#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.