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Holistic dentistry is raging hot, rapidly emerging and rivals in popularity with cosmetic dentistry. Generation X is living an age of environmental awareness, toxin free lifestyles, green planet initiatives and holistic, alternative or integrative medicine beliefs. What took the Chinese two thousand years to develop is finally being appreciated by Western civilization. Following this path is a logical progression for dentistry, developing less invasive treatment modalities, minimizing hazardous material exposure and incorporating more natural remedies into treatments.  Why then, does the public majority still perceive holistic dentistry as granola dentistry, Coop dentistry and quackery?  

Probably because “holistic dentistry” has its roots more anchored in marketing than scientific evidence.  With a deluge of publicity surrounding the “green” movement, holistic practices have jumped on the bandwagon, aligning themselves with this concept hoping to achieve greater recognition.  Just as organic food, cannibalized by large multinational food conglomerates, so too is holistic dentistry, commandeered by patient starved dental practices.

Definitions of holistic include:

1.     Emphasizing the organic or functional relation between parts and the whole.

2.     Relating to holism; relating to an analysis of the whole instead of separation into parts.

3.     All encompassing view based on the knowledge of the nature, functions, and properties of the components, their interactions, and their relationship to the whole.

The proponents of holistic medicine and dentistry should be mortified.  Outstanding efforts to legitimize Integrative Medicine by utilizing evidence based scientific methodology are being undermined by savvy marketers, riding the coattails of a new paradigm in medicine.   Punching an Internet search of holistic dentistry yields hundreds of links to “holistic dentists” throughout the country.  Once into their website you are lured by all the buzz words such as “mercury free”, “nutritional based”, “biofeedback”, “TMJ” and “metal free restorations” to name a few.  Conspicuously absent from web content is any link to evidence based literature published in refereed journals.  What can be found are bulleted postings of “facts” concerning a variety of dental therapeutics and materials such as dental amalgam, root canals, and conventional dental anesthesia.  Without evidence to back these “facts” however, self-anointed holistic dentists stand to do more harm to their cause than good.

Legitimate holistic dentists and mainstream dentistry may not be as far apart as one would think. "A lot of what I've heard holistic dentists advocate is what most dentists should already be doing," said Chicago dentist Robert Brandstatter. "At our office, we try to prevent dental diseases by explaining how overall behaviors to the whole body, such as drugs, medications, nutrition and smoking can affect the teeth." http://featuresblogs.chicagotribune.com/features_julieshealthclub/2008/05/holistic-dentis.html

The tenets of Integrated Medicine, alternative health care and holistic approaches to wellness all share one common ingredient, listening and educating their clients to formulate therapeutic approaches best suited to their client’s interests and needs.  This is also what every DDS or DMD candidate is taught throughout their lengthy educational process.  What happens after graduation is largely dependent on philosophy, ethics and personal beliefs.  Holistic dentists argue that traditional dentists fail to see the big picture.  For example, reading a radiograph taken on a new patient, a traditional dentist might be more focused on how to remedy the pathology on a decayed first molar.  The holistic dentist, taking a different path might first resolve to evaluate nutrition or immune system response prior to reconstructing the tooth.

In fairness to the holistic approach understanding the primary disease entity is always a better long-term approach to achieving health.  Restoring a decayed tooth in a bulimic patient doesn’t solve anything unless the underlying pathology is eliminated.  On the other hand, waiting for a patient to undergo interventional therapy while the tooth rots away doesn’t help either.

Society has a place for both extremes. For example, the benefit of nutritional counseling to high carbohydrate intake susceptible populations can have profound dental and medical implications, yet filling a painful carious lesion on a death row inmate serves his/her needs better than nutritional counseling.  What’s the common link?  Communicating with the patient/client, understanding their needs, constructing a philosophy of care commensurate with their long-term goals.  We’ve come a long way from the doctor/god model.  Modern day care is not about the doctor saving the patient but about the patient saving themselves under the guidance of teams of medical consultants.  Holistic dentistry is not about changing mercury-based fillings or denigrating municipal water fluoridation programs.  It’s about grappling with counterintuitive human tendencies, thinking outside the box when traditional therapeutic approaches strike out and relying on evidence based scientific methodology alternatives.

Care provider character qualities cannot be judged by a web site.  They are best found by asking close friends or referrals from objective medical professionals.  Be wary of web sites that offer unconventional treatment services.  For example, contrary to popular belief and unknown to most dentists “metal free” restorations are not metal free.  The majority of “all ceramic” restorations include the element zirconium http://www.crystalzirconia.com/.  Although zirconia is biologically stable, its purest element form of zirconium is still classified as a metal.  Similarly, stains used to color ceramic materials on crowns are metal-based http://ceramic-materials.com/cermat/education/273.html and some of these metals, in free form, are considered extremely toxic.  The same naysayers that expound the toxicity of dental amalgam due to its mercury content harp on the purity of ceramics in part because they are “metal free.”

The message to the public is:

1.     A holistic approach to dental treatment is a good thing. 

2.     Paramount to a successful outcome for your individual needs is an open dialogue with your practitioner regarding philosophy of care and working together to achieve realistic treatment expectations.   

3.     Ultimately, you need to trust your doctor. 

4.     When patients do their own research they need to screen for documents lacking commercial or political corruption, a task extremely difficult for even well trained individuals.  Bare in mind anything is publishable today.  A good friend and colleague once said to me “Ken, when I look around I’m concerned at what I see, so much so that I’ve taken to believing nothing of what I read and only half of what I see.”

5.     An educated consumer is a happy consumer.