Dentistry Shouldn’t Be “Just Another Profession”

By Gary M. Verigin, DDS, CTN

Last September, I was pleased and honored to be asked to present a 20 minute speech to the International Academy of Biological Dentistry and Medicine on how my colleague Ed Arana and I got the idea to form the study group that eventually evolved into that organization.

I had two months to gather my thoughts and memories; two months to condense more than 50 years in dentistry, from my days at the University of Washington Dental School in Seattle through decades of private practice; two months to distill my life’s work and calling into just 20 minutes. I confess, my talk ran a little long, but there was much to share about how and why we brought biological dentistry to where it stands today.

After my talk, past-IABDM president Dr. Bill Glaros surprised me with the first of what’s to become an annual leadership award that will bear my name. Suffice it to say, I was totally overwhelmed by this honor.

The Opening to a New Horizon

Most of my preparation for that day was spent among the books, binders and manual that fill the bookcases and large parts of the floor space of my home office. But there’s also a huge picture window that looks out on our spacious backyard. There’s a beautiful pool and redwoods, lawn and rose bed, dozens of planters that go lush with greenery and flowers from early spring into deep autumn. It’s a wonderful sight to gaze on, whether to clear the mind, focus or reminisce.

Reinhold VollMy first real introduction to biological dental medicine happened in the summer of 1984, when I attended a conference at Children Shriner’s Hospital in Honolulu. The presenter who convinced me that the traditional dental school education was unsound and harmful was Reinhold Voll (1909-1989), a physician from Plochingen, Germany.

Dr. Voll was assisted by a very capable translator from Chile, Alberto Duque. Local health professionals from several disciplines brought patients to the conference for Dr. Voll to evaluate. Photos and x-rays of their teeth were projected onto a screen as Dr. Voll examined them with the Dermatron, his electro-dermal screening unit. As he did, Duque described which meridians Dr. Voll was measuring, the readings and pertinent remarks.

What Dr. Voll did not do was ask directly about either symptoms or diagnoses. He only examined them with the Dermatron – about 30 minutes per patient – then asked them and their practitioner to leave the auditorium for a while.

Dr. Voll would then discuss his findings, both medically and dentally. He shared his thoughts on what symptoms the patient was experiencing and how the medical establishment would likely diagnose those signs. He then asked the patient and practitioner to return and tell the audience about the dental or medical problems the patient was having. Questions from the audience were encouraged for further clarification and understanding.

Constantly, Voll’s electrodermal findings and subsequent patient information were a perfect match.

I was blown away by this, by how accurately Dr. Voll had assessed each patient. I was totally impressed and astonished at the impact that dental conditions could have on an individual’s systemic health.

At this point, I had been practicing general dentistry for nearly 20 years. I had not been taught how harmful mercury amalgam “silver” fillings, root canal filled teeth, implants and chronic jaw osteitis lesions (“cavitations”) can be. Surely, the dentists who came to hear Dr. Voll speak knew that things like periodontal disease, caries (tooth decay/cavities) and orthopedic/orthodontic misalignments were trouble. How many knew about the rest?

As the conference continued, so did the shaking of my core beliefs. It felt like I was going through some kind of a career midlife crisis!

A System More Than Merely “Broken”

spilled pillsEvery day, the media regales us with stories of ever-increasing scientific knowledge and supposed medical “miracles” through new therapies, diagnostic tools and other advanced technologies. Medical professionals are particularly bombarded with hype over the latest drugs to manage symptoms of any type of illness, dysfunction or syndrome you care to name.

One “side effect” they never mention: How drug-driven medicine often distracts the health professional, effectively dulling their sixth sense – the intuitive hunch, the inner eye, the gut feeling that supports the ability to diagnose safely and quickly, even in the most primitive conditions.

Even more disturbing are the “side effects” of these drugs – though accuracy demands we understand they are direct effects, just ones that aren’t desirable in a specific situation. Their drag on health is a powerful reminder that these chemical compounds are inherently noxious.

They’re also part of the reason why we see an increase in faulty diagnoses and therapies – like in the case of a local family I read about not long ago in the newspaper. They had sued Kaiser after repeated ER misdiagnoses that ultimately contributed to her death. They told her she had sciatic nerve pain. She died of sepsis.

Such cases are yet another factor keeping emergency rooms, clinics and hospitals pushing capacity. Practitioners then become more like traffic cops; clinics and hospitals become more like assembly lines. And the vicious cycle continues.

We’re also starting to hear more expressions of disillusionment coming from within the profession – as in cardiologist Dr. Sandeep Jauhar’s recent book Doctored: The Disillusionment of an American Physician. “It occurs to me,” he writes,

that my profession is in a sort of midlife crisis of its own. In the last four decades, doctors have lost the special status they used to enjoy. In the mid-twentieth century, at least, physicians were the pillars of any community. They made more money and earned more respect than just about any other type of professional. If you were smart and sincere and ambitious, the top of your class, there was nothing nobler or more rewarding that you could aspire to become. Doctors possessed special knowledge. They owned second homes. They were called upon in times of crisis. They were well-off, caring, and smart, the best kind of people you could know.

Today medicine is just another profession, and doctors have become like everybody else: insecure, discontented, and anxious about the future. In surveys, a majority of doctors express diminished enthusiasm for medicine and say they would discourage a friend or family member from entering the profession. In a 2008 survey of twelve thousand physicians, only 6 percent described their morale as positive.

Reasons for discontent include not having enough time to spend with patients because of paperwork. But Jauhar also hates what one reviewer described as “the assembly-line medicine that makes doctors little more than electronic medical record scribes with the power to instantly order tests and medicines but no time to build relationships.”

Lest you think it’s just his own griping, Jauhar relates similar disillusionment shared by other medical professionals in venues like SERMO, a social networking site for physicians, which presents itself as a virtual doctor’s lounge, where physicians can speak freely and anonymously. Says one cited by Jauhar,

I get too little respect from patients, physician colleagues, and administrators, despite good clinical judgment, hard work, and compassion for my patients. Working up patients in the ER these days involves shotgunning multiple unnecessary tests (everybody gets a CT!) despite the fact that we know they don’t need them, and being aware of the wastefulness of it all really sucks the love out of what you do. I feel like a pawn in a money-making game for hospital administrators. There are so many other ways I could have made my living and been more fulfilled. The sad part is we chose medicine because we thought it was worthwhile and noble, but from what I have seen in my short career, it is a charade.

When a new patient comes to our office, one of the forms we ask them to fill out asks them to describe their reasons for seeking dental care in our office – at whatever length they care to tell us their needs and concerns. Often, this elicits a response like, ‘I can’t believe it!” When we ask what they mean, they explain that the request is so unlike anything they have experienced in a dental or medical practice.

What they typically experience is like what one patient recently described about her first appointment at a new physician’s office:

I went to my physician about two weeks ago for my annual checkup /physical. The nurse took my weight, blood pressure, pulse and temperature. Then the doctor walked in, gave me a 10 second look and greeting and started typing on his computer. I answered a few questions; he typed some more. After that, some clicking and a short speech on the importance of flu shots, but when I said that I read that flu shots this year were only 23% successful, he gave me a quick farewell without answering my question. He only gave me a few seconds of eye contact. He never touched me. He is supposed to be a good doctor. All of this took between 9 and 10 minutes!

My take on this entire situation is that it leaves me sad and wondering if this medical system is far from merely “broken.”

And yes, dentistry is much in the same state…

From Biosis #46
Image by Ano Lobb, via Flickr

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Eminently Quotable: Mahatma Gandhi

gandhiWe have got into the habit of calling in a doctor for the most trivial diseases. Where there is no regular doctor available, we take the advice of mere quacks. We labour under the fatal delusion that no disease can be cured without medicine. This has been responsible for more mischief to mankind than any other evil. It is of course, necessary that our diseases should be cured, but they cannot be cured by medicines. Not only are medicines merely useless, but at times even positively harmful. For a diseased man to take drugs and medicines would be as foolish as to try to cover up the filth that has accumulated in the inside of the house. The more we cover up the filth, the more rapidly does putrefaction go on. The same is the case with the human body. Illness or disease is only Nature’s warning that filth has accumulated in some portion or other of the body; and it would surely be the part of wisdom to allow Nature to remove the filth, instead of covering it up by the help of medicines. Those who take medicines are really rendering the task of Nature doubly difficult. It is, on the other hand, quite easy for us to help Nature in her task by remembering certain elementary principles, — by fasting, for instance, so that the filth may not accumulate all the more, and by vigorous exercise in the open air, so that some of the filth may escape in the form of perspiration. And the one thing that is supremely necessary is to keep our minds strictly under control.

Source: A Guide to Health by Mahatma Gandhi,
translated by A. Rama Iyer, MA

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Product Review & Giveaway: Waterpik Aquarius Professional Water Flosser

Let’s face it: Most people don’t floss regularly. Why else would things like this

flossing pie chart

and this

flossing card

be at all funny?

Yet that simple fact goes a long way toward explaining why periodontal (gum) disease is so rampant. As many as 75% of the adult population has it to some degree. It’s the sixth most prevalent disease in the world. (Other factors include tobacco and other drug use; a carb-rich, sugar-centric diet; chronic stress; insufficient sleep; and physical inactivity.)

If your gums bleed when you brush or floss, it’s a likely sign that the disease process is well underway. If left unchecked, the final result is deterioration of the supporting jawbone and tooth loss.

The good news? Gum disease is treatable and preventable.

One of the tools Dr. V commonly recommends for achieving both goals is an oral irrigator, which streams water under the gums and into periodontal pockets, where other tools just can’t reach. It can be used in addition to or even instead of conventional floss. Plain water can be used, or you can add peroxide or herbal compounds to further disinfect and promote healing.

All of us here at the office are big fans of these devices.

So even though, as mentioned, we don’t typically review or recommend specific products on this blog, we were glad to accept a sample unit offered to us by a Waterpik rep to try out and write about here – unconditionally.*

And unconditionally, we can tell you that we think the Aquarius Professional Water Flosser they sent us is a dandy little unit. (They also sent us a second unit to offer as a giveaway to one of our readers. But more on that in a minute.)

Waterpik Aquarius Professional Water FlosserOne thing we like about the Water Flosser is that it’s small, taking up less counter space than other models. It also comes with a variety of tips suited for specific dental situations or general use. For instance, the Pik Pocket Tip is designed to deliver water deep into the pockets that form around the teeth thanks to gum disease, becoming perfect little harbors for pathogens to colonize and multiply: dark, damp, low-oxygen environments. A Plaque Seeker Tip, with its small brushes, is for cleaning around crowns, bridges and other dental work, while an Orthodontic Tip is suited for cleaning brackets. There’s even a Toothbrush Tip.

And yes, we tried them all out, as well as the conventional tips, using both plain water and water spiked with an herbal tonic. We tried different settings, both for flossing and soft tissue massage. Unlike in some older models we’ve used, it seems there’s much more gradual variation between settings, so you can get just the right intensity that’s comfortable for you. (In the case of the Pocket Tip, the lowest setting is always recommended to prevent inadvertent damage to the soft tissues.)

The unit also includes a timer so you’ll know when to switch from one arch to the other, irrigating your mouth for the recommended minute total.

One of the nicest things about this – or any – irrigator is just how thoroughly cleansed your mouth feels afterwards. It may be the closest you can get to that just-done-at-the-dentist feeling at home – especially when used with an herbal medicament like the Dental Herb Company’s Under the Gums Irrigant.

According to Waterpik, the device is up to 50% more effective than traditional dental floss and clinically proven to remove up to 9.9% of plaque from treated areas in 3 seconds. While regular readers know we tend to take industry-sponsored research with many proverbial grains of salt, we also know that, clinically, we see a big difference in the health of tissues of those who routinely use an irrigator compared with those who don’t.

And now, thanks to the good folks at Waterpik, we can give away an Aquarius Professional Water Flosser to one of our readers (an $80 value)!

How to Enter: Between now and March 12, 2015, simply leave a comment below describing how you think a Water Pik Aquarius Professional Water Flosser would help you improve your home dental care. (Note: We hold all comments for moderation, so if you don’t see yours post right away, no worries.) We’ll draw one name at random from all entries. The winner will be contacted by email and announced here on Tuesday, March 16.

* Water Pik provided the product unsolicited “for editorial consideration.” At no time were we told what to say about it. All views expressed here are the collective opinion of Dr. Verigin and his staff.

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Biosis #46: Dentistry Shouldn’t Be “Just Another Profession,” Embracing Difference, & More!

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The February 2015 issue of Biosis, our quarterly newsletter, is now online. In this issue:

  • JoAnne’s Motivational Minute: Embracing Difference

    I think of the patchwork quilts my great grandmother once made. From her large basket of remnants and still serviceable parts of well-worn housedresses and work shirts, she prepared patches and sewed them together. You could remember some of the family history by identifying the patches. You could enjoy the beauty of the varied colors and textures and patterns.

    Each patch was unique. Together, they formed a functional whole – brought together with love, attention and care.

    I prefer a world that is just such a quilt…

  • Dr. Verigin’s Comment: Dentistry Shouldn’t Be “Just Another Profession”

    Every day, the media regales us with stories of ever-increasing scientific knowledge and supposed medical “miracles” through new therapies, diagnostic tools and other advanced technologies. Medical professionals are particularly bombarded with hype over the latest drugs to manage symptoms of any type of illness, dysfunction or syndrome you care to name.

    One “side effect” they never mention: How drug-driven medicine often distracts the health professional, effectively dulling their sixth sense – the intuitive hunch, the inner eye, the gut feeling that supports the ability to diagnose safely and quickly, even in the most primitive conditions.

  • From Our Blog: Yet More Evidence Pointing to Mercury Amalgam’s Risk

    In 2000, Freya Koss filed a personal malpractice suit against her former dentist. Her complaint

    alleged that the dentist had exposed her to dangerous levels of mercury vapor during the unsafe removal of an existing amalgam filling and replacement with a new one. Further, she alleged that her injuries were due to numerous deviations from the acceptable standard of care in 1998, the most significant being the use of liquid mercury rather than a pre-encapsulated form of dental amalgam. Secondly, the liquid mercury amalgam was inadequately mixed in an antiquated and damaged amalgamator, whose 1941 manufacturing date was confirmed by the company’s original records.

    In addition, the complaint alleged that the dentist did not follow recommended precautions to prevent inhalation of mercury vapors, known to cause harm to the nervous system. Also, the dentist had failed to inform her of the risks involved in the drilling out and replacement of mercury-containing amalgam fillings.

    After nearly 15 years of struggle, the case was quietly settled out of court in her favor last autumn. The evidence that she had compiled during this time and through ensuing years of activism against dental mercury was, in a word, “indisputable.”

    And the scientific record against amalgam continues to grow.

Read Biosis #46 now.

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Organic Means Less Pesticide Exposure

There are lots of good reasons for opting for organic. For instance:

10 reasons to opt for organic

More than one of those reasons hinge on a simple fact about organics: They don’t offer the super-sized, super-potent pesticide chemical cocktail industrially farmed crops provides.

Now, new research – “among the first to predict adult exposures to organophosphate pesticides based on people’s usual diets” – confirms this. According to LiveScience, the scientists found that

when matched on produce intake, people who reported eating organic fruits and veggies at least occasionally had significantly lower levels of pesticide residue in their urine than people who almost always ate conventionally grown produce.

Those who “often or always” ate organic fruits and vegetables averaged approximately 65 percent lower levels of pesticide metabolites in their urine than those who “rarely or never” ate organic.

That’s quite a difference! And keep in mind that this study only looked at organophosphates, not other pesticides that may have been used.

Organophosphates are extremely toxic. As one scientist described them to National Geographic, they’re “considered junior-strength nerve agents because they have the same mechanism of action as nerve gases like sarin.”

Probably not something you want to be eating a lot of on a regular basis…

See EWG’s latest Shopper’s Guide to Pesticides in Produce for more info on reducing your pesticide exposure from the foods you eat.

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The Orange vs. the Juice

A basic idea of nutritional approaches to health is that whole foods are generally “better” than foods derived or processed from them. It’s the total nutritional package that counts, as Dr. Royal Lee pointed out many decades ago and as research has confirmed – at least in some cases. For instance, a study published last fall in Advances in Nutrition found that, with respect to lycopene, tomatoes packed a bigger nutritional punch than supplements.

oranges and juicerSo we’ve written before about how whole fruit is preferable to juice – even 100% juice, although there are dental reasons for this, as well. After all, fruit juice is concentrated sugar. You’d have to eat several pieces of fruit to get the sugar equivalent of 8 ounces of juice. Juice also tends to be highly acidic, weakening tooth enamel and giving oral pathogens even more opportunity to wreak havoc, ultimately leading to decay.

Nutritionally, though, new research in the Journal of Agricultural and Food Chemistry shows that the picture is a little murkier than originally thought.

Its authors did a nutritional comparison of oranges and orange juice. On the one hand, they found that juice was indeed a little lower in cartenoids and vitamin C than whole fruit. However, what was in the juice turned out to be more bioavailable: More of the nutrients could be absorbed and used by the body.

And contrary to conventional wisdom, although juicing oranges dramatically cut flavonoid levels, the remaining ones were much more bioaccessible than those in orange segments.

Though from a dental standpoint, we do recommend folks go easy on juice, clearly, it does offer some benefits. If and when you choose it, just wait a half hour or so before brushing afterward, to give acids time to be neutralized so you don’t wind up brushing them into your teeth.

Image by Judy van der Velden, via Flickr

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Yet More DIY Dentistry

Is this really A Thing?!

NY Times DIY ortho headline

We’d like to think “tens of thousands” of YouTube views doesn’t necessarily mean all or even most viewers tried it at home. We hope. Who hasn’t watched more than one video for the sheer OMG factor of it – like the one here?

But apparently the American Association of Orthodontists has grown concerned enough to issue a consumer alert against trying to straighten your own teeth – whether with rubber bands, paper clips, or mail order devices. “It is the AAO’s position,” they say elsewhere,

that patients should always see an orthodontic specialist to move teeth and achieve a proper bite. “DIY” at-home treatments without orthodontic supervision, such as attempts to close gaps with rubber bands or paper clips, significantly increase the chances of irreparable harm. Orthodontic treatment is a complex medical procedure, and there is no “one size fits all” approach. Treatment is customized for each patient, taking into account all relevant information.

The trend of do it yourself orthodontic treatment appears to be increasing in North America and the United Kingdom, as well as other areas around the world. A quick Google search of the term “do it yourself orthodontics” will reveal the extent of the problem.

Well, you might be thinking, orthodontists stand to lose money from people straightening their own teeth. Of course they’re concerned!

On the other hand, the person dead-set on DIY ortho stands to lose some teeth or create other expensive-to-fix dental problems – which kind of defeats the purpose of ortho-on-the-cheap.

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