Holistic Dentistry – Lecture by Paige Woods, DDS at UCSD
Intro: Good afternoon, everybody. Good morning, everybody. I’m really happy to see you here. Welcome to San Diego. I hope that you will have a very enlightened time here. And hopefully, we’ll get to answer a lot of your questions.
I wanted to introduce to you a very, very special person, who I’m very fond of on many levels. She’s a terrific human being. She is a very smart, charismatic, caring person, and an incredibly good dentist. So, please help me welcome Dr. Paige Woods.
Dr. Paige Woods: Thank you. Thank you so much. I’m so happy to be here with you guys today. I’m a biological dentist in San Diego, and what makes it even more special to be here at UCSD talking to you guys about what I do.
So, let’s get started. You know, I’m constantly asked. People ask me where should they go to research, where should they go to find out what’s best for them. I know that with social media and with the Internet, if a patient gets a cough and they go to WebMD, they’re going to think they have cancer. So, we’re given tons of information, but who’s right?
And what I always tell my patients is, first and foremost, you have to trust yourself. If something doesn’t smell right, doesn’t sit with you right, then trust yourself and keep digging.
And that’s basically how I wrote my practice. And why my patients come to me is because they have kept pushing the limit and pushing the boundaries and asking why. Stepping away from the social norms, they find their way to me.
So, why do we need to take responsibility of our health? In dentistry, we’re taught to restore teeth. We’re given this list of materials and we learned everything there is to know about it –the bond strength, the compression strength, the sheer strength, everything you can possibly know, elasticity. But there’s no aspect really on the bio-compatibility of these materials—which I’ve always had an issue with it.
So, I think that that’s another thing that’s missing in this field. We have dental amalgams, for instance. They contain mercury. And we’ll talk about this a lot during this lecture. But another thing is for my pediatric patients. When they have decay that extends to the nerve, the standard of care is to remove the decay. We take a piece of cotton, we dip into formocresol which has formaldehyde in it, and we soak that tooth with this material. Formaldehyde is carcinogenic. It’s known to be carcinogenic. And then we have root canal sealers that are toxic as well.
So, there are all of these things that we’re putting into our mouths that contain non-toxic materials. By just stepping aside and asking, “Wait, what?” I think that that’s what makes us intelligent human beings.
We’ll get to some of these other things a little bit later, but just start kind of planting the seed.
So, my hope for you today is to provide you guys with a litte bit of knowledge to take with you to your healthcare provider and make sure that you’re getting the care that you want.
So, when patients come to me every day, these are the number one concerns that they have. They want to know about their silver fillings. Are they toxic? Are they good for them? Are they hurting them? What’s the deal, just the different metals on their mouth?
Root canals, root canals is another big issue right now as well as gum disease.
So, our mercury fillings, 50% mercury. So, aside from being 50% mercury, this is some of the things that we see everday. And just looking at the pictures, you have to ask yourself, “Do I want this in my mouth?” Let’s take mercury out of the equation. Do I still want this rusting piece of metal in my mouth?
So, aside from that, now let’s talk about the composition. It is 50% mercury. And that’s not according to me. That’s according to Health &Human Services which is the government.
We have these mercury restorations. How did we get it? Well, it goes back a long ways. It goes back to 1833 when two Frenchmen brought it over. They realized it was an easy to use material. They were able to place them into teeth and restore these teeth. We didn’t have anything else, and patients were able to function.
So, 10 years later, that was the standard of care. Everyone was using it. It makes sense.
But the American Society of Dental Surgeons caught on to the fact—and they were the ones that said, “Hey, it’s got 50% mercury. How can this be okay for the patient? How can this be healthy?” They wanted to eliminate it. And instead of that being eliminated, the mercury fillings being eliminated, the American Dental Association was founded and the American Society of Dental Surgeons was disbanded. So, the ADA has been a strong proponent of dental amalgam ever since.
So, as I was saying, mercury was one of the most toxic elements. It’s actually the third most toxic element according to Health & Human Services behind arsenic and lead. This is not me. This is not me telling you how to live your life, me telling you something is good or bad. This is the government. This is Health & Human Services telling you that mercury is the third most toxic substance and 50% of these fillings are mercury.
So, if that hasn’t convinced you enough, when you go to your dentist or in my own office—well, I don’t have this metal in my office. But if your dentist does have it in their office, this is a label from one of the containers that contains the mercury or amalgam for placing in these restorations. And right here, it says, “Warning: May cause neurotoxic and nephrotoxic effects.” So, you’re going to have neurotoxic and kidney devastating effects. This is the label. So that’s the toxicity based on the mercury content.
Let’s talk about just the fact of having the metal on your mouth. So if you think about highschool chemistry, highschool science classes, when you heat up a metal, it expands. You eat hot and cold food, this metal expands and contracts.
Well, teeth are really strong when they’re whole and there hasn’t been anything placed in them. You can put a lot of pressure. I mean, we put 250 lbs. of pressure on our molars. So, we have really strong jaws. But now you have a wedge inside of your tooth that’s expanding and contracting and it’s creating these cracks, and also, open margins. So, it expands, contracts, expands, contracts. You have all these openings for bacteria. Microscopic bacteria just flows right in.
So, aside from the toxicity effect, it’s also not a good restorable material based on the devastating effects long-term.
I can’t tell you how many clients—everyday, I do at least one (and mostly like two to three crowns) a day just because of the fractures that occur with these restorations.
Once we remove the amalgam—actually, this is a really nice picture. I know, this is not bad. But you can actually see here, you see this crack, it runs all the way across, all the way across. And sometimes, these teeth, this crack runs so deep that it runs to the root of the tooth and the tooth actually has to be extracted. So, a simple filling turns into a tooth extraction.
But there is good news. We are able to remove these amalgams in a safe way and restore them. This is a case from our office. We removed the metal, the mercury fillings, and we replaced it with some porcelain inlays and onlays. It looks much better.
So, a lot of times, my patients come in, and they’ve done a little bit of research—I’m really happy that they have. They’re on the right path. They’ve made the decision to have these toxic restorations removed—and they want to know what my protocol of choice is, if it’s Huggins or International Academy of Oral Medicine and Toxicology. These are all very great protocols. The fact that they’re removing these toxic restorations, A+.
But you’re taking your eye off the 8 ball. The key is making sure that none of these metal and this metal material is going to be ingested or inhaled when we remove it. And that all starts with this nice sealed rubber dam.
This is water-tight. We test it. Once we put this on, we put a clamp, we test it with water, we ask the patient, “Are you getting anything in?” before we even do this.
We add a second layer of protection. We use some homeopathy remedies to make sure. We give our patients a couple of tablets. If anything gets in—which it doesn’t—if anything does, it allows the body to flush that mercury out rather than being absorbed into the fatty tissues.
So, we have our rubber dam, our sealed rubber dam. We place an oxygen mask over the patient’s nose to make sure that none of these toxic gas is being inhaled.
And we section out the metal pieces. We section it out. We use electric hand pieces that we’re able to put the RPMs way down, so that it doesn’t heat up this metal too much, and we section these pieces out.
So again, this goes over our protocol that we used in our office. And we’ve had great success. We kind of combined a couple of different protocols, and it works.
So, some other things your dentist should be using in the office is homeopathy, acupuncture, a lot of natural ventilation, nutritional guidance, and of course, quadrant dentistry. We want to take care of each quadrant at a time.
So, once you remove these metal fillings, then what? What are we going to replace them with?
So, we have a couple of different options. We have composites and we have porcelain. Composites is basically plastic and glass. It’s not baked. And then, you have porcelain which is baked glass.
With the composites, unfortunately, at this point in time, we don’t have a perfect material. We have two types of composites. Ninety-nine percent of the composites out there in the market now contain BPAs. In my office, it doesn’t have BPAs in it, but it does have a little bit of flouride which we’re not a fan of. We don’t use flouride in our office, but this is the one material that does have it. We just find that we would rather sacrifice and have a minute amount of flouride versus containing a large amount of BPAs. We tend to go that way.
When I’m talking over these issues with what the options are with my patients, I put it really simply as, “Would you rather eat your food on a China plate or a plastic plate?” It’s up to them. But at least the choices are known.
So, I think that more and more dentists are starting to join and they’re starting to realize that these mercury fillings or amalgam fillings are not healthy. I’m actually really happy to see that dentistry is changing course. It’s taken a long time I think from what, 1833 to now. We’re starting to slowly move away, but we’re getting there.
So, oral and systemic disease, it’s all connected. There had been countless of research done showing that there was a direct connection between periodontal disease. And that’s been known for 15 years at least—hardcore evidence.
And then, lately, the ADA came out with a study that said that there actually isn’t. But I think that there’s more to that. I don’t believe that. I think that due to malpractice, if a periodontal condition isn’t seen or diagnosed, that the dentist is going to be liable for malpractice with their heart disease. So, I don’t believe that. There’s just too much evidence showing otherwise.
In the gums, you have a large amount of vasculature; in the teeth, you do as well. And it’s a direct connection to your heart. It’s commonsense.
So, what is periodontal disease is when we have a patient that has a large amount of bacteria that basically starts to form here. And it eats away. It’s anaerobic bacteria, so it doesn’t like oxygen.
So, when I have a patient that has four, five, six millimeter pockets, they’re not able to clean here. A normal toothbrush can get two to three millimeters if you’re really diligent. But once we get past that, this bacteria is just having a field day. It’s just going to town.
This is actually really interesting. So, some of that bacteria that we found in the bottoms of those pockets that I just showed you, they also found that same bacteria in patients that have pancreatic cancer. And yet, it’s not all connected.
So, how do you know if you have periodontal disease? Here, we have some areas where we have moderate gingivitis, and we’re getting into some moderate periodontitis here. You can see the recession, the gum tissue. And then, when you get to the more advanced—and we see this in our office actually more frequently than you would realize.
How do we treat it? In our office, we take a little bit of a different approach. Of course, we want to use our traditional hygiene—brush, floss. But with our patients, we find that the biggest resource that we can have is by their homecare.
You come to our office, you see our hygienist every four months? Then how is that bacteria being eliminated between then? I mean, do you clean your house every four months? No! You need a maintenance every day to allow new growth to attach to that tooth.
So, in our practice, we use ozone because it’s three molecules of oxygen. When you have these anaerobic bacteria, bacteria that hates oxygen, and you’re throwing three oxygen molecules at it, it’s the most we can do to try to eliminate this bacteria.
So, we have our patients buy a water pick. It doesn’t have to be anything fancy. We just want a reservoir. We have them buy an ozone machine. You ozonate the water, and they basically put the ozone water, the ozone-infused water down into those pockets. That helps to eradicate that bacteria. And by doing that every day, we’re seeing these four, five, six millimeter pockets become those two, three and four—and even better.
And here are some of the statistics for an ozone machine that we recommend. Feel free to email me about this so we can help you.
And again, this is just talking about the water pick. I even have all my ortho patients, I tell them to use it because it’s harder to floss. The most important thing to realize is you’re just trying to flush that bacteria out.
I don’t want to say that it’s not important to keep coming to your hygienist. It absolutely is. You need to have the tartar removed. We learned how to brush our teeth when we’re really young. We all kind of get in there and go to town, but there are places that we miss. So, you have to continue to come to your hygienist and keep having these pockets measured to make sure that we’re getting new reattachment.
So, aside from hygiene and using ozone, some other things that we see that causes increased periodontal pockets and periodontal disease is a lot of crowding. Our teeth are supposed to be aligned in a certain fashion to where your saliva just flows through and it eliminates naturally this bacteria. But when you have all of these crowding, even the patient with the most diligent hygiene, it’s almost impossible. They’re just set up for failure. You’re going to see a plaque trapped here. You’re going to see it here.
Not only that, a lot of times, when they have this, some teeth are being worn more than others. You’ll see a lot of wear on the biting surfaces of the back teeth. So, we absolutely want—of course, there’s an aesthetic component of the braces which that’s the majority of why people get them. But what I care about is just the health of their mouth and eliminating these pockets and areas for bacteria to sequester.
So, it’s not perfect for every patient, but a lot of our patients are able to use these clear braces. They’re BPA-free. A lot of times, our patients don’t want to have metal in their mouth. So, this is a great alternative.
Okay! So, the big hot topic is root canals. I see patients every day. They’ve done a lot of research, and they want to know, “Is this root canal causing cancer? Is this root canal hurting me? Is it making me sick?” That’s a valid question. So, what is a root canal?
So, inside of this canal, you have a nerve, you have an artery and you have a vein. And when you have decay or trauma or something that causes this nerve to die, we have to have it removed.
So, we open the tooth. We open this up and clean all of these out and fill this area. That is a root canal.
So, traditional root canals are done with Gutta Percha and that sealant—that sealant that I was telling you about that’s made of a really toxic material. We have more bio-compatible materials now thankfully that I will recommend to some of my patients depending on their own situation.
So, traditional root canal materials, it’s a hydrophobic material. So, when it comes into contact with moisture, it actually starts to shrink. And over time, these materials shrink anyway.
So, if you think about this, when you fill this area with a material that’s starting to shrink and get smaller, it basically becomes a place where bacterial can just come and re-infest this canal. Whereas the new bio-compatible materials that are on the market and that we use in our office, when it comes into contact with moisture, it actually expands. So, it eliminates any of those pocketings or voids for bacteria to enter. And again, this is the traditional root canal material.
So, aside from whether or not we can do root canals with the bio-compatible materials or not, most of the patients that come in have done some research and they have come across Dr. Weston Price.
So, in 1920, Dr. Price did a study where he took some root canal treated tooth from some patients that had some systemic conditions. One patient had had a heart attack, and they took this tooth out. Another patient had diabetes. So, they had some of these root canal-treated teeth. He implanted them under the skin of some rabbits.
Eighty-eight percent of those rabbits developed the systemic condition that the patient had had that had the root canal-treated tooth. For instance, one of the patients had a heart attack. The rabbit had a heart attack after having this root canal placed under the tissue.
So, not only Weston Price, but the Mayo Clinic also had research as well showing the bacteria lodged in these root canal-treated teeth were connected to some of these systemic conditions.
So now that we know that, what do we do? That’s what my patients come to me. They’ve done this research. They have this information. They have this knowledge. It’s out there. It’s not a secret. What do we do?
This is the part that I love about my job. It’s because each patient is unlike any other patient.
So, we evaluate the tooth. I look at their situation. We look at the tooth. Does it have an infection? If it does have an infection, is it a tooth that they need for chewing? If we extract it, are we going to be able to utilize other teeth around it to replace it with a bridge? Do we have enough bone there for an implant?
These are the questions that I ask myself, ask the patient. We have to come up with a gameplan.
We also look at the systemic conditions of a patient. If this tooth is on a meridian where they have some other manifestation—let’s say they have a premolar that is infected and they have breast cancer along that meridian—I’m absolutely going to say, “No way! Get it out.” So, every case is evaluated individually.
Systemic manifestations on that meridian, are there life-threatening health challenges. Do we want to add to that possibility of introducing more bacteria into their system or is it better just to get rid of it completely? At the end of the day, it’s just a tooth. Their life matters more.
So, here are some examples of our tooth-organ relationship. Like I was saying, with the premolar, any breast cancer, thyroid, we’re not going to want to mess with that, a lower molar—and this is all online, this tooth-organ relationship. So, if you have any root canals that you’ve been questioning having re-treated or having removed, you can look this up and evaluate it.
So, with the bio-compatible option, if there is not a systemic condition along that meridian and the tooth is needed for function, then we do have an option. And this is what I will talk to my patients about.
So, it doesn’t use Gutta Percha, and it doesn’t have the hydrophobic sealers. It has this hydrophilic points that actually expand.
And here’s a research article basically talking about how it will expand when it comes into contact with moisture.
A little bit more about this study. I don’t want to bore you guys. You guys can look this up.
So, what’s my position on the root canals? I’m not an advocate for it. I’m totally opposed to it when it’s used with traditional materials. But it’s not off the table. I feel like that’s doing a disservice to my patients. I don’t want my patients to think if they come to me, we’ll have all your root canals removed. I can’t buy that.
But each patient, they’re an individual. They’re unlike anyone else. I need them to come to my office. Let’s sit down, let’s talk about it, let’s evaluate their case individually.
So, let’s say that we’ve decided to actually remove the tooth, then what are our options? Do we just leave it alone? Absolutely not. We have options.
So, what is the best thing? We have implants, bridges and removable partials. Maryland bridges aren’t done very much these days just because it takes a lot of maintenance. You have to have them recemented every few years or so. We’ll talk about it, but I think people are more in line with implants and bridges.
So, an implant is a titanium or a zirconium screw that’s put into the bone. We allow it to heal for a few months. And then ,we uncover it and then we can place a crown on it.
During those four months, the body will osteointegrate and basically move into the threads of this implant, and it’s accepted as part of the body and part of the bone.
You can see the threads. There’s bone going straight into these. It’s totally integrated. It’s solid.
Zirconia implants are also on the market. The problem with these right now is that it’s all one piece here—not to mention that it’s larger. So, it’s a ceramic implant. It has to be larger so that it can take on the mastication forces. You have all these micro-fractures that can occur if it’s smaller.
So, they’re still in the research and development phase right now. With it being one piece, the patient is able to actually bite on it immediately which I’m not a fan of because it’s not allowing the bone to actually integrate into the implant.
So, there is hope for having zirconia implants. They have come out with something that has two individual pieces, but they’re having problems with the attachment of the two pieces. So, for now, I’m not ready to advice my patients to go in this direction until I see a little bit more success. So, there are options.
If they don’t have enough bone, and there aren’t teeth for an implant—I mean for a bridge—then we can do something that’s removable to help them to bite.
This is what we do in the majority of cases. If a patient has restorations on two adjacent teeth here and we have to remove a tooth, then it’s kind of killing two birds with one stone. We can clean up those two adjacent teeth and place a bridge, a porcelain bridge.
If the two teeth are virgin teeth, then I would probably go more towards an implant.
And this is that Maryland bridge. This is not as common, but it’s still an option. So, you can ask your dentist how they feel and if you’re a candidate for them. Again, every case needs to be evaluated individually.
So, to reiterate, are there systemic manifestations along the meridien of the affected tooth? Are there life-threatening health challenges? And will intervention improve or decrease the quality of life? If we remove that tooth, are they not going to be able to eat on that side?
So, those are the things that we address in our office. I really appreciate you guys listening to what I have to say. Feel free to come and see us at Brighton Dental. Thank you. Thank you so much.
For a holistic dental consultation with Dr. Woods, call (619) 359-6569