the Dental – Medical Partnership
Traditional “dental medicine” has always concerned itself with dentistry for people with diseases – how to provide dental support for people with diabetes, for example, or the consequences of cancer treatment. The “Health Model” brand of dental medicine that the IAOMT advocates has more to do with health promotion, the relationship of dental health and the rest of the body, and, all too often, dealing with the systemic consequences of previous dental treatment.
One of the things IAOMT members seem to be particularly aware of is the necessity of combining the efforts of dentistry and medicine for the best health improvement for our patients. The Academy is a meeting ground where this dialogue takes place – both between dentists and physicians, and among physicians themselves, as we sort out the many complicated ways that dental health affects total health. In a world in which health care is sliced and diced into narrow specialties, we seek collaboration and interdisciplinary solutions.
The physician members of IAOMT are a valuable brain trust, and the Academy’s link to the world of creative medical thinking. They are M.D.’s, D.O.’s, as well as D.C.’s, N.D.’s, and other doctoral level practitioners. Their experience gives us a great deal of depth. Eight physician members participated in this interview, which reveals a diversity of background and approach. They are:
- Thomas A. Dorman, M.D., Federal Way, Washington
- Stuart Freedenfeld, M.D., Stockton, New Jersey
- Sam Queen, D.Sc., Colorado Springs, Colorado
- David Schenk, D.O., Clearwater Beach, Florida
- Brian Wilson, D.C., Englewood, Colorado
- John Wilson, M.D., Asheville, North Carolina
- Robert Battle, MD., Houston, Texas
- Ted Rozema, MD, Landrum, South Carolina
What drew you to ally yourself with a group that is made up primarily of dentists? Why is working closely with dentists part of your vision for your own practice?
Dr. John Wilson: I joined IAOMT because of the strong curiosity that I had about the physical effects, both negative and positive from dentistry. IAOMT’s pioneering perspective in identifying the hazards of dental amalgams, as well as their strong political stance on this issue made IAOMT an appealing organization and one that I wanted to participate in and support with my attendance and membership.
Dr. Freedenfeld: I have been involved with mercury toxicity problems for many years and have come to realize that dental amalgam has been the main source of total body mercury in 99% of the hundreds of mercury toxic patients in my practice. Because of this fact I find that a biologically trained dentist is a vital link in the process that includes removing the source of toxicity. This must be done in a safe and effective manner in order to protect the patient’s welfare. Furthermore confounding problems in the periodontal and surrounding bony areas often need to be addressed appropriately for patients to regain health.
Dr. Dorman: I came to realize that the taken-for-granted attitude implanted in me from my famous medical school that dental issues are separate from medical issues was wrong. Many illnesses effect the mouth as well as the rest of the body. Contrariwise, many illnesses in the mouth have remote implications. As an internist, it would be irresponsible not to look at the whole scene.
Dr. Brian Wilson: I originally heard about IAOMT from a colleague of mine when we were working on education for the chiropractic internists on oral morbidity and toxicology. Numerous cases later in which toxic teeth showed a remarkable effect on patient’s health, I was pleased to find out that a physician membership was available.
Dr. Rozema: The mouth is the portal to our continuing existence on this planet. The teeth are essential to oral processing of our foodstuffs. The dental profession plays an integral part in maintaining the health of all of us. The implications of mercury toxicity from amalgam placement became a focus of my patient’s care after seeing the benefits of amalgam removal.
Do your dental colleagues help you in any direct way in your practice of medicine?
Dr. Dorman: I interact with a number of “biological dentists” in Washington state with varying degrees of shared perspective, but, yes, the dentists who service my patients by referral often take care of mercury toxicity through removing the mercury–containing amalgams effectively and safely. They cooperate with directing the patients for appropriate detoxification, which is usually conducted in my office, and often deal with cavitations of the jawbones with great benefit to some of the patients.
Dr. Schenk: I feel that I have a good working relationship with some of the IAOMT dentists in my area and we discuss both dental and medical problems
with each other.
Dr. Battle: My clinic has a biological dentist on staff. He does the dentistry and I do the medical management. We often use some rather alternative methods – homeopathic drainage, neural therapy, metal chelation, allergy therapy, and nutritional support as indicated. This to me is the only way to give the patient comprehensive care. I think every dentist should seek out a physician familiar with these issues, and vice versa if at all possible.
Dr. John Wilson: I work very closely with a biological dentist, too. We have a fascinating series of patients for whom the physicians in my clinic identified toxicities of dental origin and areas of bone pathology in the jaws. We sent these patients to the dentist we work with for dental materials revision and surgical management of the bone pathology, after which they returned to us for medical management and to document changes in their physical condition. It’s a direct partnership, where the medical condition could not have been treated successfully without the dental input.
Dr. Freedenfeld: That’s been my experience, too. I turns out that dental health is important in all aspects of general health, especially neurologic, cardiovascular and immune systems.
Dr. Queen: Not only do dental conditions affect the rest of the body, but examination of the mouth is one of the best health screening methods. It offers a portal for actually visualizing the subclinical metabolic defects that are present in every disease. For example, in a patient with periodontal disease, you know that the same metabolic problems that contribute to the disease are active in the rest of that person’s physiology.
As you’ve begun to mention, one of the problems we are most concerned with is mercury toxicity. How involved should the dentist be in the treatment of mercury toxicity?
Dr. John Wilson: I am of the opinion that dentists should work with a physician trained in detox. Certainly basic nutritional methods could reasonably be utilized by dentists for basic “simple” detox for patients who are uncomplicated (I’m not sure I ever see any of those kind). Herbal agents like garlic, MSM, Porphyrazyme, etc., would certainly be safe for most anybody to take. I think that actual chemical chelation agents should be used by a physician trained in their safe and effective use.
Dr. Schenk: I agree – I believe that dentists should stick to the dentistry and leave medical treatment to the physicians. For the great majority of these patients treatment for mercury is only one aspect of their situation. They come to the medical clinic with conditions such as chronic fatigue, fibromyalgia, autism, or multiple sclerosis, and we discover mercury toxicity to be part of their clinical picture. You’ve got to be prepared to practice all of medicine to do a good job in these cases. How far can a dentist go in treating the whole body? Likewise, we need the specialized skills of dentists to clear the patient of dental sources of toxicity before we can proceed with the medical treatment.
Dentists need to realize that replacement of amalgam and other toxic dental materials is only the first step for the patient. In today’s climate in regard to the issue of amalgams and mercury it would be my recommendation that a patient getting the amalgams removed for whatever reason have a proper workup by a physician. I feel that the patient should always be prepared medically and nutritionally prior to amalgam removal.
Dr. Rozema: I believe the dentist can be very helpful in dealing with mercury toxic patients, especially by being aware of specific nutritional methods of biological support. The most important thing a dentist can do, though, is to be capable of removing amalgams properly without increasing exposure at the time of removal.
Dr. Queen: On the other hand, as an educator, I’ve found that dentists are just as capable as physicians of being trained to analyze a patient’s body chemistry and offering nutritional and detox advice. The line between dentistry and medicine may have to be drawn in different places for different practitioners, depending upon training and the availability of good medical support in a given locale.
We’ve spoken quite a bit about the mercury problem, but what other areas provide an opportunity for dentists and physicians to work together?
Dr. John Wilson: The relationship between periodontitis and ischemic heart disease is so well documented in the medical literature that it hardly even needs to be mentioned. Aside from that, however, the relationship between anaerobic bacteria and cavitations (ischemic osteonecrosis of the bone marrow in the jaws) is increasingly becoming recognized as an occult cause of both peripheral and central nervous system dysfunction through inhibition of autonomic function, as well as the elaboration of enzyme–inhibiting toxins that can interfere with nerve function.
Dr. Queen: As I alluded to before, my research has shown that there are six subclinical metabolic defects that underlie chronic disease: (1) acid/base imbalance; (2) an anaerobic tendency; (3) an imbalance in bound vs. free calcium; (4) chronic inflammation; (5) connective tissue breakdown; and (6) oxidative stress. As it happens, the mouth is the only place in the body where all six can be visually observed. The dentist is in the best position to screen for total health problems, which can be followed up by the physician. Or, if the dentist is trained in body chemistry management and treats the patient’s oral disease via the metabolism, salutary things just may happen in the rest of the patient’s system.
What would you like to communicate to your medical colleagues? How can they get involved and learn the things you know? How much resistance have you received from them in the past?
Dr. Freedenfeld: I have consulted on patients over the years and when I have diagnosed a patient with mercury toxicity I hear the same query from their former doctors: “I have so many patients with multiple amalgams, how come I don’t see more mercury toxicity?” Doctors need to recognize the possibility of a diagnosis so they can then consider pursuing an appropriate evaluation. They will then need to be educated as to the appropriate diagnostic tests and treatments.
Dr. Dorman: I’m much more pessimistic about influencing mainline medicine. I do not think they are interested in budging an inch from the disease – drug orientation that passes for health care. We must, though, be receptive and supportive of those physicians who come to us with an open mind and a willingness to learn from our experiences. I came to this more holistic view after being in practice for about twenty years, so there may still be hope for more inquisitive and creative doctors to pick up the banner.
Dr. Queen: Looking at body chemistry relative to a Health Model pays far more dividends in treatment outcomes than restricting your views to the disease model approach. We’ve seen great enthusiasm for our approach from health care professionals who are open to a scientifically based Health Model approach. Some health care professionals have felt intimidated because they view us as the competition. We hope to dissolve this barrier.
Dr. Brian Wilson: I tell my colleagues, simply, where you have the clinical puzzle, look to and consider the mouth as being the culprit. Greater cooperation between every school or specialty of health delivery needs better teamwork approaches if the health delivery system is to work efficiently. How can they get involved? At least I’m in a position to teach the Chiropractic Internists, and will probably teach the section on oral health next year. When it is well-presented, the questions session goes overtime. Resistance?-I do not recall any major resistance.
Dr. Rozema: Don’t keep your head in the sand. We did not learn everything there is to learn in our formal medical training period. We need to be open minded about how the body functions and not always regard it as a repository for pharmaceuticals. We need to keep our minds open and understand that the mouth is essential to the body’s health.
Thank you all for meeting with us today. This is a big subject with lots of opportunity for exploration and research, and for helping patients with challenging health problems. We look forward to expanding this horizon in the future.
Physicians interested in joining this discussion are invited to contact IAOMT at info@IAOMT.org.