Stay Away from "Holistic"
and "Biological" Dentists

Stephen Barrett, M.D.

A significant number of dentists have gone overboard in espousing pseudoscientific theories, particularly in the area of nutrition. Dentists who identify themselves as "holistic" or "biological" typically claim that disease can be prevented by maintaining "optimum" overall health or "wellness." In their offices, this typically involves inappropriate diagnostic tests, recommendations for expensive dietary supplements and/or homeopathic products; a plastic bite appliance; unnecessary replacement of amalgam fillings; and/or removal of root-canal-treated teeth. John E. Dodes, D.D.S., an expert on dental quackery, has remarked that "wellness" is "something for which quacks can get paid when there is nothing wrong with the patient.

Historical Perspective

Much of "holistic dentistry" is rooted in the activities of Weston A. Price, D.D.S. (1870-1948), a dentist who maintained that sugar causes not only tooth decay but physical, mental, moral, and social decay as well. Price made a whirlwind tour of primitive areas, examined the natives superficially, and jumped to simplistic conclusions. While extolling their health, he ignored their short life expectancy and high rates of infant mortality, endemic diseases, and malnutrition. While praising their diets for not producing cavities, he ignored the fact that malnourished people don't usually get many cavities.

Price knew that when primitive people were exposed to "modern" civilization they developed dental trouble and higher rates of various diseases, but he failed to realize why. Most were used to "feast or famine" eating. When large amounts of sweets were suddenly made available, they overindulged. Ignorant of the value of balancing their diets, they also ingested too much fatty and salty food. Their problems were not caused by eating "civilized" food but by abusing it. In addition to dietary excesses, the increased disease rates were due to: (a) exposure to unfamiliar germs, to which they were not resistant; (b) the drastic change in their way of life as they gave up strenuous physical activities such as hunting; and (c) alcohol abuse.

Price also performed poorly designed studies that led him to conclude that teeth treated with root canal therapy leaked bacteria or bacterial toxins into the body, causing arthritis and many other diseases. This "focal infection" theory led to needless extraction of millions of endodontically treated teeth until well-designed studies, conducted during the 1930s, demonstrated that the theory was not valid [1,2].

Melvin Page, D.D.S. (1894-1983), one of Price's disciples, coined the phrase "balancing body chemistry" and considered tooth decay an "outstanding example of systemic chemical imbalances." Page ran afoul of the Federal Trade Commission by marketing a mineral supplement with false claims that widespread mineral deficiencies were an underlying cause of goiter, heart trouble, tuberculosis, diabetes, anemia, high and low blood pressure, hardening of the arteries, rheumatism, neuritis, arthritis, kidney and bladder trouble, frequent colds, nervousness, constipation, acidosis, pyorrhea, overweight, underweight, cataracts, and cancer. Page also claimed that milk was "unnatural" and was the underlying cause of colds, sinus infections, colitis, and cancer.

The human body contains many chemicals, ranging from water and simple charged particles (ions) to complex organic molecules. The amounts vary within limits. Some are in solution and others are not. Legitimate medical practitioners may refer to a specific chemical or a balance between a few chemicals that can be measured. But the idea that "body chemistry" goes in and out of balance is a quack concept.

Proponent Organizations

The Price-Pottenger Nutrition Foundation of La Mesa, California, was founded in 1952 as the Santa Barbara Medical Research Foundation, became the Weston Price Memorial Foundation in 1965, and adopted its current name in 1969. It has about 1,000 members. Its Web site describes it as "the source for quality information on the origins of health through nutrition and lifestyle." Its newsletter, book catalog, and information service promote food faddism, megavitamin therapy, homeopathy, chelation therapy, and many other dubious practices. It is also the repository for many of Price's manuscripts and photographs. In January 2008, its online membership directory listed 28 dentists as professional members.

The Weston A. Price Foundation, of Washington, D.C., is another membership organization founded to promote Price's principles. Founded in 1999, it advocates holistic dentistry, organic farming, raw (unpasteurized) milk, and many questionable dietary strategies. It also opposes fluoridation.

The Holistic Dental Association was founded in 1978 to provide a forum for developing and sharing of "health-promoting therapies that were not taught in dental schools."Fourteen In March 2006, its online directory included 99 U.S. dentists.

The American Academy of Biological Dentistry (IABD) was formed in 1985 and was renamed the International Academy of Biological Dentistry and Medicine (IABDM) in 2005. IABDM's founding mission statement says: "The IABDM supports dentists, physicians and allied practitioners committed to integrating body, mind, spirit and mouth, and caring for the whole person." [3] Its seminars have promoted "mercury-free dentistry," "detoxification, "cavitation surgery," electromagnetics, sound, light, acupuncture, homeopathy, herbal therapy, nutrition, and "an integrated approach to body, mind and spirit, with diagnosis and treatment of the whole person." In September 2005, its online directory included 55 dentists and 6 members from other professions .Fourteen of the dentists also belonged to the Holistic Dental Association.

The IABDM Web site refers to its members as "dental physicians" and states:

Dubious Practices

"Holistic" and "biological" dentists use many approaches that are not only unsound but involve procedures and body areas that are outside of the legitimate scope of dentistry. Some practitioners use hair analysis, computerized dietary analysis, a blood chemistry screening test, or muscle-testing, as a basis for recommending supplements to "balance the body chemistry" of their patients. Hair analysis is not a reliable tool for measuring the body's nutritional state [4]. Computer analysis can be useful for determining the composition of a person's diet and can be a legitimate tool for dietary counseling. Dentists receive training in the nutritional aspects of dental health. However, few are qualified to perform general dietary counseling, and computerized "nutrient deficiency tests" are not legitimate. The blood chemistry tests, usually obtained from a reputable laboratory, are legitimate but misinterpreted. Instead of accepting the laboratory's range of "normal" values, "holistic dentists" use a much narrower range and tell patients that anything outside that range means they are out of balance and need treatment. Muscle-testing is a feature of applied kinesiology, a pseudoscientific system of diagnosis and treatment based on the notion every health problem can be related to a weak muscle and nutritional imbalances [5]. Variations used by dentists include behavioral kinesiology and autonomic response testing (ART). Some biological dentists also use neural therapy, a bizarre approach claimed to treat pain and disease by injecting local anesthetics into nerves, scars, glands, trigger poins, and other tissues.

Disorders of the TMJ (jaw joint) and facial muscles can cause facial pain and restrict opening of the mouth. Clicking alone is not considered a problem. Allegations that TMJ problems can affect scoliosis, premenstrual syndrome, or sexual problems are not supported by scientific evidence. Scientific studies show that 80% to 90% of patients with TMJ pain will get better within three months if treated with nonprescription analgesics, moist heat, and exercises [6].

Correction of a "bad bite" can involve irreversible treatments such as grinding down the teeth or building them up with dental restorations. The most widespread unscientific treatment involves placing a plastic appliance between the teeth. These devices, called mandibular orthopedic repositioning appliances (MORAs), typically cover only some of the teeth and are worn continuously for many months or even years. When worn too much, MORAs can cause the patient's teeth to move so far out of proper position that orthodontics or facial reconstructive surgery is needed to correct the deformity.

Proponents of "cranial osteopathy," "craniosacral therapy," "cranial therapy," and similar methods claim that the skull bones can be manipulated to relieve pain (especially TMJ pain) and remedy many other ailments. They also claim that a rhythm exists in the flow of the fluid that surrounds the brain and spinal cord and that diseases can be diagnosed by detecting aberrations in this rhythm and corrected by manipulating the skull. Proponents include dentists, physical therapists, osteopaths, and chiropractors. The theory underlying craniosacral therapy is erroneous because the bones of the skull are fused to each other, and cerebrospinal fluid does not have a palpable rhythm [7]. In one study, three physical therapists who examined the same 12 patients diagnosed significantly different "craniosacral rates." [8]

Homeopathy is a pseudoscience based on 200-year-old notions that (a) substances that produce symptoms in healthy people can cure ill people with similar symptoms and (b) infinitesimal doses can be highly potent [9].

Some practitioners use procedures based on traditional Chinese medicine (TCM) theories that relate health and disease to alleged imbalances in the flow of "vital energy" ("chi") through imaginary channels called meridians. A few dentists use a quack "electrodiagnostic device" that supposedly detects these imbalances. These devices actually measure skin resistance to a low-voltage electric current, which the practitioners claim is related to "electromagnetic energy imbalance." The procedure is commonly referred to as electrodermal testing, galvanic testing, or electroacupuncture according to Voll (EAV). It typically leads to multiple false diagnoses, unnecessary tooth removal, and/or the sale of useless dietary supplements and/or homeopathic products [10].

Some dentists who espouse TCM theories claim that areas of the body are "represented" by the tongue and the teeth, These claims have no anatomical basis and should be regarded as preposterous.

The diagram to the right is from the Web site of a "holistic" dentist. I have also seen diagrams that relate each tooth to one or more of the body's internal organs [11].

 

 

Auriculotherapy espouses the notion that the body and organs are represented on the surface of the ear. Proponents claim it is effective against facial pain and ailments throughout the body. Its practitioners twirl needles or administer small electrical currents at points on the ear that supposedly represent diseased organs. Courses on auriculotherapy are popular among "holistic" dentists. Complications from unsterile and broken needles have been reported. There is certainly no scientific evidence or logical reason to believe that fiddling with someone's ear can modify a disease process at a remote part of the body [12]

A few hundred dentists claim that the mercury in amalgam fillings is toxic and causes a wide range of health problems, including multiple sclerosis, arthritis, headaches, Parkinson's disease, and emotional stress. They recommend that mercury fillings be replaced with either gold or plastic ones and that vitamin supplements be taken to prevent trouble during the process. However, scientific testing has shown that the amount of mercury absorbed from fillings is only a small fraction of the average daily intake from food and is insignificant. In 1992 an extensive review by the U.S. Public Health Service concluded that it was inappropriate to recommend restricting the use of dental amalgam [13]. The American Dental Association Council on Ethics, Bylaws, and Judicial Affairs considers the unnecessary removal of silver-amalgam fillings "improper and unethical."

The most outspoken advocate of mercury-amalgam toxicity has been Hal A. Huggins, D.D.S., of Colorado Springs, Colorado, who describes himself as one of Page's students. Huggins promoted "balancing body chemistry" so vigorously that in 1975 the American Dental Association Council on Dental Research denounced the diet that he recommended. Another Price follower is George A. Meinig, D.D.S., whose book Root Canal Cover-up Exposed was published in 1994.

In the mid-1980s the FDA forced Huggins to stop marketing mineral products with false claims that they would help the body rid itself of mercury. Huggins has also claimed that root canal therapy can make people susceptible to arthritis, multiple sclerosis, amyotrophic lateral sclerosis, and other autoimmune diseases. As with mercury-amalgam fillings, there is no objective evidence that teeth treated with root canal therapy have any adverse effect on the immune system or any other system or part of the body [14]. Huggins's dental license was revoked in 1996. During the revocation proceedings the administrative law judge concluded: (a) Huggins had diagnosed "mercury toxicity" in all patients who consulted him in his office, even some without mercury fillings; (b) he had also recommended extraction of all teeth that had had root canal therapy; and (c) Huggins's treatments were "a sham, illusory and without scientific basis." [14]

Huggins is among a small number of dentists who maintain that facial pain, heart disease, arthritis, and various other health problems are caused by "cavitations," within the jaw bones, that are not detectable on x-ray examination or treatable with antibiotics. Advocates now call this condition "neuralgia-inducing cavitational osteonecrosis (NICO" and claim they can cure the patient by locating and scraping out the affected tissues. They may also remove all root-canal-treated teeth, most of the vital teeth close to the area where they say a problem exists, and even parts of the jawbone. Worse yet, the surgery may result in severe infections and a lifetime of pain [16].

Huggins's Web site states that, "Cavitations are hard to find. They require lots of skill, years of experience, and most of all, a vivid imagination to spot them on an X-ray film." Vivid imagination may well be the basic requirement of holistic and biological dentistry.

The scope and dangers of biological dentistry can be seen by reading the complaints against Alireza Panahpour, D.D.S., a California dentist. Many suits have been filed against him by patients who charged that he had subjected them to inappropriate treatment that left them with severe discomfort and a need for expensive corrective procedures [17-24].

The Bottom Line

My advice is simple. Steer clear of dentists who practice "holistic dentistry" or "biological dentistry" or who use or even recommend any of the dubious methods described in this article.

Disciplinary Actions against Holistic or Biological Dentists

References

  1. Easlick K. An evaluation of the effect of dental foci of infection on health. Journal of the American Dental Association 42:615-97, 1951.
  2. Grossman L. Pulpless teeth and focal infection. Journal of Endodontics 8:S18-S24, 1982.
  3. Founding mission statement. IABDM Web site, accessed Feb 3, 2008.
  4. Barrett S. Commercial hair analysis: A cardinal sign of quackery. Quackwatch, April 20, 2006.
  5. Barrett S. Applied kinesiology: Muscle-testing for "allergies" and "nutrient deficiencies." Quackwatch, Sept 26, 2004.
  6. Okeson JP (editor). Orofacial Pain: Guidelines for Assessment, Diagnosis, and Management. Hanover Park, IL: Quintessance Publishing, 1996.
  7. Barrett S. Why craniosacral therapy is silly. Quackwatch, Sept 21, 2004.
  8. Hartman SE, Norton JM. Interexaminer reliability and cranial osteopathy. Scientific Review of Alternative Medicine 6(1):23-34, 2002.
  9. Barrett S. Homeopathy: The ultimate fake. Quackwatch, Oct 4, 2007.
  10. Barrett S. Quack "electrodiagnostic" devices. Quackwatch, Sept 5, 2007.
  11. Barrett S. Bizarre tooth charts. Dental Watch, Nov 9, 2004.
  12. Barrett S. Auriculotherapy: A skeptical look. Acupuncture Watch, Feb 2, 2008.
  13. Benson JS and others. Dental Amalgam: A Scientific Review and Recommended Public Health Strategy for Research, Education and Regulation. Washington, D.C., 1993, US Public Health Service.
  14. Barrett S. The "mercury toxicity" scam: How anti-amalgamists swindle people. Quackwatch,
  15. Administrative Law Judge's conclusions about Hal A. Huggins, D.D.S (1999)., Quackwatch, Dec 23, 1999.
  16. Barrett S, A critical look at cavitational osteopathosis, NICO, and "biological dentistry."Quackwatch, April 4, 2010.
  17. First amended complaint. Ripsime (Rita) Filikyan vs. University of Texas Houston Health Science Center and others. Los Angeles Superior Court Case No. BC 355412. The case was settled out of court with a nondisclosure agreement.
  18. Complaint for damages. Jill Cresap vs. Alireza Panahpour, South Coast Center for New Medicine, and Leigh Erin Connealy. M.D. Orange County Superior Court Case No. 30-2008-00114601, filed Nov 12, 2008. In 2010, shortly before the case was tried, Connealy and her clinic (where Panahpour had worked) settled for a modest undisclosed sum. At the trial, the jury ruled in Panahpour's favor.
  19. Complaint for damages. Anne Harrison Stone vs. Alireza Panahpour and others. Orange County Superior Court Case No. 30-2008-00114750, filed Nov 14, 2008. The case was settled for an undisclosed sum.
  20. Complaint for damages. Andre Vaillancourt vs. Alireza Panahpour and others. Los Angeles County Superior Court Case No. SC 100818, filed Dec 3, 2008.
  21. Complaint for damages. Ardis and Henry Morschladt vs. Alireza Panahpour and others. Orange County Superior Court Case No. 30-009-00323131, filed Nov 24, 2009.
  22. Complaint for damages. Jeaneen Bauer vs. Alireza Panahpour and others. Orange County Superior Court Case No. 30-2009-0329075, filed Dec 17, 2009. The case was settled with a nondisclosure agreement. Panaphpour was discharged when he filed for bankruptcy. The other defendants settled with nondisclosure agreements.
  23. Complaint for damages. Sarah Haynes vs. Alireza Panahpour and others. Orange County Superior Court Case No. 30-2010-00344946, filed Feb 18, 2010. The case was settled with a nondisclosure agreement.
  24. Complaint for damages. Chelsea Bibb vs. Alireza Panahpour and others. Orange County Superior Court Case No. 30-2010-00355539, filed March 22, 2010. Panaphpour was discharged when he filed for bankruptcy. The other defendants settled with nondisclosure agreements.

This article was revised on December 28, 2012.