Advantages of a Holistic and Nutritionally Based Dental Practice

In light of new data in scientific literature, increased awareness of the benefits of proper nutrition, and the growing acceptance in the medical community of  the concept of fighting disease by improving the body’s natural defenses, I have developed a program for the dental office which integrates what I feel are the best and most scientifically valid treatments from diverse fields of healing.

I have been practicing dentistry in New York for about 23 years, have taught dentistry at 2 major dental schools and been published in dental industry literature. I love my work and am very excited about the recent developments in both dental technology, which has opened up a wide range of treatment options unavailable before, and in the general health field, where new research is changing the practice of medicine at all levels.

It is becoming increasingly clear that a person’s overall health depends upon many diverse factors, including genetics, physical fitness, mental and psychic health, stress levels, interpersonal and family relations and nutritional status.  In my dental practice, I have found that nutritional status often plays an important role in both the development of diseases I treat, and in the healing that occurs after dental care. I believe that a health care practitioner is responsible not only for treating disease, but for promoting health.

Consequently, we do some things differently than in other dental offices.  You will be asked to complete an in-depth medical questionnaire, which you and the doctor will discuss thoroughly.  This includes your family history, exercise, diet and vitamin regimens, in addition to the traditional medical issues.  With your permission, the dentist will conduct a complete examination of your teeth, gums and jaws, evaluate your pulse and blood pressure, test the pH of your saliva and conduct a nutritionally based evaluation of your oral cavity.  During the treatment planning phase of your visit, you will receive guidance in the improvement and maintenance of your health using both traditional and innovative concepts.Your visit to our dental office is a unique opportunity for you to get nutritional guidance for 4 reasons:

1. My dental and scientific training is such that I am deeply familiar with the physiology and biochemistry of the body.
   
2. The oral cavity is the first place nutrients enter the body and begin the process of absorption into your system.
   
3. Systemic diseases and deficiencies often manifest themselves first in the oral cavity.
   
4. I have developed a philosophy of dental care which utilizes the best of both traditional conservative dentistry and current advances and innovations in the field of general health.  I believe that it is my responsibility not only to treat disease, but also to educate you and promote your health.

Here are some examples of the benefits you will experience from a holistic and nutritionally oriented dental practice:

Protection from X-rays

Many of us are concerned about excessive exposure to X-rays at the doctor’s office.  But do you know why that concern is justified?  When exposed to X-rays the body forms compounds known as free radicals.  At high enough levels, these molecules can cause tissue damage, aging, genetic mishaps and even diseases of varying form and severity. However, without X-ray examination, the doctor is blindfolded
and cannot diagnose fully or meaningfully. In my office, we do a number of things to minimize the damaging effects of necessary X-rays:

1. X-rays are only taken when absolutely necessary.
   
2. Hi tech digital X-rays are used, which minimizes your exposure time.
   
3. State of the art x-ray equipment minimizes “scatter” radiation and calibrates the exposure individually for different parts of the mouth.  A lead apron drapes your entire body, except the areas of the head and neck being examined.
   
4. You will be offered special antioxidant nutrients (more sophisticated than simply vitamins C and E) prior to your x-rays, which may help to inactivate and scavenge free radicals.

Periodontal treatment

Periodontal diseases are the major cause of tooth loss in adults.  There are several types of periodontal disease.  All begin with a bacterial infection which attacks the gums, bone and ligaments supporting the teeth and holding them in the jaw.  The progression of this disease is usually slow and painless and depends on a number of factors  (These factors also govern the course of any infectious disease).

• The number of bacteria
• The virulence of the bacteria
• The resistance of the host  (That’s you!)
  

It is this last factor which can be substantially affected by nutritional therapy. An approach which I believe utilizes the best of traditional periodontal therapy and incorporates new concepts about promoting health through nutrition is:

1. Hygiene:  Causative agents such as plaque, calculus, bacteria and toxins are removed from your teeth and root surfaces by a dental professional.
   
2. Education:  You are educated about the latest concepts and newest tools for exceptional home care and improving the health and cleanliness of your teeth and gums.  For example, some electric toothbrushes have been scientifically demonstrated to be more efficacious than manual toothbrushing, not only in studies by the manufacturer of the toothbrush, but by respected dental schools and institutions.  In some cases, only improved oral hygiene is recommended, in others, chemotherapuetic agents, local antibiotics, lasers and other non-surgical periodontal therapy may also be indicated.
   
3. Nutritional therapy:  The importance of vitamin C in maintaining healthy gums has been recognized for centuries.  Newer data on nutrition, alternative therapy and periodontal health has demonstrated that many other components are important, including calcium, B-complex vitamins (including Folic Acid), Coenzyme Q10, connective tissue nutrient formula (CTNF)-- a homeopathic remedy, and grapefruit seed extract and cranberries (without sugar!).  A strong nutritional support system can be tailored to your individual lifestyle which will augment your body’s own clean up, healing and rebuilding processes.
   
4. Re-evaluation:  We will re-evaluate you to determine whether additional treatment is necessary, and recommend a schedule for your continuing care.

Endodontics-Root Canal Therapy

The most common reason for root canal therapy is an infection or inflammation of the nerve inside of the tooth.  As in all infections, the host's (that’s you!) resistance is an important factor in determining the course of the disease and your recovery from it.  One of the reasons for the controversy about root canal treatment in holistic dentistry is that after root canal treatment, some microscopic contamination probably still remains at the tips of the tooth’s root system.  By bolstering your body’s natural defenses with nutritional support during the course of treatment, your chances of succumbing to secondary infection are decreased and the healing qualities of your body are improved.

Surgery and Extensive Reconstruction

During surgical procedures and extensive dental procedures, your body (not just your mouth) undergoes considerable stress.  As you may know, healthy, nutritionally strong individuals heal faster and are not as susceptible to secondary infection as are people who are nutritionally deficient.  Nutritional support prior to and during these traumatic procedures can have a big impact on the outcome and on your recovery.

As your awareness of the importance of nutrition increases, you may find that you wish to continue nutritional therapy as a part of your daily routine.  Your holistic and nutritionally oriented dentist can help you develop a combination of diet and supplements that will be tailored specifically to your needs.

SOME OF YOUR EXAMINATION RESULTS AND WHAT THEY MEAN

Acidic saliva

The measurement of pH is a method of indicating the acidity or alkalinity of a solution.  A neutral pH is 7.0; anything lower  is acidic and anything higher is alkaline.  Healthy and normal saliva is either neutral or slightly alkaline.  Here are some of the problems believed to be associated with acidic saliva  (Anything below 6.8):

1. People with acidic saliva are more likely to develop cavities.  In addition, the cavities that form in such individuals tend to be larger and to progress more quickly.
   
2. The first step in digestion occurs in the oral cavity.  As food is chewed, an enzyme called salivary amylase or ptyalin is released and begins the breakdown of starches.  Ptyalin does not function in an acidic environment.  Therefore, in an individual with acidic saliva, the first step of digestion is bypassed altogether and starches go directly to the stomach, where they place potentially harmful stresses on your digestive system.
   
3. The fact that your saliva is acidic indicates an imbalance in your biologic systems.  It is difficult to measure exactly which systems are responsible, but it is surprising how often it is possible to correct such imbalances simply by providing your body with the elementary basics of proper nutrition. Your body already knows how to take care of itself--it just needs the right equipment!

Tongue Coatings and Grooves

A healthy tongue is pink, with a fairly regular looking surface which appears, on close inspection, slightly pebbly.  Coatings on the tongue, which are usually brown, green or yellow, are an indication of a problem.  The problem could be as minor as the necessity of a good cleaning (Cleaning the tongue is an often neglected part of oral home care), or could indicate systemic disease or nutritional insufficiencies, such as inadequate digestion of protein.  A deeply grooved tongue, on the other hand, might indicate a deficiency in B-complex vitamins. 

Cavities

Dental caries, or cavities, are a dietary disease.  Many of us know that cavities are most likely to form in individuals who eat a lot of sweet, sticky foods.  But most of us don’t appreciate how significant the damage caused by such dietary and nutritional imbalance (as manifested by caries) is. 

Just think about it. Your teeth are the hardest component of your body.  If your diet is so unbalanced that those structures are being destroyed, what must be occurring elsewhere, in more fragile components and systems of your body?

Caries are a problem in and of themselves.  But they can also be viewed as a symptom---of dietary and nutritional imbalance, which can be readily addressed with the right information.

Periodontal disease

Periodontal disease is a disease of the attachment structures holding the tooth in the jawbone.  Most periodontal disease is caused by inadequate oral hygeine and much of it can be treated simply by a professional tooth cleaning and improved home care.  However, some periodontal disease is a manifestation of systemic disease, such as some types of anemia or diabetes mellitus, or nutritional deficiencies, such as scurvy (A deficiency of vitamin C) or a B-complex deficiency.  People with a fully balanced nutritional system definitely respond better to periodontal therapy, heal faster, and maintain healthy gums for longer.

PHASE 1 DENTAL SERVICES

As a patient in our office, you can expect an extraordinary quality of care.  I believe in providing patients with the benefit of all of the current advances in technology, the latest techniques and new information and approaches in the field of medicine. Your first experience of this will be when we perform Phase 1 services.  These include:

1. An exceptional examination:  Before or during your 1st appointment, you will complete an in-depth medical questionnaire, including nutritional information.  You will have your blood pressure and pulse taken, and I will personally review your medical history with you.  We will test the pH of your saliva, evaluate your breath for odors, administer special antioxidant nutrients, take necessary x-rays and perhaps chart your gums and make models of your teeth.
   
   Your examination consists of a complete head and neck evaluation, oral cancer screening, and comprehensive examination of the soft and hard tissues of your mouth.  I will evaluate the results of your salivary pH test, blood pressure and pulse results, x-rays and clinical examination and we will discuss the findings and your concerns together.  Your nutritional questionairre is especially important at this point, since we will be deciding upon a treatment plan and nutritional and dietary program for you at this time.
   
2. Successful non-surgical periodontal care:  Once we have created your individual treatment plan, you will have a thorough, professional tooth cleaning.  We will recommend a variety of aids specifically tailored to your home care needs, such as electric toothbrushes, irrigators, special toothpastes and mouthrinses, and nutritional supplements.  We will follow up on the success of these therapies at your scheduled periodontal maintenance appointments, when we may recommend more aggressive treatment, such as more frequent maintenance visits and cleanings, chemotherapuetic agents or localized antibiotic treatment in areas of continuing periodontal problems. In some cases, even more aggressive therapy may be recommended. 
   
3. Nutritional care:  For individuals interested in a complete nutritional program, we will do a detailed dietary and nutritional evaluation.  Specific recommendations will be made based upon your lifestyle, and dietary changes and nutritional supplements to suit your needs will be suggested.  We believe that it is only be coordinating all of the information at our disposal that we can get the best possible results -- improved, long lasting health for all of our patients.

Terry S. Gotthelf, DDS