Definition of Holistic
UK /həˈlɪs.tɪk/ US /hoʊlˈɪs.tɪk/
Ask most people about holistic dentistry and they’ll likely give you a puzzled look, kind of similar to when asked about homeopathy. Having been in practice for nearly 35 years, I find it perplexing how some of my colleagues, mostly well-meaning and dedicated individuals, have adopted a pseudoscientific rather than evidence-based philosophy towards our profession. I imagine that being regular people, some are more easily swayed by smooth talking ‘mentors’, who based largely on weak or anecdotal evidence, spread misinformation and falsehoods. Perhaps others, well aware of the largely susceptible public’s ever increasing appetite to embrace the latest niche health fad, see an opportunity to increase income. So what exactly is holistic dentistry?
Stating the obvious
Holistic dentists assert that when treating patients, a whole body approach, comprising one’s overall physical and psychological state should be emphasized. Rather than focusing solely on teeth and gums, dental care is not viewed in isolation but in parallel with comprehensive healthcare. Well, guess that makes me a holistic dentist!
What’s in a name
Holistic or Biological dentistry is a superficial, self-designated term adopted by a relatively small number of practitioners who advocate "health-promoting therapies not taught in dental school." It is not a recognized specialty such as endo or periodontics, nor requires any additional formal training. Any dentist can call themselves a holistic dentist, or any other alluring name. Psychic dentist anyone? Forming proponent organizations like The Holistic Dental Association or even more impressive sounding International Academy of Oral Medicine and Toxicology, many of their member-dentists do not accept mainstream dentistry, believing in an ongoing conspiracy to mask any evidence of harm from traditional treatments.
In a Nutshell
As with conventional clinicians, holistic dentists can vary greatly in their philosophies and practices. Typically, they oppose the use of certain materials and agents deemed toxic like amalgam and fluoride, while rejecting some well established, efficacious therapies such as gum surgery and root canals. While some avoid using amalgam, not unreasonable given vast improvements in composite restorative materials, others falsely alarm patients by making unscientific claims regarding toxicity from tiny amounts of mercury vapour released from silver fillings. They often recommend replacement of sound amalgams, considered an unethical practice by both American and Canadian Dental Associations. Fluoride is a naturally occurring mineral long proven to help prevent tooth decay. While one may argue against adding it to public water supplies, instructing people to avoid fluoridated toothpaste is unscientific and irresponsible.
Simply put, dentists are the doctors of the mouth. While practitioners must have a general health science background, a license to practice dentistry is essentially limited to the prevention, diagnosis and treatment of diseases of the oral cavity. We are taught and obliged to base our practice of the profession on well established, evidence-based protocols conforming to guidelines set forth by our governing bodies. Alternatively, proponents of holistic dentistry subscribe to some treatments outside the legitimate scope of dentistry. That’s why they are not taught in dental school.
Lions and Tigers and Bears (Oh My!)
Dentists are aware that we ramble on ad nauseum about the importance of avoiding sugary foods and the perils of smoking, particularly in relation to good oral health. We help our patients overcome fear of dental treatments. But that does not qualify us as dieticians, MDs., or psychologists. Holistic dentists often engage in conversation regarding lifestyle, nutrition, and emotional well-being. Some prescribe blood and hair tests to measure for body chemistry imbalances while marketing expensive ‘detoxification’ formulas and vitamin supplements. Lacking meaningful evidence, they may espouse one type of diet, typically vegan or plant-based as being superior for the maintenance of healthy gums. Alleging specialized care, some charge higher fees than mainstream dentists while promoting unconventional treatments.
Hypocritic Oath [sic]
Perhaps most controversial among this group are those whose views are so extremist that they are strongly condemned by the mainstream dental community.These practitioners don’t believe in doing root canals, alleging serious health risk by “sealing” bacteria at root end, while opting for ineffective therapy or extraction. Some recommend removing perfectly functional, asymptomatic teeth with root canals and replacing them with more ‘biocompatible’ and costly implants. This is a grave violation of a dentist’s hippocratic oath to do no harm. Not only are they harming patients, but the whole profession as well. Dentists who undertake these procedures risk serious sanctions from professional regulatory bodies.
In today’s ever- increasing health conscious world, more consumers are seeking out alternative, pseudoscientific treatments. While many holistic dentists are undoubtedly dedicated practitioners, patients should not hesitate to get second opinions regarding certain treatments that fall outside the scope of mainstream dentistry. And that’s the whole truth!
Dr. Mark Grossman is a practicing dentist and likes to take a bite out of nonsense when it comes to dental issues.