What is a biological dentist?
Recently a few of my patients have asked me if I am a biological dentist. This is a sometimes mistakenly believed to be a specialty in the field of dentistry. It is not a dental specialty. It is more of a focus of philosophy in treatment. I care deeply about the bio-compatibility of all of the materials and methods that I use in my practice. So I do call myself a biological dentist. I don’t belong to any organization but I do read and study to many of their studies and I form my own opinions and philosophies.
We, as dentists, correct pathology of the mouth and do so with foreign materials and medications. We remove tooth structure – some bad, some good, and replace it with metals, ceramics, or resins. Its not too unlike what construction teams do, but on a micro-scale. The big difference is that in dentistry the materials are going into a biologically active human body. Chewing will break down the surfaces of the fillings and crowns, enzymes will do the same. Certainly, a very minute amount of the restorations are being slowly, slowly ingested and making the external dental work, internal and systemic.
So a huge burden is put upon dentists to research every material that is used in a practice. The material should be strong, esthetic, long-lasting, but more importantly, it must be bio-compatible.
Key Points of Biological Dentistry
Mercury in Amalgam
I spoke about mercury in fillings in last weeks blog. The main reason that I don’t use silver amalgam at all in my practice is because it contains mercury. Mercury is a horrible poison toxic. Every reputable scientific study has shown that silver amalgam fillings are reasonably safe. That doesn’t mean that they are bio-compatible. My philosophy remains that silver amalgam should be avoided. It is a wonderful material as far as strength, durability, cost, and ease of use. But I simply can’t justify using it with the biological understanding we have.
Our waste water goes into the city sewers. Eventually everything ends up in the ocean. I’m not an environmentalist but I do believe we need to do our parts to keep our world healthy. My biggest environmental concern has always been the ocean. I support great organizations like The Surfrider Foundation. I can’t control issues like over fishing, but I will do my best to put chemicals into the ocean. I have an amalgam separator incorporated into my vacuum suction system which removes the toxic chemicals from the waste so I can responsibly dispose of them.
Safe Removal of Mercury
I don’t advocate removing silver fillings for the sake of removing them. Studies have shown that the majority of mercury exposure happens at the time of placement and the time of removal. So when a silver filling needs to be removed I advocate placing a rubber dam to isolate the tooth from the body. I also use a special suction tip that more effectively isolates the area. This provides safe removal without the peak in mercury exposure that is too common.
I understand that what might be right for one is not right for all. I am committed to testing the bio-compatibility of my work at follow-ups and check ups. I understand that irritation of the tissue around a crown is likely not due to poor oral hygiene but due to a bio-incompatibility. I will replace any restoration, even though I believe it is safe, if it is not individually compatible.
I part ways with many biological dentists on this point. I believe that water fluoridation is safe and effective. I have read too many studies and articles and my conclusion is that we should take advantages of the benefits of fluoride.
It is universally accepted that pathogens cause just about every issue common to oral health. Historically, dentists have only corrected the damage caused by pathogens. Biological dentistry advocates being proactive and treating the pathogens instead of their damage.
I am committed to treating each patient as a whole person and not tooth by tooth. I will do this through keeping up to date in the latest that evidence based research and technology has to offer. I look forward to any questions or discussion that anyone has on this topic!