Military research finds no sex difference for Ankylosing Spondylitis

The incidence of ankylosing spondylitis (AS) did not differ between men and women in a large study of military personnel, which called into question the previous assumption of male predominance for this disease.

In a retrospective study that included more than 700,000 military service members, the incidence rate was actually slightly lower for men than for women, at 26.53 versus 31.36 per 100,000, according to Michael H. Weisman, MD, of the Cedars Sinai Medical Center in Los Angeles, and colleagues.

Accordingly, the incidence rate ratio for men was a nonsignificant 1.16 (95% CI 0.91-1.49, P=0.233), the researchers reported online in Arthritis Care & Research. The sole prior population-based study on the incidence of AS in the U.S. was from Olmsted County in Minnesota from 1980 to 2009. In that study’s largely white, homogeneous population, men were three times more likely to have AS than women, but a Canadian report suggested that the incidence amongst women was increasing.

To provide an up-to-date estimate on the incidence of AS — a heterogeneous disease characterized by pain and stiffness of the spine and considerable disability — Weisman’s group analyzed data from the longitudinal Stanford Military Data Repository from 2014 to 2017. Amongst 728,556 active duty personnel, they identified 438 incident cases of AS, for an overall incidence of 27.22 per 100,000 person-years. The greatest difference between sexes was seen amongst individuals ages 24 and younger, amongst whom the incidence rate for women was 21.43 per 100,000 person years compared with 11.11 per 100,000 for men, for an incidence rate ratio of 1.93 (95% CI 1.13-3.29, P=0.015).

A total of 92.69% of patients diagnosed with AS reported having low back pain, and 83.56% had received either x-ray or MRI evaluation of the sacroiliac region. Additional clinical features more frequently experienced by AS patients versus non-AS individuals included (all P<0.001):

  • Uveitis, 11.42% versus 0.32%
  • Psoriasis, 7.76% versus 0.70%
  • Inflammatory bowel disease, 1.83% versus 0.30%

In a multivariate analysis, the adjusted odds of AS were slightly but nonsignificantly lower among men than among women (OR 0.79, 95% CI 0.61-1.02, P=0.072).

However, the adjusted odds ratios rose significantly with increasing age:

  • Ages 25 to 34, OR 2.62 (95% CI 1.95-3.52)
  • Ages 35 to 44, OR 5.13 (95% CI 3.79-6.93)
  • Ages 45 and above, OR 7.30 (95% CI 5.17-10.32)

A further finding was that white patients were significantly more likely to have AS compared with Black patients (OR 1.39, 95% CI 1.01-1.66).

A secondary analysis that required two separate diagnostic codes for AS supported the findings of the primary analysis for the lack of association of AS with male sex, with an adjusted odds ratio of 0.99 (95% CI 0.70-1.40).

In discussing their findings, the researchers pointed out that there were several possible explanations for why their findings differed from those of the earlier Olmsted study. One was that the previous study relied on the modified NY classification criteria for AS, which required the presence of sacroiliac x-ray changes, whereas in this study, almost two-thirds of patients underwent advanced imaging, such as MRI, that could detect more subtle changes.

The use of a military population also might have contributed to the differences in study findings. The majority of the U.S. military is younger than age 30, which is the time frame when AS symptoms first appear. Military personnel have full access to free specialty healthcare, and spinal complaints are addressed by a specific Department of Defense clinical practice guideline.

“Our findings challenge the widely held belief that AS in the U.S. occurs substantially more frequently in males than in females,” the authors concluded.

A limitation of the study was its use of a military cohort, who may be more physically fit and healthier than the broader population. The researchers therefore called for further investigations involving other populations.

Source reference:

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Guillain-Barré Syndrome recur after mRNA COVID vaccine, but the risk is really low

Guillain-Barré Syndrome (GBS) is an acquired demyelinating polyneuropathy that often begins in the lower extremities and ascends over time with loss of reflexes, causing muscle weakness, or in the most severe cases, paralysis. Some cases may start a few days or weeks after respiratory or gastrointestinal viral infection. GBS is often reversible.

Researchers from the Maccabi Healthcare Services, the second largest HMO in Israel, searched cases that had been diagnosed by a hospital neurology department, linking them with COVID vaccine records, medical care encounters, and hospital visits after patients received at least one vaccine dose. They conducted a manual review of the electronic medical record of all cases to ensure patients with a GBS diagnosis were accurately identified.

They identified 702 GBS cases between 2000 and 2020; 48% were women and the average age was 53. Of these patients, 579 received one Pfizer vaccine dose and 539 received two doses. The researchers followed these patients for a median of 108 days after the first dose and 90 days after the second. This study is the first to assess the safety of mRNA COVID-19 vaccines in previously diagnosed cases of GBS.

A total of five formerly diagnosed GBS patients were referred to the hospital for neurological concerns after they had the vaccine. Two patients had paresthesia, one had tremor for several months, and one was evaluated for a seizure. These four people were released from the emergency department within a few hours without medical observation. The fifth patient had progressive leg weakness and paresthesia that started soon after she received the first vaccine dose, which lasted for several weeks. She was admitted to the hospital several days after receiving her second dose.

The clinical picture and electrodiagnostic evidence were suggestive of sensorimotor demyelinating polyneuropathy, and the patient was treated with plasmapheresis in the hospital and, by the day of discharge, had a significant improvement in her lower limb weakness and only minor proximal weakness without any sensory disturbance. The analysis was limited because it relied on medical records and diagnosis, the researchers acknowledged. It included only hospital visits and may have underestimated other symptoms that presented only in the community. Nevertheless, any significant serious neurologic concern would probably have been evaluated in a hospital setting.

There were a small number of GBS cases following the swine flu vaccination campaign in 1976, and this question has unfortunately been a vaccination barrier ever since. In reality, patients often are more at risk of neurologic complications such as GBS from the infection than they are from the vaccination designed to prevent it.

Source reference:

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What Exactly Is a “Mild” Stroke?

It’s important to know that every stroke is different and therefore every recovery will be different. No one can estimate minor stroke recovery time with absolute certainty. Still, there are some patterns worth noting for mild stroke patients. Hopefully these patterns can help you understand what lies ahead on the road to recovery.

To understand the severity of a stroke, it helps to know what the NIH Stroke Scale is.

The NIH Stroke Scale is an assessment tool used to assess the secondary effects of a stroke. This scale helps your medical team “score” you in a variety of areas that can be affected by a stroke, such as movement, vision, and speech.

A high score indicates a significant stroke while a low score implies a mild or moderate stroke. Specifically, a stroke is considered mild when a person scores less than or equal to 5 on the NIH Stroke Scale (out of a possible 42).

Scoring as low as 5 signifies that not many secondary effects are present. For instance, if mobility was affected, the individual is unlikely to be paralyzed. Perhaps the person can lift their affected arm but it may drift down after 10 seconds or so.

It is possible for a mild stroke patient to have significant impairments in one area, but a score as low as 5 would imply that most other areas are unaffected. For example, if speech was severely affected, then mobility and vision remain mostly unaffected for the mild stroke survivor.

Of course, these statements are all generalities. Because every stroke is different, every prognosis will be unique, even for minor strokes.

How Long Does Mild Stroke Recovery Take?

If you had a mild stroke, your stroke recovery timeline will probably be shorter than others with more severe strokes. Because mild strokes do not typically cause major impairments, recovery is usually fast. Sometimes recovery from a mild stroke can occur within 3-6 months. Other times it can take longer.

There are many variables that affect the time it takes to recover. Instead of focusing on recovery time, it can help to focus on the recovery process instead.

When you focus on the steps you can take to recover, you are empowered to take action. And action is how results are made.

Stroke Recovery Process for Mild Stroke

After a stroke, you will spend some initial time at the hospital. But instead of going to an inpatient rehab facility (where patients participate in 3+ hours of therapy per day), mild stroke patients are often discharged straight home.

Generally speaking, if you are able to accomplish the activities of daily living on your own, you are likely to go straight home after the hospital. Your rehabilitation team should instruct you on how to continue rehabilitation at home before discharge.

Once you arrive home, recovery is in your hands. It’s up to you to pursue rehabilitation through various home therapy programs that address your specific needs, especially if it’s not recommended that you go to outpatient therapy.

A Proactive Approach Is Necessary

There’s a myth that mild stroke survivors don’t need to do much to recover, but that’s not true. It’s best to avoid assuming that recovery will take care of itself.

One study noted that “patients with mild stroke are assumed to achieve full recovery with little or no intervention. However, recent studies suggest that such patients may experience persistent disability and difficulty with complex activities.”

This means that a full recovery from stroke is not guaranteed, even for minor stroke survivors. However, even though it’s not guaranteed doesn’t mean it’s not possible.

The ingredient that makes recovery possible is action. Regardless of the size of your stroke, it’s important to participate in rehabilitation in order to maximize your chances of recovery.

With a rigorous therapy regimen, most mild stroke survivors can achieve a full recovery, or get very close to one.

Taking Charge of Your Recovery Time

Instead of participating in therapy at an inpatient rehab facility, most mild stroke patients are discharged home and must keep up with rehab on their own, and/or with outpatient therapy.

Even if you do go to outpatient therapy, it is imperative to participate in a rigorous at-home therapy program as well. This will help patients get the consistent practice that’s necessary to maximize results.

Some mild stroke patients stop pursuing rehab and feel like they are stuck at the level of impairment that they left off with. This doesn’t have to be true.

The brain is capable of changing throughout our entire lives. Whenever we begin to put in the work, the brain will respond. This is why recovery is possible even decades after a stroke.

Again, the essential ingredient is action. You get better at the skills that you practice regularly, no matter how long it has been since your stroke.

Mild Stroke Recovery

Overall, recovery from a mild stroke takes less time than recovery from a massive stroke. The results you see will be dependent upon how consistent you are with rehabilitation. 

Because mild stroke survivors often do not go to inpatient rehab, recovery is in your hands. The good news is that, if you keep up with a rigorous home therapy program, you are likely to see a great recovery.

In-home physiotherapy may be better designed by a Physical Therapist, who can personalize treatment and select proper activities in order to increase quality of life. If you want to have a physiotherapy assessment, please give us a call. We are ready to work with you!

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Foam Rolling, is it For Me?

If you have been to a physiotherapy clinic in the last few years, then you have almost certainly witnessed, or felt first hand, the technique of foam rolling. Foam rolling is a popular technique that releases tight muscles and mobilizes the network of connective tissues.

When should I consider foam rolling as a treatment?

Scar tissue, adhesion and tightness develop in many ways, namely from trauma, or via less serious injuries, such as repetitive stress and postural dysfunctions.  This tightness needs to be dealt with in order to restore proper function and mechanics to the body.

Muscles need to have sufficient strength, but also sufficient flexibility.  Whether you are a rugby player, yoga instructor or office worker, it is important to not only have strength but to also have optimal function through a full range of motion.

The Solution?

Foam rolling offers patients an inexpensive, effective and convenient method to reduce scar tissue, breakdown adhesions and improve tissue tone.  A patient will use their body weight between the roller and the soft tissue being treated.  The patient will roll along the length of the tissue.  When a tender spot is found,  focus on rolling on that area. The more time spent rolling on the specific area will serve to decrease the degree of pain and tenderness and improve elasticity in the muscle tissue. 

Interested in more information on the services we provide? Contact us today!

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Exercising with Resistance Bands

What are Resistance Band Exercises?

Resistance bands are strips of stretchable rubber that come in a variety of resistance levels and colors.  They are used to perform strengthening exercises for your muscles by providing resistance during the entire movement, causing your muscles to work both concentrically (while shortening) and eccentrically (while lengthening).

When would I consider Resistance Band exercises?

Strength training is an integral part of rehabilitation after an injury.  It is important to do strengthening exercises to regain the muscle power you have lost, correct any muscle imbalances and to prevent re-injuring yourself.  Resistance bands are an inexpensive, effective and versatile method of strengthening muscles in a functional way.

Indications for using Resistance Bands include:

  • Correcting muscle imbalance
  • Posture correction
  • After joint sprains e.g. twisting the ankle
  • Post-surgery e.g. Joint Arthroscopy, Knee and Hip replacement and rotator cuff repair
  • Shoulder impingement syndrome
  • Improving balance and hip control
  • Stabilizing hyper-mobile joints
  • Correcting training techniques
  • Core strengthening

Are Resistance Band exercises preferred to dumbbells, barbells or machine weight exercises?

In order to return to your daily activities or a specific sport, it is important to not just strengthen the individual muscles but to do functional strength training. Functional strength training focuses on doing exercises that involve rotation, pushing, pulling and diagonal movements, to mimic day to day movements we do. Exercises with weights only apply resistance in one plane using gravity, limiting you to bending and straightening movements, while with resistance band exercises can be applied in all planes of motion simultaneously. This prepares you to return to rotational sports such as hockey, golf or baseball, or household activities such as making a bed.

Every resistance-training exercise has a strength curve. The weight you can lift from the starting position may be less than the weight you can lift when the muscle is fully contracted. When using resistance bands, the resistance at the start of the movement is less and increases as you complete the movement.

Tips when training with Resistance Bands:

  • While doing any resistance band exercise a neutral posture should be maintained.  Concentrate on aligning the neck, shoulder blade and shoulder joint, pelvis, lower back, hips while contracting the core abdominals and bending the knees slightly.
  • Use the band strength prescribed by your physiotherapist/kinesiologist and stick with the prescribed sets and repetitions. Remember to rest between every set as directed.
  • Perform all exercises in a slow and controlled manner.
  • Avoid going into extreme joint positions when exercising e.g. locking the joint at the end of a movement.
  • Breathe evenly while performing these exercises. Exhale while contracting the muscles and inhale while releasing.  Don’t hold your breath.
  • Start off by performing the exercises without the resistance band until you are comfortable with the movement, then add the resistance.

For more information on all of the services we offer at Vick Physiotherapy International, please visit our services page.

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Heel pain and what to do about it

Plantar fasciitis is the most common cause of heel pain. It is an irritation or inflammation of the plantar fascia — the ligament that runs from the heel to the ball of the foot. This is a strong, dense strip of tissue that supports the arch of the foot, almost like the string on an archer’s bow.

When the foot is on the ground, the plantar fascia is forced to stretch as the arch of the foot is flattened under weight of the body; like the string stretching as the bow is trying to straighten.

This leads to stress on the plantar fascia ligament, where it attaches to the heel bone. Some small tears of the fascia may result. These tears are usually repaired by the body, but repetitive stress may result in incomplete healing. A bone spur can form as the body tries to compensate for too much stress.

Pain in the heel can occur due to such bone spurs, inflammation of the plantar fascia (known as plantar fasciitis) or impingement of the small nerves in the foot. The condition is most common between the ages of 40 and 60.

Symptoms of plantar fasciitis include pain on or around the heel when weight is placed on the foot. This is usually worse in the morning, especially with the first few steps out of bed and can be described as sharp, burning or stabbing pain. Pain usually reduces during the course of the day as the tissue warms up. In most cases, there is no pain at night since the plantar fascia is not stressed. Prolonged standing, walking or getting up after long periods of sitting usually irritate the fascia.

Common causes

  • Overload of physical activity, excessive running or jumping
  • High arches, flat feet, abnormal gait
  • Wearing improper shoes while walking or running
  • Recent weight gain or pregnancy
  • Occupations that keep you on your feet
  • Diabetes contributes to heel pain in the elderly
  • Right steps to relief

    In most cases, plantar fasciitis does not require surgery and can be treated conservatively. If you suffer from heel pain, make an appointment with your physiotherapist. Ignoring plantar fasciitis may result in chronic heel pain that hinders your regular activities. Simply changing the way you walk to avoid pain could lead to other foot, knee, hip or back problems.

    Therapy usually involves identifying the cause of your foot pain and a series of treatments. You may be prescribed specific footwear and exercises. Physical Therapists will design exercises to improve flexibility in the calf muscles and the plantar fascia. Treatment helps control pain and swelling. We may use ultrasound, mild electrical stimulation, ice packs and soft-tissue massage to help you recover as fast as possible. We may even recommend the use of orthotics depending on your condition. Keeping mobility and flexibility in the foot is key to improve quality of life.

    Call our practice today, and we’ll help you take the right steps without pain!

    How to get the most from your physiotherapy appointments

    An appointment with a physiotherapist is an excellent step towards improved function and injury prevention. To make the best use of your time, please use the following guidelines:

    Wear comfortable clothes. Jeans or long sleeves are not advisable during your initial evaluation since the therapist may need to evaluate your joint stability. You may be asked to take off some clothes and put on a gown to give your therapist access to the body areas needing evaluating.

    Make sure to arrive a few minutes prior to your appointment in case you need to fill out some forms.

    Elaborate on the things you are unable to do, or the level of function you would like to achieve with your physiotherapist. This will help the therapist to serve you as effectively as possible.

    Provide information about when the pain started, the nature of pain (sharp or dull), what caused it, and what aggravates it.

    Remember that you and your physiotherapist are part of a team with a common goal – to get you better as quickly as possible. Do your home exercise program exactly as instructed and try not to miss any appointments in an effort to reach that goal.

    Quick tip

    Using your hands, gently pull the toes back and forth or apart. This stretches the muscles underneath.


    Enter every activity without giving mental recognition to the possibility of defeat. Concentrate on your strengths instead of your weaknesses, on your powers instead of your problems.

    ~ Paul J. Meyer

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    Avoid Dental Dangers: 10 questions to ask your Dentist

    #1 Are you using universal infection control protocols?

    Every dental office should be using standard of care infection control protocols. This includes using predominantly 1-time use materials such as suction tips, cotton products, cleaning cups, and neck aprons to name a few, as well as heat-based sterilization for all reusable items like drills and burs.

    Ask to see your dentist’s process. This should include a special area in the laboratory for cleaning of the instrument, soaking in a glutaraldehyde or similar disinfectant solution, a way station to rinse after soaking, and a heat sterilizer. The sterilizer should be in excellent condition and the dentist must show that she/he has it tested often using special sterilization testing strips.

    It is important to understand that in any dental office that is adhering to strict infection control procedures, and all of them should be, any and all infections become a non-issue. Whether it is COVID-19 or Hepatitis B, every patient is treated the same – as if they are infected. In other words, you have nothing to fear when visiting your office for treatment if that office follows the standard of care.

    #2 Do you place amalgam fillings?

    As strange it sounds to have to ask this in 2021, many offices around the world still allow placement of these mercury-based fillings. There are hundreds, if not thousands, of scientific, peer-reviewed, research articles showing the deleterious effects of mercury-amalgams to human health that the use of them should have been banned years ago.

    There is no dispute that mercury vapors are emitted from these fillings 24h a day, with increased exposure during brushing, chewing and grinding. You can find many studies showing how you, the patient, the dentist and the assistant are all exposed when working with these fillings. In fact, biologic dentists have to wear and provide a lot of protection for all of you when removing these feelings (see 3#).

    Biologic dentists strongly recommend that if your dentist is still placing mercury-amalgam fillings, you should choose another office. And do not be confused by the “amalgam” name or any comments by a dentist who says they are really silver fillings. Amalgams contain 50% or more mercury as the main ingredient. Silver, copper, and tin make up the rest, and are not exactly completely inert in their own regard. “Let the buyer beware” when it comes to amalgams.

    #3 Are you a mercury-safe office?

    Do you empty the SMART protective protocols when removing and replacing these feelings? You need to choose a biologic dentist when having your amalgams removed who is SMART certified and experienced in safe removal.

    It is important to know that as recently as 2019, studies have come out showing not only vapor exposure during removals, but particulate matter exposure as well (small pieces flying as far down as your feet). This is important to know because most dental offices do not even use rubber dams, a basic protective barrier for your mouth, let alone all the other protective armamentarium.

    Having your amalgam fillings removed can be very dangerous if not performed properly. Skipping any steps involved in the SMART process will expose you to high amounts of mercury exposure. Many years of observation, clinical experience, and scientific studies all contributed to the safe removal process. You need to treat the most potent neurotoxin on Earth with respect and prudent care.

    #4 Do you ask me about my diet and other health related information?

    Your dentist needs to do a comprehensive exam. If the first time you meet your dentist for an examination is at your cleaning visit, this is NOT comprehensive.

    Your dentist needs to spend time with you discussing your health history (including dite and family history), getting records including x-rays, photographs, oral cancer screening, and periodontal probe evaluation, as well as discussing findings and recommended treatments. Simply walking out with a proposal the day of your cleaning is not comprehensive, not it is likely accurate. It takes time to carefully assess everything, study and devise a plan, and go over it in detail with you. The best dentistry in the world will fail in a patient with a poor diet.

    Some offices offer complimentary 30-minute consultations, where you and your dentist can get to know each other and discuss all your concerns and desires BEFORE you actually do the exam. The comprehensive exam is the cornerstone of the practice, and it should be seen as a standard. It his imperative, especially in today’s “microwave” society, that you have enough time to truly build a trusting relationship with your dentist.

    #5 Do you use fluoride in your treatments? Do you recommend its use for good oral health?

    You should definitely refuse fluoride treatments used during cleaning appointments. Exposing your or your child to fluoride-tray treatments (when the dentist or hygienist places trays in your mouth filled with fluoride gel) is not only unnecessary but dangerous as well.

    There are documented cases of children dying after swallowing the harmful chemical. You just look on the back of your toothpaste tube to see how toxic this material is… “do not use more than a pea-sized amount of paste and if swallowed, contact a poison control center immediately”.

    Keep in mind that in-office fluoride treatments contain far higher amounts and concentrations of fluoride. A huge argument against community fluoridation is that there is NO dosage control.

    The amount in those trays is enough to easily kill a child if swallowed. In addition to tray treatments, some dentists like to place fluoride varnishes on the gumminess to help sensitivity. This is unnecessary and again a fairly high concentration of the chemical. There are other ways to reduce sensitivity including ozone therapy (safe with no negative side effects) and other gels like MI paste.

    Although fluoride does indeed help with sensitivity, it alters the enamel by weakening the collagen Maria, making it more brittle. This conversion from hydroxyapatite, the normal makeup of enamel, to fluoroapatite is what makes the enamel somewhat resistant to sensitivity and carious breakdown, but the disruption of the enamel matrix is forever changed and this permanent disruption is not necessary since there are other alternative treatments that do not alter the tooth.

    Fluoride is the most reactive element on the entire periodic table and causes a myriad of systematic disturbances involving the thyroid, the pineal gland, and your bones, to name just a few. There are 65 published studies showing a definite correlation between fluoride and reduced IQ in children.

    It is important to note that only 3% of the world uses fluoride as a “medicament” in our water supplies and as a prescription supplement. The majority of that 3% is the United States.

    It is very difficult to completely avoid fluoride in dentistry as most of the resin materials (composite, sealant, glass ionomers) contain small amounts of it. Fortunately, there are some materials that do not contain it al all, and these are the options that most biologic dentists employ.

    #6 When doing my periodontal treatment, is your goal to kill all my “bad” bacteria?

    This may seem like a silly question, but killing your “bad” bacteria is the common goal of most dental offices. Most dentists will subscribe to the theory that bacteria in your mouth cause all your problems like tartar accumulation and decay. So they prescribe scraping, antibiotics, and antibacterial rinses like chlorhexidine (Peridex) to destroy all the germs.

    While certain bacteria do indeed become opportunistic when pH is off and/or your immune system is compromised, it is only because your microbiome is not happy. This is why a comprehensive evaluation is so important. Taking a more functional approach is how your dentist can plan proper treatment aimed at getting your oral microbiome in a state where ALL your bacteria is happy and commensurate.

    Some individuals will still require manual scraping (scaling and root planing) to remove hardened calcules, but keep in mind that work on prevention is also important, so you do not reach that hard level of treatment.

    Seeing less patients and spending more time on comprehensive care, is the only way to provide truly focused, precise care. The model of getting in as many patients as possible and working as quickly as you can is not only counterproductive, but also poses more opportunities for mistakes.

    You have likely heard of the stories of patients who have the wrong leg or organ removed because the hospital made a mistake when preparing the patient for surgery. Well, the same thing happens in dentistry in a busy, “chair-to-chair” office. The wrong tooth is pulled, a root canal is done on the wrong tooth, and a patient ends up having a crown placed on a perfectly healthy tooth.

    Working on one patient at a time, and doing careful, focused care is the only way to practice in a health-conscious practice.

    #8 Are you placing any metals in my mouth?

    This used to be one of the controversial topics that separated conventionally-trained dentists from “holistic” dentists. Doing “metal-free” dentistry became the niche dentists employed when trying to become more natural.

    It is important to understand that even porcelains (tooth colored veneers, onlays and crowns) contain metal salts, so it is impossible to provide completely metal-free dentistry. That being said, you can certainly avoid all obvious metals like amalgam, nickel, silver and titanium, to name a few.

    We now have the technology and materials to provide tooth-colored, strong, stable restorations. Composite fillings easily last as long, or longer than amalgams. Zirconia-based crowns and implants are incredibly strong and biocompatible, finally offering a healthy alternative to titanium implants and metal-based crowns.

    Gold restorations (ie – very high content gold – around 80-88% pure gold) for use in inlays and onlays is a strong, predictable restoration option. This is one metal that has stood the test of time both restoratively and compatibility-wise.

    #9 Do you do root canals?

    This is the most controversial topic in dentistry today. Most biologic dentists will tell you that you should never get a root canal because it can never be completely cleaned properly and becomes a focus of systemic problems.

    Weston Price, a very famous dentist who practiced in the early 1900s, did many animal studies where he showed that root canals caused illness to rabbits when just a sliver of the tooth was placed under the skin.

    His premise, which holds true today for the most point, is that a dentist can never get all the bacteria and other bugs removed from the nearly three miles of dentinal tubules inside the tooth. Therefore, onde the nerve (pulp) of the tooth becomes infected, you HAVE to remove the tooth. There is no other choice.

    However, there are quite a few studies completed or in the process that show when the dentist uses the Fotona Lightwalker PIPS or SWEEPS laser protocol, along with oxygen-ozone therapy (or the ultrasonic GentleWave technology), you can indeed get the entire tooth clean, thereby creating a more biologically sound result. This is exciting information because now patients do not have to end up orally crippled by having all their root candled teeth removed.

    Mastication process with artificial teeth or dentures is not properly, causing digestive problems due to chewing food incorrectly. Please, do your own research (look very carefully for reputable peer-reviewed studies and not just simple Google searches) before deciding whether to pull your teeth or do these special root canals.

    There are certainly a fair number of dentists and consumers who completely eschew all root canals and ultimately having a non-vital tooth in your mouth is probably not an ideal situation to live with… but neither is pulling your teeth. It is always important to have a thorough discussion with your dentist and ultimately make your decision.

    Get informed. Information is powerful and will help you decide if your gut instinct is correct.

    #10 Do you offer a biocompatibility test?

    Having any materials in your mouth 24/7 can possibly lead to systemic problems. Dentistry is the one profession where there are literally NO rules as to what they can place in your mouth. Metallurgists cringe when they know how some dentists place nickel crowns next to mercury-amalgams next to gold.

    All of you with dissimilar metals in your mouth are walking around with a battery in your head. Your saliva is the electrolytic solution that allows all the metals to react with one another.

    If you have ever tasted metal, felt a shock on a tooth when metal touches it, or possibly heard some radio sounds coming from your mouth, you are experiencing a galvanic response.

    Most dentists pay no mind to this topic, but a biologic dentist will take it very seriously. They will offer the Clifford Biocompatibility Assay Test to their patients to see which material are suitable for their individualized system.

    Some people can handle a lot of different materials, while others are very limited. You won’t know until you do the test. It is an inexpensive way to get peace of mind and security before you have your dentist place materials permanently in your mouth. This test also opens up the opportunity for some dialogue about your health and personal desires in this relationship.

    Most biologic dentists offer this kind of test, but any dentist can do it. If your dentist does not offer it, simply ask to do one. Take charge of your health. True healthcare is not dictatorial anymore. It is a team effort, but one where you are in control. Choose your healthcare providers carefully and you will enjoy a mutually beneficial relationship and one that provides you with the best care possible.

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    Focus on nutrient density, not on calories

    Some people are concerned that a vegan or plant-based diet won’t provide all of the nutrients they need to stay healthy. While this could be true if you rely on white flour pastries, potato chips, and soft drinks, with a little planning, even an entirely plant-based diet can meet — and surpass — your nutrient needs.

    Many people fear that critical nutrients like protein, calcium, and iron are only in animal products. But meat, eggs, fish, and dairy are far from the only — or the best — sources of these nutrients. On the contrary, rest assured that plants can indeed provide all of these nutrients and more! In fact, whole plant foods are chock full of the vitamins, minerals, fiber, antioxidants, and phytochemicals that are strongly linked to better health outcomes.

    While packed with nutrients, plants are less calorically-dense than animal products, meaning they contain fewer calories in a similar serving size. Therefore, you’ll need to eat more of them in order to get the same amount of calories. (That’s one of the important reasons plant-based diets are so good for weight loss: you can eat until you’re full without consuming too many calories.) By focusing on nutrient-rich plant foods, however, you’ll have no problem meeting your vitamin and mineral requirements.


    A good place to start is to incorporate some of the most nutritious, health-promoting plant foods on the planet. We like Dr. Joel Fuhrman’s acronym G-BOMBS, which stands for:

    • Greens: Leafy greens like spinach, kale, Swiss chard, collard greens, and other cruciferous veggies like broccoli and Brussels sprouts are full of anticancer compounds, vision-promoting antioxidant carotenoids, phytochemicals, folate, calcium, and fiber.
    • Beans: Legumes like beans, peas, and lentils are an excellent source of fiber and resistant starch, which are healthy carbs that can help lower high cholesterol, manage blood sugar, keep intestines clean, and reduce the risk for colon and digestive cancers.
    • Onions: The Allium family — made up of onions, leeks, garlic, chives, shallots, and scallions — contain powerful organosulfur compounds, which may help boost immunity, promote heart health, and have anticancer, antimicrobial, and anti-diabetic effects.
    • Mushrooms: All mushroom varieties, including white button, cremini, Portobello, oyster, shiitake, maitake, and reishi, contain anti-inflammatory, immune-stimulating compounds that appear to protect against cancer, prevent DNA damage, and trigger cancerous cells to self-destruct for the good of the entire organism.
    • Berries: Blueberries, strawberries, and raspberries are among the most antioxidant-rich foods on the planet. Regular berry consumption promotes heart health, reduces cancer risk, lowers inflammation, and is protective against cognitive decline.
    • Seeds: Nuts and seeds are full of vitamins, minerals, omega-3 fatty acids, protein, fiber, and calcium. And they can boost absorption of other nutrients, protect heart health, help prevent diabetes, and have anticancer properties.

    Focusing on plant-based foods is a great way to enjoy a nutritionally-adequate and delicious palate that can benefit both your waistline and longevity.

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    Interference fields & the healing of chronic illness

    Interference fields can be roadblocks to healing. Once identified and removed, the body can self-regulate and heal.

    Imagine the body as a beautiful city lit up at night. Street lights sparkle for miles and buildings glow against the dark sky. But on closer inspection, there is a dark spot amongst the bright lights, a strange anomaly that disrupts the picturesque view. This is what an interference field is like in the city of lights of our autonomic nervous system: a disruption in the pathway of nerves that speaks to the brain and keeps our systems running smoothly.

    Interference fields can be scars, focal infections, tonsils, silver fillings, and root canals as some primary examples. It is an area of previous trauma that is disrupting information that another part of the body desperately needs. These bodily traumas are not fresh and are easy to overlook as they are usually not painful and, especially in the case of fillings, often completely forgotten.

    Interference fields can be the key to alleviating a chronic problem in another seemingly unconnected part of the body. Let’s go through how interference fields work, how to find them and the neural therapy that can change lives.

    What it is:

    If the autonomic nervous system is how messages traverse the body, then the extracellular matrix is how hormones, nutrients and waste products get from one place to another within the body. Interference fields can disrupt the messages from the autonomic nervous system and accumulate toxins from the extracellular matrix. Chronic conditions arise from the disruption of information and the bioaccumulation of toxins from interference fields.

    Routine examinations and bloodwork rarely diagnose the true cause of these chronic conditions. Sometimes these conditions get labeled as psychosomatic and cause patients emotional distress along with the bodily chronic ramifications of the condition.

    Where it is:

    Interference fields can be anywhere in the body and do not always have an easily discernible connection to the chronic conditions they create. These scars, dental issues and other places of former trauma can be abundant on the body and can represent multiple interference fields. Organs can also be a site for infection and the accumulation of toxins. These interference areas silently and chronically disturb unrelated parts of the body.

    When working with patients and taking a history, special attention should be paid to areas of previous injury that leave scars, concussions, surgery sites, and dental work. These areas are usually asymptomatic and give no outward signal at all to the patient.

    I Hate My Scar: Options for Reducing Scars

    Dental work in particular can be a silent site of interference

    Mercury amalgam fillings leak toxins into the extracellular matrix and cause long-term damage. Mercury is a toxic heavy metal that can make up as much as 50 percent of an amalgam filling. While most dentists have been moving away from mercury amalgam fillings, most adults have these fillings quietly building up toxins in the body.

    Root canals are another area that can present as an interference field or focal infection. A root canal is a dental procedure intended to remove all nerves connected to a tooth; however, it often leaves the area open for infection, even when sealed off with a crown.

    Wisdom teeth, and particularly the cavitation they create, can be linked to a number of disorders and serve as a common interference field. Because of their placement in the mouth, wisdom teeth can be difficult to properly care for and even treat. They can become impacted into the jawbone, causing pain along with inviting infection and interference. Especially once they are removed, the empty cavity can serve as a hotbed for infection.

    Of course, the intimate connection between dental health and the overall well being of the body has long been known. So, there can be obvious foci of infection from impacted teeth and faulty dental work. But less obvious can be the tonsils, which are a part of the lymphatic system and should be given careful consideration. Patients with mercury amalgam fillings or other dental issues should be referred to a doctor that specializes in biological dentistry. More harm than good can come from removing these if not done properly.


    International Academy of Biological Dentistry and Medicine:

    International Academy of Oral Medicine and Toxicology:

    The Huneke Phenomenon

    In 1940, German doctor Ferdinand Huneke had treated a woman with chronic shoulder pain by injecting local anesthetic in and around the painfully frozen right shoulder with no success. In fact, this woman’s pain had gone on so long and been so intense that other doctors had removed her tonsils and most of her teeth in an effort to find the focal spot of the infection. She returned to Dr. Huneke one more time when she was experiencing pain in an old surgical scar on her left shin. Dr. Huneke injected the scar with a local anesthetic to alleviate her pain and she felt immediate relief in her right shoulder.

    “This experience was so startling that I could have no doubt that I was looking at a fundamentally new pieceof knowledge and that I was on the track of a hitherto unknown law in the field of focal processes.”

    — Dr. Ferdinand Huneke (Williams, Louisa, Radical Medicine, p.277)

    How to treat:

    NEURAL THERAPY originated in Germany in the early 1900s. In neural therapy a local anesthetic is injected into the disturbed area interrupting the abnormal neural signals coming from the interference field. The injection improves polarity of cell membranes
    and as the electrical polarity improves more nutrients enter and toxins leave the interference field. This allows the body to self-regulate and heal as lymphatic flow and circulation in the tissue improve.

    Injecting with compounded, preservative- free Procaine breaks down scar tissue and resets electrical messages going through the autonomic nervous system. Neural therapy also helps the flow of the extracellular matrix and to “un- crinkle” fascial membranes.

    SCAR THERAPY is a good place to begin with patients, injecting directly into the scar or the tissue surrounding it.

    SEGMENTAL THERAPY allows practitioners to reach organs through injections into connective tissue that represent segmental patterns around major organs. This increases blood flow and helps flush out toxins and brings nutrients to the organ.

    Massage with oils and creams can be used as a home remedy for patients with needle aversions or for scars in particularly personal areas, such as episiotomy scars. Home remedies also allow patients to observe and regulate the emotions that come with relieving chronic conditions.

    Interference Fields and Emotions

    A patient’s journey often has involved a series of doctors that could not find the genesis of his or her chronic condition and labeled it as “all in your head.” As interference fields are found and dealt with, a variety of emotions may accompany this treatment. It is not unusual for a patient to suddenly start sobbing as the neural therapy takes effect. Even for patients who don’t have serious chronic conditions, interference fields can hold emotions around the cause of the scar itself and changing the electrical messages can release emotions and improve overall well being.



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    GUT Health and triggers for Brain Health

    We tend to think of our guts, if we think of them at all, as nothing more than a tube for transforming food into poop.

    Even though we still have much to learn about the intricate world of intestinal microbiota and their influence on our health, treatment paradigms are being overturned as we realize the scope and depth of the relationship between the gut and the brain.

    When we suffer from poor digestive health, it’s impossible not to pay attention to our guts.  Between the pain, embarrassment and inconvenience of diarrhea, constipation, bloating, flatulence and cramping, and carefully avoiding foods that we once enjoyed, our guts take over our lives when we are not well.

    From cardiac health to weight management, diabetes to premature aging, cancer to autoimmune disorders, our experience of health or disease is largely determined by the state of our gut. And our mental health is no exception.

    Cutting edge research is finding that the gut communicates with the brain and has a powerful influence over both the physical condition of the brain and our cognitive function.

    In order to understand the connection between our guts and our brains, we must understand the microbiome.

    The Microbiome

    There are billions upon billions of tiny organisms living inside of each and every one of us, creatures that make their homes inside our bodies and consume our food to meet their nutritional needs. These microscopic squatters have a tremendous influence on our day to day wellbeing and are, in fact, intricately connected to our long term health because they’ve evolved to manipulate our thoughts and behavior in order to ensure their own survival.

    The microbiome consists of trillions of microscopic creatures of thousands of different species. The majority are bacteria, but there are also some fungi, parasites and viruses.

    When this community is composed of the right balance of microbials, they support healthy metabolism, immune function, digestion, hormone production and cognition. But when beneficial species exist in low numbers or are completely missing, opportunistic pathogens take over. In this case, the microbiome still has a powerful influence over many of our bodily systems, except now it has a detrimental effect on our health and wellbeing. Maintaining a diverse population of microbial species along with appropriate proportions of specific species within that community is the key.

    We still have much to learn about the microbiome and its implications for our health, but the wait may not be long. Funding for such research shows how important the potentials in this field could be. In 2015 the US National Institute of Health awarded one million dollars to a research program intended to reveal the relationship between the microbiome and the brain. Meanwhile, ongoing breakthroughs are challenging our understanding of nutrition, immune response and the nervous system. We’re also having to reconsider everything we thought we knew about memory, cognition and mental health.

    The microbiome exerts a tremendous influence over our brains and behavior. Fascinating research has recently revealed direct correlations between the species at home in our guts and the personality traits that we exhibit. Specific links were established, for instance:

    • An abundance of gammaproteobacteria were found in people who exhibit high neuroticism.

    • High levels of proteobacteria were found in people who displayed low conscientiousness.

    • High levels of lachnospiraceae and other butyrate producing bacteria were found in people with high conscientiousness.

    The microbiome communicates with the brain via three principal pathways:

    Electrical Stimulation of the Vagus Nerve

    The vagus nerve is the main component of the parasympathetic nervous system. It is the longest nerve, running from the brainstem all the way to the colon. It acts on all of the organs of the digestive tract, as well as the heart and lungs, and regulates involuntary bodily processes like heart rate, breathing and peristalsis.

    We once thought the primary function of the vagus nerve was to carry motor commands from the brain to the organs, but scientists have discovered that a shocking 90% of the fibers in the vagus nerve are actually dedicated to relaying information from the gut to the brain.

    On the other hand, when the messages from the body to the brain indicate that we are safe, the brain instigates the parasympathetic response. Activating the parasympathetic nervous system initiates the “rest and digest” mode and gives our bodies a chance to focus on nutrient allocation, tissue repair and detoxification while there is no immediate threat to our wellbeing.

    Scientists believe that the most important function of the vagus nerve is carrying information about the organs to the brain and have concluded that our digestive tract, which is our largest surface that interacts with the outer world, could be considered an especially important sensory organ. The gut bacteria of our microbiome directly stimulate the vagus nerve, influencing our moods, memory and cognition.

    Production of Neurotransmitters 

    Serotonin: Known is the “feel good hormone,” it acts as both a hormone and a neurotransmitter and governs feelings of wellbeing, contentment, satiety, anxiety and fear.

    We use to think that serotonin was produced in the brain, but recent research has found that 90% of our serotonin is actually produced in our gut.

    Alterations in serotonin levels are associated with moodiness, depression, anxiety and autism.

    Dopamine: It is a neurotransmitter that is associated with feelings of euphoria, bliss, motivation and concentration. Our brains release dopamine when we experience pleasure. It also contributes to essential bodily functions including movement, sleep, learning, mood, memory and attention.

    Half of the dopamine that we require to be well is produced in our guts.

    Low dopamine is associated with lack of focus, fatigue, mood swings, poor sleep, low energy and loss of sex drive. It also correlates to mental health conditions including anxiety, depression, schizophrenia and Parkinson’s.

    GABA: Gamma-Aminobutyric Acid, better known as GABA, is produced or consumed by multiple species of intestinal bacteria.

    GABA is the body’s principal inhibitory neurotransmitter. It slows brain activity, which increases relaxation, reduces stress, calms nerves, balances mood, soothes pain and improves quality of sleep.

    It promotes intestinal motility, reduces inflammation and enhances immune function. Low levels of GABA are linked to depression and mood disorders.

    Short Chain Fatty Acids (SCFAs): They are the product of fermentation of dietary fibers by bacteria in our guts. SCFAs nourish the cells that make up the wall of the intestine, boost the protective capacity of our intestinal wall lining and support healthy digestive motility. SCFAs are also powerful anti-inflammatory agents.

    The most famous of the short chain fatty acids produced by the gut is butyrate. It is especially effective at reducing inflammation – not just in the gut, but in the brain as well. Groundbreaking treatments are using butyrate to treat neurodegenerative diseases, depression and cognitive impairment.

    Butyrate produced by bacteria in our guts enters our blood stream and crosses the blood-brain barrier, where it facilitates production of Brain Derived Neurotrophic Factor (BDNF). BDNF supports our ability to learn, remember and form new memories. It is regarded as “fertilizer for the brain” because of the way it enhances our neuroplasticity. Loss of neuroplasticity causes the trademark mental decline associated with Alzheimer’s and dementia.

    Modulation of Immune Response

    The final known pathway that our gut bacteria use to influence the brain is through the immune system. Our microbiome signals vital functions of our immune response that are essential to maintaining homeostasis. It influences both inflammation and our immune response by controlling what gets absorbed from our digestive tract to our bloodstream and what gets excreted.

    When the immune system is overstimulated we develop chronic inflammation. Inflammation in the intestines causes the junctions in the cell walls to become more porous which leads to Leaky Gut. Food particles, bacteria and toxins are then able to enter the bloodstream, causing bodywide inflammation.

    Some digestive bacteria produce Lipopolysaccharide (LPS). LPS is inflammatory and toxic. It can enter our bloodstream when our gut is hyperpermeable. Leaky Gut causes “leaky brain.” As the intestinal wall becomes more permeable, the blood-brain barrier weakens, leading to inflammation in the brain that influences the way we think and feel. Brain inflammation plays a role in depression, anxiety, brain fog and autoimmune brain disorders.

    Psychologists are now treating depression by prescribing anti-inflammatory diets. In fact, many conventional therapies for mental disorders and neurological diseases are being revamped as experts uncover the intricate relationship between the microbiome and mental health.


    A healthy gut is indispensable to a happy mind. The conclusion of a recent study from the Chinese Academy of Sciences aptly describes the shift that is taking place in the treatment of mental disorders:

    “Mental disorders and neurological diseases are becoming a rapidly increasing medical burden. Although extensive studies have been conducted, the progress in developing effective therapies for these diseases has still been slow. The current dilemma reminds us that the human being is
    a superorganism. Only when we take the human self and its partner microbiota into consideration at the same time, can we better understand these diseases.”

    We are susceptible to many threats that can diminish the diversity of our microbiome. Remember how the composition of each of our microbiomes is unique? The baseline microbial species we start with are determined by our birth and early childhood experiences. However, most of us don’t keep all of them. Throughout our lives many things can happen which deplete our microbiomes and leave us vulnerable to pathogenic infections:

    • Antibiotic overuse
    • Inflammatory diet
    • Lack of dietary fiber
    • Chronic stress
    • Traumatic experiences, especially in childhood
    • High alcohol consumption
    • Exposure to environmental toxins
    • Pathogenic infections
    • Parasites
    • Nutrient deficiencies
    • Insufficient sleep

    IMBALANCE in the microbiome creates stress in the body that not only triggers inflammation but can also lead to significant mental health problems. Recent research at Stanford University revealed that even short-term digestive problems can contribute to mental health issues later in life.

    A healthy gut supports a healthy mind. Scientists at Pacific Northwest National Laboratory have demonstrated that boosted levels of Lactobacillus are directly linked to enhanced memory. Higher levels of GABA, which of course, is produced by some species of gut bacteria, are also associated with better memory.

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