One of the first books put in my hands when I entered schooling for holistic nutrition at IET (now Bauman College) was Nutrition and Physical Degeneration, written by Weston A. Price, DDS. The concepts he explored and the theories he developed are furthered by modern biological dentistry, which addresses the whole person, the systems of the body, and does not treat symptomatologically the way traditional dentistry has for decades. Dr. Price and his wife embarked upon a journey to many places in the world, investigating the relationship between nutrition, oral health and whole-body health. They discovered people in parts of the world consuming traditional whole-food diets rich in a diversity of nutrients had naturally large, white, strong, straight teeth, a full dental arch that could accommodate all the teeth, symmetric facial structure and sound immune systems. Coming from a world of “advanced medicine” in the late 1800s and early 1900s, this was shocking and eye opening to realize that these advancements in medicine and dental technologies were not giving people the health they once had when consuming a diverse indigenous diet. They found that when food became more processed and devoid of nutrients, it caused transgenerational epigenetic changes in human offspring affecting the dental arch, the orientation of the teeth, the overall oral health as a result, and subsequently the health of all bodily systems. We’ve been coping with this ever since the advent of processed foods, which in many ways goes back much further than we might imagine. I’ve always wondered why we sprout teeth for which we do not even have space. Why is the removal of pre-molars and wisdom teeth so common, even in children? Why is there such disparity in the standards for orthodontic treatment? Despite having had premolars and wisdom teeth removed as a youth, as an adult I developed such crowding of my lower jaw that one tooth was protruding forward and trying to make its exit. A dentist suggested we just pull that front tooth and allow the others to fall into line. I found this so illogical, such a symptoms-based solution rather than systems based. Did the dentist not want to know what was causing such crowding and how that might be affecting my overall health?
Let me start by saying, I am not a dentist. But in my years as a nutritionist, I have seen the impact that oral health has on a person’s ability to achieve their optimum state of wellness. I have seen patients doing “everything right,” but still suffering and never getting over the hump of their health challenges. And I’ve seen people make nearly miraculous turnabouts in health when they finally addressed an ongoing source of toxicity stemming from their mouth and dentition. As integrative and holistic practitioners for wellness, we must ask ourselves the difficult questions that often challenge what has become “traditional.” We must look at the whole person—not just their foot, joint, heart, brain, eyes, skin or mouth. We must remember that in this whole person everything is connected, and when we start to ask questions we can often trace these connections. As a nutritionist who has learned that most everything comes back to gut health I was always disturbed by the practice of giving a few days of prophylactic antibiotics prior to dental procedures when the patient has a history of heart disease or has had joint replacements. My inquisitive mind found this quite curious and odd. If we already know there are potentially dangerous bacteria in the mouth that, when mobilized, can somehow affect a compromised organ or trigger an elevated immune response, why don’t we do more to make the mouth a safer place for our patients?
The GI (gastrointestinal) tract comprises two-thirds of the immune system, and the mouth is the gateway. In fact, the mouth and the sinuses are the first line of defense against most pathogens. Maintaining a healthy balance of health-promoting microorganisms in the mouth is crucial for this defense and for maintaining oral health. Mercury and other metals, pathogens in the mouth, and even toxins from oral biofilms are swallowed and affect the lower GI microbiome. Amalgams themselves create electrical and chemical toxicity—two dissimilar metals making contact every time you close your mouth creates a real energy pulse affecting nerves and cell function and health. The ADA (American Dental Association) has finally acknowledged there is mercury vapor being produced from amalgam fillings. This vapor can both enter the bloodstream and affect the local microbiome. It also halts nerve growth and repair. Amalgams, crowns and root canals are used to “save the tooth” or at least the visible perception of a tooth. Yet, many people with past oral surgeries are walking around with latent bacterial infections not only in the teeth, but also in the jawbone. Bone, especially in the interior, should be a sterile environment. Chronically infected teeth and gums will cause documented pathogenic perfusion into the jawbone.
In my early years as a nutritionist in medical practices, the focus on the oral contribution to overall health was mostly regarding mercury amalgams. A trend developed of encouraging people who had symptoms of heavy metal toxicity, and even positive test results, to get their amalgams removed and replace them with composite material. This was often followed up with IV chelation therapy when available. Who was the patient with heavy metal toxicity? They may have presented with heart disease, neurological disorders like multiple sclerosis, cognitive impairments, autoimmune conditions, rampant candidiasis or often combinations of conditions. At that time we blamed everything on the heavy metals, and mostly mercury. While the toxicity of chronic exposure to mercury and other heavy metals has been fairly well demonstrated over the years, we knew little of the microbiome back then and had no idea of the enormous role it plays in these health conditions. The oxidative stress from chronic heavy metal exposure definitely takes a toll, but the infections hidden beneath fillings, crowns and root canals are contributing culprits and impediments to achieving optimum health. Removing the amalgam fillings is a huge step in the right direction but, without cleaning out and resolving old infections in dental roots and the jawbone, a patient’s health will not resolve. Not only are these chronic infections a source of constant oxidative stress, but they also cause disease in remote areas of the body because they lie along meridians that are now well mapped out between our teeth and the rest of our bodies.
One of my clients, in her 30s, was suffering from multiple physical and mental health issues: POTS, depression, anxiety, mental fog, fatigue, bloating, dermatitis and food intolerances. She was already employing many of the dietary changes and supplement regimens I wanted to suggest. And she had beautiful white, straight teeth! We just kept going in circles until I learned that she had several silver fillings still in her mouth. More interesting, she received them around the age of 12, the same age her mental health challenges began, resulting in her being placed on antidepressants before she had even entered puberty. We discussed getting the amalgams removed, and I cautioned her that it might cause a cascade of symptoms that would seem worse at first. I was also concerned that she might put all her faith in once causative factor and be disappointed. In her case, though, the result was astounding. She had to travel far to find a biological dentist, but she made the commitment and followed through. They performed safe amalgam removal, investigated for latent infections and repaired the teeth with a material she could tolerate. For several days she was upended, but I had prepared her for that and provided detoxification support. She also needed emotional support because the origin of this insult to her system was tied to life experiences as a youth. In short order her health turned around dramatically. All the dietary protocols, supplements and exercises she’d been trying so hard to maintain finally gained ground. I saw her skin change, her eyes, her energy, her diction and articulation, and her whole outlook on life. Not every person who has toxic amalgams removed has such a sudden turnaround, and that is why the recommendation must be approached holistically and with peripheral support. This case demonstrates how important it is to actually look into our patients’ and clients’ mouths for clues that they may not know to even tell us about. A written questionnaire is a good prompt, but nothing beats observation by a keen eye.
The U.S. is known for our dental hygiene, straighter and whiter teeth, and even the elderly can have gleaming straight dentures that we may not see in other parts of the developed world. But we must realize that this can be a façade. Beneath what has become a largely cosmetically focused practice, our patients can have serious underlying conditions affecting their health in a myriad of ways. Modern dentistry has focused on saving the tooth by sealing up the problem, much like shoving all your junk into a back room and keeping the door locked. Often, it’s more like storing your garbage in a back shed, at some point all that festering and oxidative stress will reveal that the problem was never cleaned up. Biological dentistry works with the whole being on a solution that is best for health, function and appearance. We actually don’t need our teeth; not like we need a heart or a liver. Though it can be hard to let go, sometimes it is healthier to remove infected teeth teeming with pathogenic bacteria, clean out the cavitation in the bone, and allow proper healing to take place. In some cases, people find that they feel immediately better, and the other protocols they’ve been using for improving their health are more effective. My father was one such person, chronically ill for years during midlife, but he had all his teeth! When an oral surgeon deeply investigated and suggested removing the whole lot and going to dentures, his health turned around instantly. Today he’s a thriving 83-year-old, and no one even knows he has dentures!
While we are blessed with a medical system that offers not only general practitioners, but highly skilled specialists for every part of the body and mind, we must remember to address the patient as a whole being. Pain in the foot does not always originate in the foot, high blood pressure does not always originate in the cardiovascular system, cognitive decline is not necessarily due to a brain problem, even a sore tooth may not be a tooth problem. Though the investigation is much more arduous for holistic and integrative practitioners, the outcome for our patients can be whole body, whole systems health. Many people are embarrassed to open their mouths to their health care provider (I know because, as an ayurvedic practitioner, I always ask to see the tongue), but it is so important that we explain how pivotal oral health is in the whole picture. We must not only inquire of the patient, but also inspect and observe. Look for metal amalgam fillings, crowns, implants, darkened areas even on composites and sealants, bumps and lumps on the jawbone, wear patterns, redness and inflammation, and definitely use your olfactory sense. This inspection will prompt an honest discussion that will lead to a better resolution of health for your patient, and a more successful practice for you.
Amber Lynn Vitale practiced as a certified nutritionist, ayurvedic clinical consultant, advanced bodyworker and yoga therapist since 1996. Much of her nutrition practice was in collaboration with functional medicine doctors and other integrative practitioners. Since 2008, she has also produced written and video educational content for many publications, as well as for her own clients and an interested public audience. By 2012, she had realized that raw materials sourcing, labeling transparency, legitimate certifications and educational support were the criteria that would set quality natural products companies apart from others; and she made it her mission to educate the public on the importance of education before supplementation. Vitale continues to write, lecture, and produce online content on health and wellness topics important to the practitioner and the patient alike.