Wellness or wellness-based dentistry is similar to holistic dentistry in many philosophies, but they are not the same.
Holistic dentistry emphasizes using bio-compatible, non-toxic, non-carcinogenic dental materials and utilizes more natural, herbal ingredients in their practices. Practitioners of holistic dentistry also advocate using herbal, natural materials for home care. Fluoride, amalgam silver fillings, metals in the dental prostheses, root canal therapies etc., are not kosher. This form of dentistry is also known as:
- alternative dentistry
- natural dentistry
- unconventional dentistry
- biocompatible dentistry
- progressive dentistry
- integrative dentistry
Wellness-based dentistry takes on a different philosophy and approach to treatments. Wellness dentistry is more evidence-based in its approach to considering treatment options to the patients – what is the best for the patient overall that has scientific evidence to back up the treatment’s validity, effectiveness, and safety. It encompasses the practice of family, cosmetic, children, implant, gum-disease and any other fields of dentistry. The proficiency in delivering wellness dentistry bases on how much the practicing dentists 1) know about the body and the diseases that can be expressed in the head and neck areas, and vice versa – how much the diseases in the head and mouth that can affect the rest of the body; 2) can recognize the signs and symptoms of the diseases in the head and neck, discuss the findings with the patients and come up with a treatment plan or refer to the appropriate specialists for consultation; and 3) be able to provide preventative treatments and advice to patients.
As a wellness-based dentistry practitioner, I want to mention that our treatment approach should also consider the financial burden of dental treatments. The affordability of the proposed treatment should also be presented and discussed with the patients to avoid financial stress to the patients. The “best treatments” recommended may not be the same as the patients’ overall “best care.”
What the best treatment is for the patient may not be what the patient wants for the time being. Insisting on only the “best treatment” based on the practice philosophy may harm the patient as the patient decides not to have any treatments.
Wellness dentistry is holistic in essence because it considers how oral health affects the whole body and vice versa. We treat oral problems by focusing on all aspects of health. Our health includes your physical, emotional, and spiritual health.
We all know that our mouths are the gateway to our health, and they are an integral part of our bodies. There are many factors to consider when we are treating the well-being of a person’s mouth. And it is my goal to be the whole-istic dentist for you and your family.
On my website, I mentioned the strong correlation between periodontal disease and systemic diseases. Systemic diseases like cardiovascular diseases, diabetes, Alzheimer’s disease, gastrointestinal diseases, adverse pregnancy outcomes and respiratory diseases have been linked to poor oral health. Therefore, during dental treatment and examination of the head and neck area, I routinely look for signs and symptoms of diseases that could manifest in the head and neck region. Cancers like squamous cell carcinoma, Kaposi sarcoma, leukemia, anemia, Vitamin B12 deficiency, iron deficiency etc., can manifest in our oral area first or as well.
Oral manifestations of Crohn’s disease are not uncommon, especially in pediatric populations. It may be the first sign of the disease. Oral presentations may include swelling of the lips, angular cheilitis, dry mouth, hyperplasia, erythematous gingiva, recurrent canker sore, and orofacial swelling.
When a patient presents with constricted/narrow upper and or lower arch forms, I will pay attention to the possibilities of chronic nasal breathing issues caused by allergies, asthma, enlarged nasal polyps, deviated septum. They all caused narrow or restricted nasal pharyngeal space. Which, in turn, likely cause sleep-disordered breathing (SDB) or obstructive sleep apnea (OSA). In some cases, the upper arch form is narrower than the lower arch in the molar regions, resulting in crossbite in the molars and premolars. Having breathing issues can have many adverse effects on our health and growth. Dental professionals need to recognize the predisposing factors to SDB and OSA as early as in childhood. The patient must be referred to our medical colleagues as soon as possible to avoid developmental deficiencies.
Dental x-rays are often taken during a visit to a dental clinic. Dental x-rays can reveal issues that can affect outside our teeth and mouth more often than we think. In a panoramic x-ray, when there is radiopacity in the film that is not associated with teeth or the jaw bone, dentists should investigate if those masses can be an artifact or one of the following diseases:
- Calcified stylohyoid complex
The stylohyoid complex originates from the styloid process on the bottom portion of the temporal bone. A piece of ligament travels downwards from the base of the styloid process, attaching to the lesser horn of the hyoid bone. When the ligament calcification is long enough to the hyoid bone, it can cause cervicalpharyngeal pain, dysphagia, foreign body sensation, odynophagia, hypersalivation, and even temporary voice changes. - Calcified Carotid Artery Atheroma (CCAA)
It is also known as carotid artery atherosclerosis. There is a common carotid artery branching out into two terminal branches in the neck below our mandible. The two branches are the internal and external carotid arteries. When enough plaques are deposited in the region, the plaque can show the white mass in a Panoramic dental X-ray, usually cylindrical and heterogeneous. Some risk factors for atherosclerosis are high cholesterol, diabetes mellitus, obesity, hypertension, smoking, inadequate diet, chronic kidney disease, and menopause. Panoramic radiographs, obtained during professional dental examinations, are a potential. - Sialoliths. Sialolithiasis is the most common disease of the salivary glands characterized by obstruction of salivary secretion by a calculus, associated with swelling, pain and infection of the affected gland. There are three major glands: parotid, submandibular and sublingual salivary glands. Patients with sialolithiasis may complain of moderate to intense pain, particularly at mealtimes, when salivary flow is stimulated. It is sometimes associated with enlargement of the gland that can be palpated with fingers or even visible as swelling.
- Phleboliths. Phleboliths are idiopathic calcification that results from the deposition of calcium in the normal tissue. Patients with phleboliths are usually asymptomatic, but they should be referred to medical colleagues for investigations to eliminate underlying diseases.
- Tonsilloliths. There are two oval-shaped pads of tissue at the back of the throat — one tonsil on each side.
Tonsilloliths or tonsil stones are calcified particles found in a tonsil. The causes are a buildup of bacteria and debris within the nooks and crannies of your tonsils. This debris hardens into small, stone-like growths. This condition is different from tonsillitis, which occurs when the tonsils themselves become infected. However, there is a good correlation between having tonsil stones and chronic tonsillitis. Suppose there are no signs and symptoms of tonsillitis, including swollen tonsils, sore throat, difficulty swallowing and tender lymph nodes on the sides of the neck. In that case, a daily gargle with antiseptic mouth rinse is recommended. Otherwise, a referral to medical colleagues is warranted.
The other important pillar of our wellness-based dentistry is prevention and education. Nothing is better than prevention and staying healthy. Prevention dentistry includes periodic examination and cleaning to ensure no signs and symptoms of diseases and keep the healthy status quo. Education on diets, nutrition, gum disease, the causes of cavities and daily oral hygiene technique is far more important than treating the disease. An ounce of prevention is worth a pound of cure.
During the regular, continuous dental care to our patients, the Affinity Dental Care team provides fluoride treatment after a thorough cleaning and scaling. Numerous scientific studies have demonstrated the beneficial effects of fluoride in fighting cavities and reducing the sensitivity of exposed dentine. The fluoride ion is incorporated with the calcium phosphate in our enamel to become fluorapatite. It is more resistant to acid attacks.
After a thorough cleaning and scaling, the fluoride varnish applied to our patients’ teeth is less than 11.3 mg of fluoride ion. This level is in line with the safety guidelines set by the American Dental Association, the Canadian Dental Association, the American Academy of Pediatric Dentistry, and the American Academy of Pediatrics.
Notwithstanding the proven beneficial effects of fluoride, we provide an alternative to fluoride treatment in controlling and preventing caries if the patients do not want fluoride. We have fluoride-free prophy paste for removing the stain and plaque on the teeth. We can apply nano-hydroxyapatite (a natural substance found in our enamel) paste onto the teeth after a good cleaning to reinforce the enamel structure on the teeth.
My office does not have mercury silver filling materials, and I only provide non-metallic fillings to my patients. When I remove harmful silver amalgam fillings, I routinely use rubber dams (a drape around the operation area) to prevent the mercury filling chips and shavings from being swallowed. A high-volume evacuation system is also used to eliminate any vapour.
Certain holistic dentists do not perform or recommend root canal treatment (endodontic treatment). They believe root canals are not totally safe due to the procedure and chemicals used. We recommend and perform root canal treatment as an option to our patient when the teeth are diagnosed with pulpal infection or abscess in the supporting structures. There are risks and benefits of root canal treatments, just like the alternative treatment with extraction of the diseased teeth. Many evidence, both published scientific studies and clinical evidence observed at my office, show that endodontically treated teeth heal nicely with bone filling in the space where the bone was lost before. The x-ray images show the normal structure of a healthy tooth. When the root canal treatment was done right, the canals were disinfected thoroughly, and the seals were good. The endodontically treated teeth can last just like a healthy tooth.
Suppose extraction is performed instead of root canal treatment. In that case, the cost to the health can be a lot higher with inefficient chewing, space that can be cosmetically unacceptable when you smile, drifting of adjacent teeth etc. The cost of replacing an implant (then we are talking about metal in the bone) supported tooth or prosthesis could be costly and financially prohibitive to some patients.
There are many more factors besides what I have mentioned above that a wellness approach can recognize your current health issues and change your health and development. We like to advise young patients on their diet that may have a long-term effect on their craniofacial growth. We look out for signs of symptoms of a patient who exhibits craniomandibular disorder that can predispose to SBD.
The dental provider should be empathetic and understand the patient’s wants and needs. The patient should be clear with their dentist about their main concerns and their priorities. This way, both the dentist and the patient are on the same page. The dentist can then prioritize the proper treatments for the patient based on what appears to be most important for them.
We do not upsell our patients some treatment plans for financial gain. We like to look at what is in the patient’s best interest. We recognize that different dental dispositions require individualized care. Dr. Wong provides his dentistry with this in mind and understands that the mouth is a part of the entire body, thus reflecting health. With a wellness-first approach, we will always seek the safest, least toxic way to accomplish the mission of treatment and do it while treading as lightly as possible on the patient’s biological terrain. A more biocompatible approach to oral health and overall wellness is the hallmark of wellness dentistry.
