The Dramatic Benefits of Minimally Invasive Dentistry
February 24, 2013
Story at-a-glance
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Unnecessary drilling and filling your teeth with toxic
materials can have far-reaching, long-term health
ramifications. Newer alternative types of dentistry, such as
minimally invasive dentistry and biomimetic dentistry offer
dramatically safer and more effective solutions
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Biomimetic dentistry offers excellent alternatives to large
fillings and crowns, such as inlays, onlays and crowns made
by CEREC® material. These are permanent restorations that do
not need to be replaced with time like regular resin
fillings and metal or porcelain crowns
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Ozone can be used in combination with air abrasion. Ozone
kills bacteria and safely changes the chemistry of the tooth
and allows it to remineralize
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Everyday dental hygiene tips include brushing without
toothpaste, or using baking soda or a toothpaste containing
calcium sodium phosphosilicate (an effective mineralizer,
far superior to fluoride); and applying ozonated oil to your
gums and between your teeth (a very effective plaque
remover)
By Dr. Mercola
Dental health is an important part of your overall health.
Unnecessary drilling and filling your teeth with toxic materials
can have far-reaching, long-term health ramifications.
Fortunately, there are options, but it can be tricky finding
a dentist that is fully familiar with alternative types of
dentistry, such as minimally invasive dentistry and biomimetic
dentistry – the latter of which means 'mimicking nature,' and
involves using tooth restorations and techniques that
imitate natural teeth, both in appearance and function.
Both of these are covered in Carol Vander Stoep's book,
Mouth Matters. Carol has been a dental hygienist for 25
years.
She chose a career in dental hygiene over dentistry because
she valued prevention over repair, and her book can be a
valuable resource for lay-persons and dentists alike. It
discusses whole body health from a dental perspective, along
with advanced forms of dental diagnosis and treatment that we
should all be requesting from our dentists.
"When I wrote the first edition of Mouth Matters, it
was all about how gum disease affects heart disease,
diabetes, stroke risk – all of those degenerative diseases
of the body. I wasn't all that interested in teeth."
Carol says, "What I started to realize, as the
question of root canals and breaking down teeth started to
surface, was that if a tooth does break down or
catastrophically fail, you're facing the same issue about
introducing germs back into the body.
As a result of having written the first edition, it
was wonderful for me to be able to be introduced to some of
the top dental researchers, clinicians, people who are
really trying to start a revolution in dentistry and trying
really hard to do it.
But we all know that revolutions don't start from the
top-down; they have to start from the bottom-up. That's why
I'm here today. Because really, we need to educate people as
to what it is that we want in dentistry. We need to know the
kind of care that we want."
Naturally, preceding technological developments in dental
tools is the foundation of diet. If you get your diet right,
which includes avoiding sugars, processed foods and grains, then
you're creating an environment in your mouth that will be
resistant to dental decay.
Fermented foods, such as fermented vegetables, can be
tremendously beneficial for your oral health. I've had a
significant problem with tartar buildup on my teeth, having to
get a cleaning once a month. Once I added fermented vegetables
to my diet, I've been able to extend it to every two months. So
diet is really the foundation of healthy teeth and gums.
Modern Dentistry Really Isn't as Advanced as it Could Be
Modern dentistry is still fairly primitive in many ways.
About half of American dentists still use amalgam, half of which
is neurotoxic
mercury – not silver as the name "silver fillings" would
imply.
But that's not the only problem. The act of drilling into a
tooth is in and of itself very destructive to the tooth,
especially when using a high speed drill. It can create tiny
little cracks that lead to further deterioration of the tooth
over time. Low-speed drilling is not as destructive to the tooth
but is still far from optimal. The conventional strategy to
"drill and fill," regardless of the restorative material used,
is an impermanent solution. An estimated 70-80 percent of the
work done by dentists is re-repairing previous dental work.
"It's important to really understand – and one thing
that I didn't appreciate was – that teeth are one of the
most complex structures in your body," Carol says.
"It takes a full nine years for them to even form. It's a
series of arches. If you would think about masonry, anytime
you cut an opening in masonry in order to handle the
compress of strengths, a mason has to build an arch to hold
that strength. If you were to take the keystone out of that
arch or to cut the leg out off of that arch, the whole arch
would collapse; the whole structure would collapse.
What I think is so beautiful about a tooth – an adult
molar – is that it is a series of arches. There are at least
four to five arches built into the tooth. They're actually
made of different layers.
You have an outer, very tough shell called enamel.
That's only two percent organic, and it doesn't flex a lot.
But the internal part of the tooth, the body of the tooth,
is 55 percent organic. It's made of collagen and water. It's
made to shake, rattle, and roll, as we put all these
compressive strengths on it. Chewing is a very, very tough
thing. We want these teeth to last a hundred years and stay
in function, and they're designed to do that."
The concept of minimally invasive dentistry is still in its
infancy, although Dr. Tim Rainey has been tirelessly lecturing
on the subject, all over the world, for the last 25 years. He
has also written about it in dental journals. He still has a
dental practice in Refugio, Texas where the majority of his
patients are underprivileged children on Medicaid.
"The beauty of this dentistry is that it doesn't
require shots. It doesn't take a lot of time. It's not
painful. In fact, since he introduced ozone into his
practice, he has never had a child come in with an
asymptomatic tooth (meaning a tooth in pain) that has ever
needed a root canal or an extraction. He's never even needed
to anesthetize them," Carol says.
The Importance of Early Diagnosis
Early diagnosis is essential if you want to avoid invasive
restorations. Unfortunately, conventional dentistry still has a
lot to learn in this respect. According to Carol, traditional
means of diagnosis, using an explorer, and x-rays only have a 25
percent success rate in terms of accurate diagnosis. False
positives and false negatives can occur and do so quite
frequently. Carol explains:
"You can have a tooth to be completely stain-free...
It cannot stick with an explorer. If we take an X-ray of the
tooth, nothing shows up. It looks completely
pristine. However, [decay] can be hiding up under those pits
and grooves – some rather significant decay. In fact, when
the enamel is forming, a lot of times there are little
folds, fractures, and not completely mineralized enamel.
There are defects in the enamel that we can't catch for
many, many years. You can't really diagnose or treat an
unopened fissure. That's really the first most important
thing – I think – that people need to know.
...The decay has to get pretty deep into the tooth
before we can diagnose it. In fact, X-rays are very
late-stage diagnosis. Decay has to be at least two
millimeters into the second layer of tooth under the enamel
before an X-ray can begin to catch it. Then you have to be
much more invasive in treating it. You want to be able to
catch diagnosis early."
Fluoride is commonly thought to be a primary prevention
strategy against tooth decay, despite the fact that, like
mercury fillings, it is a highly toxic substance, shown to lower
IQ in children. According to Carol, fluoride also makes early
diagnosis more difficult.
"When that outer shell is heavily infused with
fluoride, it changes the way an X-ray goes through a tooth,"
she says. "I think it delays diagnosis, because
we're not able to see that decay as easily."
There are Better Alternatives to Crowns
Eventually, after a tooth has been repaired a number of
times, a crown typically becomes necessary. However, biomimetic
dentistry offers excellent alternatives to crowns.
"There are principles of adhesive dentistry that
dentists should know, but again, most of them don't know.
There are six different ways to put [resin material] in to
where it can recreate the tooth structure," Carol
explains.
For example, the dentist can section the resins, layering the
material in according to something called C-factor (which has to
do with the shrinkage of the material), so that it's not
creating too much pressure on the tooth in any direction.
Another alternative is to use more expensive inlays or onlays. A
CEREC® machine can cut the material into precise-fitting pieces
that are then permanently adhered into the cavity. CEREC®
material can also be used to replace an entire tooth, like a
crown. However, CEREC® inlays and crowns are far better than
other resin fillers and metal or porcelain crowns as they are
permanent and will not need to be replaced with time.
The Benefits of Ozone in Dentistry
Now, most people get concerned when they hear ozone, equating
it with ozone pollution. When ozone levels rise, we're likely to
get sick. But this is due to the pollutants caught in the ozone
– ozone itself is actually nature's way of cleaning the air.
Granted, ozone gas, by itself, should not be breathed as it's
toxic to lung tissue in high concentrations. But when
selectively applied, it can provide significant benefits in
dentistry. In fact, according to Carol, ozone is the only way to
predictably re-mineralize the tooth. The conventional thought is
that this is the function of fluoride, but this is not true.
Another component of minimally invasive dentistry is the use
of ozone. "I can't believe I didn't hear of ozone until
about a year and a half ago,"
Carol says. "But it's wonderful."Fluoride actually
has a powerfully detrimental effect, because while it can
strengthen the tooth, that's not the most important factor in
preventing decay. While making the enamel denser, it also makes
it more brittle by destroying the surface crystal matrix that
helps protect the tooth. It's a very similar process as
osteoporosis drugs that make your bones denser but more
brittle...
"We are using it close to the mouth, so there are
precautions that you have to know," Carols says.
"You have to take a course in it. You can't just start using
it. But since we deal with microbes in the mouth, I can't
imagine a better place for ozone. I use it all the time in
gum disease.
...The beauty is, with ozone, you don't have to
remove all the decayed material. You just remove the worst
of it, then you hit it with ozone. If there are any dentists
listening, they can take it down just to what we call the
leathery layer. There's still plenty of structure there. The
crystalline structure is still there, and it's still strong.
It's just been infiltrated by bacteria and their end
products.
In the old way, you would want to take all of that
out. We don't want to do that. Leave that there. Hit it with
ozone for a few minutes and change the chemistry of the
tooth. Let it re-harden. If you don't fill it, it will take
about two months to re-harden. If you fill it, it takes four
months to re-harden. It's kind of a lovely concept, isn't
it?
...Ozone is the only way to predictably re-mineralize
the tooth – it's a component of the process. Because what
it's going to do [when applied in gas form], is diffuse into
the tooth, through those little white spots into the
tooth... First, it's going to kill all the microbes in the
tooth. That's important... The end products of bacteria are
acids. It changes the chemistry of the tooth from acid to
neutral, so that now the tooth can re-mineralize the way
it's supposed to.
A lot of people think that re-mineralization happens
from the outside in, but most of that re-mineralization is
actually going to be coming through the pulp. The pulp, of
course, is that hollow internal structure of a tooth that is
filled with blood vessels and nerves and is designed to give
the tooth nutrients and keep it hydrated. The minerals are
going to come in through the pulp, feed out this way, bring
the minerals to that area, and harden it."
Everyday Dental Hygiene Tips
If you're like most people, you probably use toothpaste. But
according to Carol, not only do you not need fluoridated
toothpaste, you don't need any toothpaste at all. This is
because plaque is removed through mechanical scrubbing, and the
toothpaste might just give you a false sense of "clean."
"Many of these toothpastes have surfactants and
things that keep the tongue from telling you when it's
clean. If it still feels like a sweater's on your tooth, it
is. Also, you can tell better if you're jiggling it under
the gums. That's an important feedback for you to know,"
she says.
"I have people using the toothbrush as long as it
takes to where the teeth feel nice and smooth. If they want
to add those adjuncts, I have them use baking soda at night
because that's when our saliva slows down, and we really
want to raise that pH. It's going to have a longer effect."
Another interesting tip is to use ozonated oil. This is
simply olive or jojoba oil through which ozone has been bubbled
through (note it must be medical grade ozone). You can use it to
brush your teeth with, or apply it to your gums with a
toothpick. (One caveat is that it doesn't taste good.)
"My favorite tool might be the butler soft picks...
It's just a little tool that I can dip in the ozonated oil
and put in between my teeth. You can put it anywhere there's
a plaque. It pretty much melts the plaque off," Carol
says.
More Information
For more information, please read Carol's book, Mouth
Matters. You may also want to recommend it to your dentist.
After all, the only way dentistry will change is by patients
asking for better alternatives. You can also find more
information on her website,
mouthmattersbook.com.
"You can say, 'this is the kind of dentistry I
want,'" Carol says. "Then also, for those who don't
have a dentist, I have developed a database. I thought that
was really important to do, so that people can go to see who
it is that's been trained in it, who are using it, who are
doing biomimetic dentistry, and who are using ozone in their
practices. Ideally, it's a marriage of all three."
Alternatives such as CEREC® inlays are taught at the
University of Southern California under Pascal Magne and Dave
Alleman, and dental applications for ozone therapy are taught by
Mollica & Harris (for information see
oxygenhealingtherapies.com).
© Copyright 1997-2013 Dr. Joseph Mercola. All Rights Reserved.
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