by Gary M. Verigin, DDS, CTN
I graduated from the University of Washington School of Dentistry in 1965, having been taught according to the dominant mode of industrial, corporate dentistry. Since disease was viewed as just an abnormality in an otherwise functioning machine, dentists were trained to be glorified mouth mechanics. Tooth carpenters. Oral plumbers. And since the insurance companies were the “mothering teat” of dentistry, disease processes were reduced to little more than computer code.
As you know, my practice and understanding of dental medicine have been transformed over the years. Sadly, most other practices have not. They continue to run on the old industrial model. This is what I gather in talking with new clients who are searching for a more humanistic, integrated approach. Yes, I said “clients” instead of “patients.” Why? As any dictionary will tell you, patients are passive recipients of treatment. Clients take a more active role.
Our practice is known as integrated, biological dentistry. It’s an approach that focuses on the underlying mechanisms of dysfunction, or imbalances We look at what is happening both biochemically and bioelectrically. We understand symptoms, or disease processes, to be a reflection of lifestyle reacting with each person’s unique genetic code. Since illness involves the whole of one’s being, we must also consider the emotional, mental and spiritual imbalances co-existing with the physical. Our dental team then serves as a teaching team for our clients. They, in turn, become our students as we try to enhance awareness of the whole person to the implications of dental disease.
One implication is the link between systemic diseases and inflammatory pathways. Type 2 diabetes, cardiovascular diseases and strokes, for instance, are all strongly associated with such pathways. The elevated production of inflammatory mediators and markers play a major role in insulin resistance – a relationship that was only recently understood. Likewise, the inflammatory conditions that lead to periodontal disease were once thought to be only local. Because they were thought to be isolated in the oral cavity, dentists and other oral health professionals were thought to be the only ones concerned. But recent evidence suggests that periodontal disease may play a role in many other conditions – conditions that impact systemic well-being.
How does this happen?
The periodontium, made up of the gums and gingival tissues, is a unique ecological niche in the human body. Before the teeth erupt, or after they are all removed, the oral cavity’s mucosal lining is intact all the way from the mouth down the throat to the end of the bowel. Comensal bacteria live in this lining. When there are no imbalances or physical trauma in either the bioterrain or bioelectrical system, these microbiota pose little challenge to the host. But when teeth are present, the scenario changes. Radically.
Most people who have a full complement of teeth have 28, though with wisdom teeth, they can have as many as 32. Each one is a vital organ. Within the hard outer coatings of dentin and enamel, a tooth teems with arterial and venous capillaries, nerves, connective tissues and lymphatic tissues. When these organs grow, they push through the once intact mucosal surface. But though bone and soft tissues surround and adhere to the teeth, there is a small space between the gingival tissues and teeth. When healthy, this space is called a sulcus; when diseased, a pocket. In either case, the space is ideal for the growth of bacteria and other microorganisms.
The balance between microbial colonization and the immune system is a delicate one. And if a dental restoration doesn’t fit or isn’t contoured properly, the ecology of the tissues and sulcus will be challenged. The same thing occurs when dental materials are used that are incompatible with the individual’s lymphocytes (white blood cells) and there is an abundance of stress hormones or a dysfunctional terrain. Bacteria can flourish and become destructive.
An intact wound-healing response is necessary to prevent infection of the site and possible local tissue destruction. If hard tissues are destroyed, demineralization of the enamel or dentin will progress, leading to a cavity. If soft tissues are destroyed, periodontal disease results. Without an intact wound-healing response, such infections can lead to the introduction of bacteria to the general circulation. From there, the microbes can travel to other parts of the body, including the heart and brain.
Industrial, corporate dentistry fails to account for this. And this is one of its greatest failings. As Steven Green, DDS, writes in his book Eclectic Dentistry: Demystifying Medicine, “Sophisticated technology simplifies repair of the ravages of disease. With the mouth as a useful barometer of the immune system, the dentist of the future becomes the primary care physician, helping the patient prevent other painful diseases of decadence.”
If a client is to be properly provided and cared for, it’s crucial that both dental and medical providers understand the interrelationships among dental and whole body diseases. Treatment plans must be carefully tailored and closely monitored by all professionals concerned. To best treat dental dysfunction in ways that can help the physicians, naturopaths, nutritionists and acupuncturists who refer their clients to us for dental diagnosis, I have spent a great deal of time studying such disciplines and attending classes in them. As a result, I am now certified in traditional naturopathy and can identify myself as a CTN, or Certified Traditional Naturopath, as well as a dentist. But more importantly, it means I am better equipped and informed to work with practitioners in allied fields – and thus provide even better, higher quality care to the people who come to our office seeking help.
Back in the 1970s, when I was just coming to this new understanding of dental medicine, I learned this quote from F. Harold Wirth, DDS. It has since become a part of me:
The mouth in its entirety is an important and even wondrous part of our anatomy, our emotion, our life; it is the site of our very being. When an animal loses its teeth, it cannot survive unless it is domesticated; its very existence is terminated; it dies. In the human, the mouth is the means of speaking, of expressing love, happiness and joy; anger, ill temper, or sorrow. It is the primary sex contact; hence it is of initial importance to our regeneration and survival by food and propagation. It deserves the greatest care it can receive at any sacrifice.
From Biosis 8, January 2006
For more articles like this one, visit Dr. Verigin’s Biodental Library