holistic dentistry

    Close up of multicolor toothbrushes in glass

    ‘Holistic dentistry’: a popular term that is perfectly pointless

    16 December 2016

    If you assume that a holistic dentist is someone who drills holes in our teeth, you would be mistaken; holistic dentistry is something entirely different.

    But what precisely is it? For sure, it is popular: a quick Google search produced well over seven million hits for this term. A recent paper in the European Dental Journal seemed to imply that using a ‘natural toothbrush’ is holistic. And what is holistic about using miswak (chewing stick) instead of my electric brush, I wonder. Perhaps we need to ask the ‘holists’ among the dental profession what holistic dentistry really is; this article seems to be from the horse’s mouth (pun intended):

    Holistic dentistry involves an awareness of dental care as it relates to the entire person, with the belief that patients should be provided with information to make choices to enhance their personal health and wellness…

    Some of the philosophies include:

    — Alternatives to amalgam/mercury fillings
    — Knowing and following proper mercury removal
    — Multi-disciplinary, or integrated, health care
    — Nutritional and preventive therapies and temporomandibular joint disorder therapy.

    Sounds like a string of pompous platitudes designed to boost business by attracting gullible patients? The knowledge that the mouth and its content are part of the whole body is not a philosophy; alternatives to amalgam have existed for decades and are used by most ‘normal’ dentists, integrated health care is a bit of a con, nutrition is part of conventional healthcare, and temporomandibular joint disorders are issues for conventional dentistry. Perhaps another article might do a better job at enlightening us about ‘holistic dentistry’:

    Holistic dentistry is not considered a specialty of the dental profession, but a philosophy of practice. For those dentists who take the concept to its core, holistic dentistry includes an understanding of each patient’s total well-being, from their specific cosmetic, structural, functional, and health-related dental needs to the concerns of their total body and its wellness. Holistic dentists tend to attract very health-conscious individuals.

    Some of the things holistic dentists are especially concerned about are the mercury found in traditional amalgam dental fillings, fluoride in drinking water, and the potential relationship of root canal therapy to disease in other parts of the body. Holistic dentists’ primary focus is on the underlying reasons why a person has dental concerns, and then help correct those issues by strategic changes in diet, hygiene and lifestyle habits.

    Natural remedies to prevent and arrest decay and periodontal (gum) disease can also be utilised. Many holistic dentists are skilled in advanced levels of nutritional physiology and use natural means of healing patients, often avoiding the more standard use of systemic antibiotics, pain control management and surgical procedures.

    Part of this text describes what good dentists have always done, while the other part is simply nonsense. For instance, natural remedies for tooth decay and gum disease? Really? Which remedies precisely? As far as I can see, no such treatments are backed by anything approaching sound evidence.

    In my search to find something that does make sense in the realm of ‘holistic dentistry’, I went on Medline and found a new systematic review published in the British Dental Journal which indicated that holistic dentistry is mainly about patient-centred care. But this message confused me even further: is normal dentistry not patient-centred? If so, what does it focus on? Cash flow? The paper concluded: ‘The concept of patient-centred care (PCC) is neither clearly understood nor empirically and systematically assessed in dental settings. Whilst most authors seem to suggest that PCC is about delivering care that is humane, involving good communication and shared decision-making, there is no work assessing these concepts empirically or relating them to practical outcomes.’

    ‘Holistic dentistry’, I began to realise, makes as much sense as holistic banking, holistic hairdressing, or holistic medicine. Dentistry, medicine and hairdressing are either good, not so good, or outright bad. And, like good medicine, good dentistry is patient-centred, takes account of the fact that the teeth are attached to a human being, is concerned with patients’ well-being, etc, etc.

    The term holistic, as it is currently used by many dentists, turns out to be little more than an advertising gimmick.

    Edzard Ernst, emeritus professor at the University of Exeter, is the author of Homeopathy: The Undiluted Facts and the awardee of the John Maddox Prize 2015 for standing up for science. He blogs at