Making Healthy Dental Choices: Take Charge!

My Experience With Holistic Dentistry
by Michelle Yeager

 

I used to think that every dental office was similar, for they all seemed to mimic the mold of years past: a stark, dark, and smelly office.

Like many people, I’ve never been overly fond of going to the dentist. My earliest memories begin with the dreaded smell of the dental office where I grew up. There I would sit, in the waiting room, waiting for what seemed forever until they called my name to come to the back room.

I was young and usually had no idea of what they were going to do and was much too shy to ask. My appointment would begin in the hygiene chair, where I would do my usual gagging on the fluoride tray, followed by the general, thirty-second look-over by the dentist.

As I got older, I began to ask questions about what was happening. I don’t recall ever getting a straight answer to any of my questions – even the simple ones. The usual answer was, “It’s supposed to be like that.” But I couldn’t see how every person on every continent could possibly have the same issues with their teeth as I did.

I used to think that every dental office was similar, for they all seemed to mimic the mold of years past: a stark, dark, and smelly office. When I first walked into a holistic dentist office I was trying here in Anchorage, however, I knew I had found something better. I immediately felt welcomed and put at ease by the helpful, friendly staff. Even the view of the spectacular Alaskan mountains provided a bit of unexpected comfort. But most impressive of all was the comprehensive care and focus on total health that I experienced.

Although my first was for a “cleaning,” this was like no other hygiene appointment I had ever had before. The appointment was an hour and a half and included a thorough periodontal exam to check for bleeding, infection, and bone loss. The hygienist told me that 85% of Americans are in some stage of periodontal disease. She explained that bleeding is due to unhealthy gingival tissues that are filled with infectious toxins and microorganisms. Healthy gums should have the appearance of hard, pink plastic, and flossing should not cause them to bleed.

During the periodontal charting, my hygienist found that I had a few areas that bled and a few pockets that were up to 4mm in depth. She explained to me that I am actually in the beginning stages of periodontal disease! I was incredibly surprised to hear that, since former hygienists had always told me that I was “doing fine” and “had a beautiful smile.” The holistic hygienist informed me that I should have periodontal therapy in the near future – a procedure that would remove calculus and toxins below the gum line. Once the root surfaces and tissue are cleared of toxic debris, the gums can then begin to heal.

The appointment was an eye opener for me. And, for once, when I asked a question, I got an answer! I quickly made an appointment to have a session of periodontal therapy. Once that procedure was complete, I left the office feeling like my whole mouth was clean – and I don’t mean toothbrush clean, I mean really clean.

During these appointments, my hygienist also noted that I had quite a bit of popping from my joints each time I opened my mouth. I explained that I had orthodontic braces several years earlier and that, ever since, my jaw had continually “popped.” I also had daily recurrent headaches since getting my braces off. (Until that moment, I had always connected the headache to some other problem – lack of caffeine, disturbed sleep, environmental changes.) My hygienist explained that during an upcoming exam, a full analysis of my temporomandibular joint (TMJ) would be done as well.

A few weeks later, I had my first exam with the dentist. It was the most thorough dental exam I have ever had. The assistant took my blood pressure, checked the Ph level of my saliva, and tested the levels of Vitamin C in my system. When the necessary x-rays had been developed and tests completed, the doctor came in to begin the exam.

The exam included a review of the x-rays to look for any unhealthy bone, abscesses, cysts, recession, root trauma, or other anomalies that might be present. My dentist then went on to review the x-rays for possible areas of decay. He examined the panoramic x-ray to determine the size of my sinuses and to see if there was any current congestion in them and then went on to check my carotid arteries and jaw joints. He continued with a soft tissue and periodontal exam, checking my mouth for any anomalies that could develop into something else, such as oral cancer. He checked every tooth for cracks or crazing, areas that have been worn into the dentin, and mobility. He made note of any teeth that were rotated or extruded and then continued to do a thorough check of all of the muscles and tissues surrounding my head, face, neck (lymph nodes), jaw muscles, and sinuses.

As the doctor checked the range of motion of my jaw joints, he noted that the popping noise was due to an occlusion that was not correctly aligned; thus, my joints and muscles were overcorrecting the difference. (It’s no wonder I always had a headache!) He explained to me that an extensive “bite study” and “bite balancing” would be beneficial.

Once these procedures were completed, I had immediate relief from the headaches that had plagued me for years. While the bite balancing alone worked to relieve my headaches, I knew that other people continue to have problems with headaches and health problems. Perhaps the ongoing controversy between amalgam (silver) fillings and composite (non-mercury) fillings plays a part.

The word is spreading about mercury and its effects on the human body. Memory loss, depression, and headaches are just a few of the many side effects that have been linked to mercury toxicity. Mercury is more toxic than arsenic and the Environmental Protection Agency (EPA) considers it a toxic waste. When placed in the body as an amalgam filling, shouldn’t it still remain a toxin?

I learned that during amalgam placement and removal, toxic mercury vapors are at their highest levels for absorption into body tissues. My holistic dentist told me that when removing a failing amalgam filling, he takes multiple steps to protect the patient, himself and his staff from mercury exposure. This may include IV Vitamin C chelation, high-speed vapor suction, rubber dam placement and mercury traps, along with specific mechanical techniques during the procedure.

I am looking forward to my next appointment and getting my mercury fillings removed in the near future. It was a wonderful experience to be in a holistic dental office that was willing to answer all of my questions. I think their mission statement sums it up perfectly. It reads, “We are a team of health centered professionals dedicated to excellence and wellness. Our mission is to share information of wellness with our clients, so that they may make informed choices about their dental health.”

Michelle Yeager, a recent graduate of UAA, works for Health Centered Dentistry, the holistic dental office she wrote about, as a dental assistant and scheduling coordinator. To learn more about holistic dentistry, call her or the staff at 277-2600.

What is Bioesthetic Dentistry?
by Dr. Bill Gerace

 

Would you have ever believed that headaches may indicate a chewing system that isn’t working correctly?

Curing my headaches: A true story 

The following true story is, unfortunately, one that is commonly shared by many patients:

“When I was 13 years old, I dove into a pool and hit my face and jaw on the bottom of the pool. I started to have headaches every morning in my temple region. It soon became worse and spread to my neck and then between my shoulder blades as well. Finally, my parents took me to a neurologist who had no explanation for my headaches but started me on medication for headaches and prescribed physical therapy. I sensed from the beginning that there was something wrong with my bite and eventually ended up in the office of an orthodontist.

“Things seemed to be better but it wasn’t long before the headaches would return and now I was getting more than tension headaches. I was getting migraines. They were so bad that I would be bed ridden a couple of times a month. I started to see chiropractors and, once again, would get better for a short period but eventually my neck would “go out” and the migraines would return. 

“By now I was a practicing dental hygienist, married, and was having children. The headaches were getting so bad that I went back to the neurologist who now suggested I see an osteopath for Cranial Sacral manipulation. By this time, I was taking every migraine medication that was on the market and frequently found myself in the emergency room because the pain was beyond what I thought I could handle.

“Things began to crumble around me. I felt I was a terrible mother and a failure as a wife because my pain was so debilitating. I just felt there was no hope. I finally concluded that life like this was no longer worth living. I was doing no one any good including myself. I began to consider suicide.

“In an act of total desperation, I went to see my dentist, a man for whom I worked when I was a very young girl. I remembered that he did things differently, and treated the whole chewing system. He suggested that I try a MAGO, Maxillary Anterior Guided Orthotic (a specially designed hard plastic splint worn on the upper arch) to harmonize my bite. Amazingly, I got not only relief of my headaches but—more importantly—realized that something could finally work in giving me headache relief. 

“After a period of time, my dentist corrected my bite and helped my teeth match my jaw joint position. Although it took surprisingly little dentistry, the incredible news is that I haven’t had a migraine headache in over two years! I sensed from the beginning that there was something wrong with my bite but I never realized in over fifteen years of agonizing, almost life-threatening headaches that the solution would come from my dentist.” 

What is a Bioesthetic Dentist?

Bioesthetics is the study of living things in their natural environment of health, function and beauty. In the case of Bioesthetic Dentistry, we have studied long lasting, highly functional, exceptionally beautiful chewing systems. These are nature’s “great chewing systems” that don’t manifest the usual problems that plague most of us. There are certain characteristics found in these systems that, when duplicated in failing chewing systems, enable the patient to achieve long lasting function and beauty.

The primary goal of Bioesthetics is the restoration of function as opposed to a very strong movement in dentistry today toward cosmetics only. When the function is restored properly the cosmetic result is beautiful as well. 

A Bioesthetic Dentist is one who has (in addition to Dental School) undergone a rigorous three to four years of additional study and training specifically to diagnose and treat failing chewing systems as opposed to merely treating problems as they occur in tooth by tooth dentistry.

What are the signs of a failing chewing system?

Would you have ever believed that headaches may indicate a chewing system that isn’t working correctly? Knowledgeable Bioesthetic dentists have been helping headache patients successfully for years. However, headaches are just one of many symptoms of dysfunctional chewing systems. More common indications are worn teeth, frequently cracked or fractured teeth, TMJ problems (popping, clicking, or pain), gum recession, a history of multiple root canals and tooth loss. Other indicators may also include ringing of the ears, equilibrium problems similar to Menier’s disease, and many Fibromyalgia-like pains in the neck and back. 

Dysfunctional chewing systems are actually the norm, not the exception, and most of us demonstrate one or more of these signs and symptoms of failing chewing systems. 

How is Bioesthetic Dentisty performed?

The basics of what we attempt to do are to incorporate the same characteristics or principles that we find in naturally occurring great chewing systems. The first objective is to get the bite to match the correct jaw position. We then reestablish the original unworn form of the teeth in a position that insures good function. What we are doing, therefore, is moving toward health as opposed to merely away from disease. 

Dr. Bill Gerace, of Anchorage, serves on Alaska’s Board of Dental Examiners, is an Adjunct Professor at UAA’s medical program, and has lectured extensively as a faculty member of Oragnathic Bioesthetics, Int.

Bioesthetic Dentistry, Part II

Dr. Bill Gerace

 

nature’s great chewing systems don’t manifest the usual problems that plague most of us…

 

In the last issue of Alaska Wellness, I wrote about a young woman who had been plagued by headaches for over 15 years, seen numerous healthcare providers without relief , tried numerous prescription drugs for headaches, and finally was cured by her dentist—a Bioesthetic dentist.  It turned out that the headaches were a result of a bite problem, the most common dental disease yet the least understood (by patients and dentists) and the least treated problem in dentistry today.

 

Bioesthetics is the study of living things in their natural environment of health, function and beauty. In the case of Bioesthetic Dentistry, this refers to a study of long lasting, highly functional and exceptionally beautiful chewing systems.  These are nature’s “great chewing systems” that don’t manifest the usual problems that plague most of us.  There are certain characteristics found in these systems that, when duplicated in failing chewing systems, enable patients to achieve long lasting function and beauty and, in many cases, eliminate or greatly reduce headaches and many other orofacial pain conditions. 

 

So, what are the traits discovered in great chewing systems?

The first is that tooth position and correct jaw position match one another in a very accurate manner.  In most situations when the teeth are in contact, the jaw has to slightly move from its correct position to accommodate. When we carefully manipulate the jaw into its correct position, however, the teeth don’t fit together correctly. In other words when we close our teeth together to chew or swallow we are actually dislocating the jaw joint.  The degree of dislocation can be minute or very significant.  This bite discrepancy is responsible for many maladies.  The most common are tooth grinding, headaches and Temporo-mandibular joint problems (commonly referred to as TMJ).  In the greatest chewing systems that we’ve studied over the years, there is very little or no discrepancy in the tooth and jaw positions. However, these comprise less than 5% of a normal population!  The rest of us demonstrate some degree of dis-ease.

 

The second trait discovered is that great chewing systems tend to look the same.  The front teeth are unworn.  The eye teeth (or cuspids) are generally equal in length to the centrals and pointed while the laterals (the teeth in between the centrals and cuspids) are shorter and rounded.  The form of the front teeth is spectacularly beautiful, but also provides the function of guidance and protection for the back teeth.  In other words, the back teeth don’t contact until the front teeth guide them into contact at the last moment of closure.  Also, grinding becomes more difficult because with any movement of the lower jaw the front tooth form immediately separates the back teeth. This is not what the media portrays as beautiful on most magazine covers and make-over programs on television.  In fact, cosmetic dentistry as it is usually practiced typically fails to meet these criteria as well.  As a result, it doesn’t last as long as a Bioesthetically restored chewing system.

 

The third trait of great chewing systems is that the teeth don’t wear.  Because the back teeth are “protected” by the front teeth, there is very little wear.  In naturally occurring great chewing systems—and in Bioesthetically restored chewing systems—the chewing stroke is primarily up and down while in worn dentitions the chewing stroke becomes much flatter, thus perpetuating wear.

 

Bioesthetic dentistry is about moving patients toward a model of health based on what we know about great chewing systems.  This is in contrast to how most dentistry has been taught, which is essentially reacting to “problems” as they occur.

 

How do we approach the diagnosis and treatment of a failing chewing system? 

So, where do we start?  First, we deal with the bite. How do we correct or reconcile this mal-position of the teeth and jaws?  The first step is the use of a hard, plastic splint we term a MAGO.  This stands for Maxillary (upper arch), Anterior (front), Guided Orthotic.  With this, we are able to provide for two of the “traits” of great chewing systems: that is, the jaw remains in the correct position and the front part of the splint guides and protects the back tooth area.  This is a passive and totally reversible action and allows the chewing muscles to naturally position the jaw correctly.  It is only from this correct jaw position that an accurate diagnosis of a failing chewing system is possible. The use of a splint in this manner distinguishes a dentist as one that treats the entire chewing system as opposed to tooth by tooth dentistry. 

 

When the jaw is positioned correctly, the teeth normally will only touch in the back of the mouth upon closing.  If this tooth discrepancy is minor, we can usually get the teeth to match by simple means: superficially reshaping the appropriate teeth.  Of course, there is a limit as to how much tooth structure we are willing to give up in order to reconcile this bite discrepancy. Sometimes, other measures are needed.  The second task in this process is restoring the protective form to the front teeth.  There are many ways to do this, too many to list here.

 

Recent research cited in a national magazine found that one third of cosmetic dentistry fails in the first year. The reason is that it is generally done without concern for the correct jaw position and doesn’t generally concern itself with functional issues.  All dentistry that is performed—whether by a general dentist or by one in a specialty area—will last longer if Bioesthetic principles are followed in the diagnosis and treatment planning.  Please feel free to call my office with any questions you might have about this process.   

Dr. Bill Gerace, of Anchorage , serves on Alaska ’s Board of Dental Examiners, is an Adjunct Professor at UAA’s medical program, and has lectured extensively as a faculty member of Oragnathic Bioesthetics, Int.

What Should You Expect from Your Dentist?

Dr. Greg Bragiel & Naomi White

 

When choosing a dentist, ask questions to determine what dental staff seems best suited for your needs

 

When developing a relationship with a new dentist, you may encounter a wide range of office facilities, services, and dental approaches. Dentists have a varying professional training, ongoing education and interests. Thus, you may receive different advice from dentists about the same concern.

 

Generally, you should feel that the entire staff is there to help with your needs for ongoing dental maintenance. They should be compassionate and kind while answering all your questions. This should take place in a comfortable atmosphere for a reasonable fee with the highest quality treatment and your comfort in mind.

 

Additionally you should expect the following:

 

  The dentist and/or staff should listen to your concerns thoroughly and may clarify their answers by asking you additional questions.

 

  They should review your health history questionnaire and question positive responses, (i.e. allergies, medications taken, health issues).

 

  The dentist should perform a comprehensive examination. This includes checking teeth and gums, as well as surrounding tissues (throat, lips, muscles, jaw joints, glands). The dentist should also check your bite and teeth for wear, and do a screening for tumors, cancer, cysts, etc. Necessary x-rays are typically taken at this point.

 

  Next, the dentist or staff member should discuss all findings with you. This may cover anything from tooth decay, breakage and weak fillings to diagnosis of gum disease or abscesses.

 

  Diagnostic information that is taken (i.e., x-rays, models of teeth, etc.) should be shown along with an explanation of problems or concerns. Treatment recommendations can be made at this time, provided they are not of a complex nature. The approximate number of appointments and fee estimates involved should also be discussed, as well as the benefits, risks, possible complications and treatment alternatives of the recommended care.

 

  You should be allowed to ask questions and receive a full answer to all your questions.

 

  Lastly, the dental staff should help you decide on treatment for your dental care.

 

When present at the dental office for a specific procedure, the following should be expected:

 

  You should be seen within a reasonable time of your scheduled appointment (though dental emergencies typically take priority over previously scheduled care).

 

  Your dentist, hygienist and dental assistant should perform procedures with care while making you comfortable, (i.e., numbing and/or administering anti-anxiety medications when appropriate).

 

  The dentist should immediately stop and administer additional local anesthetic if you are having discomfort. (It is your responsibility to inform the doctor if you feel you need more anesthetic.)

 

  The dental staff should tell you about treatment complications or additional care not previously diagnosed, (i.e., a filling that ends up needing a root canal or crown).

 

  At the end of an appointment, the staff should summarize the treatment that was done, what to expect as a result, and what will be done at the next appointment. You should also have one more opportunity to ask questions.

 

  Lastly, you should receive a statement for services rendered, and the office staff may assist you with filing dental insurance, if appropriate.

 

  In some cases, your dentist or the dental staff may call later in the day or week to check on you when certain procedures are done, (most usually, in the case of oral surgery).

 

Recommended check-up intervals based on your dental condition may range from three months to yearly. (The maximum interval for dental exams is one year, though children should have an exam every six months.)

 

When choosing a dentist for your child, it’s wise to first visit the office you are considering. Make sure that the office is child friendly. Are there toys and books in the waiting area? Ask if you can accompany your child into the treatment area. Some offices do not promote this, but it may be important to you. You might also care to schedule a consultation so that you and your child can meet the dentist prior to treatment. Ask the doctor how often he or she works with children, and what procedures are used to attend to difficult children.

 

When choosing a dentist, call first and ask questions to determine what dental staff seems best suited for your needs. It is not wise to base your choice of a dentist solely on price. A low (or high) fee for a particular service does not always mean the best service. If you feel your needs are being ignored or that you are not important, then it is time to speak up or find another office!

 

Dr. Greg Bragiel is a general practitioner dentist at 2525 Gambell St., #304 .  He has a special interest in Biological Dental Care, Cosmetic Treatment, TMJ and Implants. Call 274-4407.