open?
• Has your jaw ever become "stuck" in either the open or closed position?
• Are you aware of any changes in your bite?
• Do you have "clicking" or "popping" in either jaw joint?
• Do you have pain in your temple, face, or ear?
• Do your ears "ring", "buzz", or hurt?
• Do you have frequent headaches or facial pain?
• Do you have morning headaches?
• Are you tired even though you slept through the night?
• Do you clench of grind your teeth during the day or night?
• Have you sought treatment for headaches or TMJ disorders?
If you answer yes to any of these questions, an evaluation may be in order.
Early treatment options may include: adjustment of the occlusion (bite), jaw repositioning with an Occlusal Appliance, physical therapy and treatment with medication. If it severe, you may be referred to the TMJ Clinic.
Initial treatment objectives are designed to reduce muscle spasm, swelling in the joint, and restore a more harmonious relationship between the teeth, facial muscles, and temporamandibular joint.
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Biocompatible Materials/Amalgam Alternatives
In Holistic Dentistry, there is an effort to find biocompatible materials to reduce the potential for toxicity. Silver Mercury "Amalgam" fillings are avoided due to toxicity concerns. Amalgam removal, with supplemental oxygen if requested, and replacement with natural-looking bonded materials is the standard.Testing for mercury levels in the body may also be performed.
Old Mercury fillings have cracked and leaking edges. The natural tooth structure is weakened by the "Wedge" effect of the filling on the tooth.
New esthetic materials are strongly bonded to the tooth. The resulting Cerec (One visit metal-free crown) or BPA-free composite restoration restores not just function and beauty, but returns most of the original strength of the tooth
Over the years as dentistry has evolved, there have been a growing number of options available for repairing teeth. The goal of dentistry has always been to develop materials that would simulate natural tooth structure as closely as possible, in both appearance and physical properties, and avoiding any potential harmful side effects.
In the past few years there has been a growing concern for the potential health hazards imposed by use of dental materials that include toxic compounds. The most common source of concern has been the mercury found in silver fillings. Mercury is one of the most toxic metals found in nature and is major component of silver amalgam fillings.
In addition to concerns of Bio-compatibility, when choosing a restoration we have to consider the size of the defect that is being repaired, the function of the tooth, and the biting surface involved. Strength, durability, and cosmetic acceptability are all considerations when choosing a restorative material.
A typical Silver Amalgam Filling with fractures and underlying decay.
Beautifully restored with Cerec one-visit Bio-compatible porcelain restorations.
Composite Fillings: Composites are a tooth colored materials that is combination of glass like particles and a resin. The material bonds strongly to the tooth structure and miniscule glass-like particles make the material resistant to wear. The use of these materials is restricted to smaller type fillings and areas not under heavy chewing pressure. We use BPA free materials.
Inlays: We often encounter situations where a significant part of the biting surface of a tooth has been damaged and weakened. Here the material of choice would be a Cerec one-visit ceramic inlay. This material is well tolerated from a biological standpoint and provides the strength and durability that is needed.
Onlays and Crowns: When the defect to be repaired grows to a significant size, the strength of the tooth will be compromised. Teeth with very large silver amalgam fillings often develop cracks that extend deep into the tooth structure. These teeth are best restored by a means that reinforces the strength of the tooth by completely covering and protecting it. A one-visit Cerec ceramic onlay or full crown, accomplishes this objective.
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Gum Disease (Periodontal Disease)
An estimated 80-85% of the adult population exhibits various stages of gum disease. It is the leading cause of tooth loss in adults. Most recently there has been considerable research linking the risk of both heart disease and strokes with the occurrence of gum disease.
With such serious consequences at stake, we take our responsibility - to thoroughly diagnose and treat gum disease at its earliest occurrence - very seriously. We employ an early detection technique called Modulated Microbiological Periodontal Therapy also known as "KEYES THERAPY". Developed by Dr. Paul Keyes while he was at The National Institutes of Health, this non surgical approach to the treatment of gum disease involves the assessment of the bacteria risk that a person has present in their mouth. The quick, painless, and very cost effective analysis involves taking a small sample of the bacterial plaque from under a person's gum line and placing it under a phase contrast microscope. Just as high cholesterol count is a risk factor for heart disease, a high degree of pathogenic bacteria present in your bacterial slide sample can put you at significant risk of gum disease and eventual tooth loss.
We use lasers to destroy bacteria before periodontal therapy, to reduce the numbers of bacteria that are released into the bloodstream during dental "cleanings", and biostimulate the tissues to regenerate.
Lasers may also be used in lieu of traditional surgical techniques in some cases of more advanced gum disease.
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Safe Removal of Amalgam Fillings
Dentists all over the world remove millions of amalgam fillings every day. Finished, or "set" amalgam on the bench, at 37°C (bofy temperature) will emit as much as 43.5μg of mercury vapor per square centimeter of surface area per day, for extended periods of time. Cutting the amalgam with a dental bur produces very small particles with vastly increased surface area, and vastly increased potential for subjecting the people present to a mercury exposure. In fact, in a recently published experiment, volunteers with no amalgam fillings swallowed capsules of milled amalgam particles, and, sure enough, their blood mercury levels increased. These authors concluded that "the GI uptake of mercury from amalgam particles is of quantitive importance." Molin, et. al. demonstrated a three to four fold increase in plasma mercury, and a 50% rise in urine mercury for a month following amalgam removal in ten subjects, after which their mercury burden began to decline. Snapp, et. al. showed that efforts to reduce mercury exposure during amalgam removal resulted in less uptake of mercury than that cited in the Molin study.
We are able to use a number of strategies for reducing the amount of mercury exposure to both patients and dental staff during amalgam removal.
Cut and chunk, keep it cool.
Most of these techniques are simple and obvious, common sense, physical means of reducing mercury exposure. We remove an old amalgam by slicing across it and dislodging big chunks, this way less of the contents aerosolize than if we grind it all away. It is kept under a constant water spray while cutting, to keep the temperature down, and reduce the vapor pressure within the mercury.
The best tool for removing mercury vapor from the operating field is the high volume evacuation (HVE). It is kept going next to the patient's tooth until we are finished with the removal and clean-up process.
A very patient friendly isolation device incorporating the high speed suction and a guard to protect the throat area.
"Rubber" (non-latex) dam
Some patients hate rubber dams, while others can't live without them. Reduced exposure amalgam removal can be done either way. A rubber dam will help contain the majority of the debris of amalgam grinding, among its many other benefits. But you must know that mercury vapor will diffuse right through it.
We always use a saliva ejector with the dam to evacuate air that may contain mercury vapor.
We rinse the dam well as we go, because amalgam particles left on it will emit mercury.
Isolite is an alternative to "rubber" dam
The patient may choose piped in oxygen, so they do not have to breathe the air directly over the mouth during amalgam removal. A nitrous oxide nose hood, or a similar ventilation device, is more effective at isolating the incoming air than a nasal cannula.
Cover the Skin
We cover the patient's face with a barrier that will prevent spattered amalgam particles from landing on the skin, or the eyes. The barrier can be simple as darkened glasses, or a moist paper towel.
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Material Reactivity Testing
Many of our patient charts are flagged with a warning not to use latex gloves. These are patients whose immune system will trigger a negative reaction when it recognizes certain proteins or contaminants. Likewise, there are patients who can react to any of the materials we use in dentistry. Reactions can range from mild to severe, but can be particularly troublesome when the material is placed permanently in the patient's mouth.
We now offer a way to assure our patients that the materials we use are compatible with their immune system. It is called Materials Reactivity Testing. Our office works with a naturopathic practitioner who may order a serum sample to be sent to a specialized lab which analyzes the patient's unique antibody record. The result is a comprehensive report listing virtually every material used by our office and stating whether there are potential negative reactions to them.
76-6225 Kuakini Hwy, Suite B203 • Kailua Kona, HI 96740