Concerned About BPA in Dental Fillings? What You Need to Know

“But I heard that tooth-colored fillings contain BPA,” you’ll hear some folks say – as if that somehow negates all concern about the mercury in amalgam fillings.

And yes, it’s true: Most composite resins available today do contain this endocrine-disrupting chemical or related compounds. One recent study found that of the 130 products its authors looked at, over 86% were based on BPA derivatives. Just 18 composites were free of those compounds.

Obviously, this is of some concern, especially since these materials are used not just for fillings but sealants, which are often recommended for children at high risk of decay. Research suggests that BPA may affect how reproductive systems and brains develop. Exposure to this chemical has also been linked to a wide variety of problems, including early puberty, metabolic disorders such as obesity and diabetes, heart disease, infertility, thyroid dysfunction, and some cancers.

The good news is that, under normal circumstances, your body is able to excrete BPA pretty well. The bad news is that we’re each exposed to so much of it every day, we may not be able to clear it so efficiently. BPA is a fat-soluble compound and may accumulate in the fatty tissues of your body.

In fact, over 90% of us contain measurable amounts of BPA.

Suffice it to say, it’s a good idea to minimize the amount we’re exposed to, including that in dental work.

Materials expert and biocompatibility specialist Jess Clifford has noted 7 products that are said to be “free of Bis-Phenol A in any form, whatsoever, bound or unbound”:

Diamond Crown Diamond Flo Diamond Link Venus Diamond

Venus Diamond Flo Venus Pearl Visalys Temp

Another 14 products that are claimed “to be free of dissociable, easily released or ionizable BPA”:

Admira Clearfil Concise Esthet-X-HD Filtek Supreme Filtek Supreme XT Filtek Z-250

Grandio SO Herculite XR Kalore Point 4 Premise Indirect Vertise Flow Z-100

Clifford adds that although these may contain derivatives such as bis-GMA or bis-DMA, the amount of energy needed to release the BPA within is “usually not commensurate with life.”

In our office, we use only BPA- and fluoride-free filling materials. (Yes, some composites contain fluoride, too.) Further testing can be done – and should be done in the case of people with longstanding illness or chemical sensitivities – to determine which of those would be most appropriate for filling teeth. (No single material is ideal for everyone or every type of repair.)

Another option is ceramic. It’s broadly biocompatible, BPA-free, and can be used for inlays, onlays, and crowns.

And if you – or your child – has already had fillings or sealants placed that aren’t BPA-free? Unlike with mercury amalgam, there’s little to gain by removing them. Most BPA exposure happens when the fillings or sealants are placed. Research has consistently shown that while initial BPA levels may be elevated, they quickly plummet. One of the most recent studies found that salivary BPA levels were near zero after 7 days.

Similar results have been found for fluoride released from composite: The main exposure is at the time of placement and dwindles rapidly.

The main thing, going forward, is just to make sure that any future fillings or sealants are in fact BPA-free.

To learn more about BPA and related compounds in dental materials, check out this presentation by Jess Clifford.

Image by Politikaner, via Wikimedia Commons

Originally posted 2017-11-30 07:03:41.

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Mercury-Safe Dentistry Is a Must – Here’s Why

When a patient asks us to remove their mercury fillings and replace them with biocompatible restorations, we follow extensive safety procedures. After all, mercury is extremely toxic – on par with substances such as arsenic and lead. Mercury toxicity has been associated with a broad range of health problems, from behavior and mental health issues to autoimmune disorders to neurodegenerative conditions.

Mercury is most dangerous when inhaled as vapor, absorbed into the lungs and introduced to the body’s general circulation, where it’s drawn toward fatty tissues, such as those of the brain. And removing mercury amalgam fillings generates a lot of mercury vapor.

New research in the journal Dental Materials offers the latest evidence of just how much “a lot” can be.

For the study, researchers used a device called a spectrophotometer to measure the amount mercury in the air before, during, and after amalgam removal. Measurements were taken for 13 patients who had a total 13 amalgams removed.

Before the procedure, measurements were below 400 ng/m³. This is already four times higher than the maximum permissible level of exposure set out in US guidelines – and not exactly uncommon in dental clinics that don’t follow mercury-safe procedures.

One 2014 study found that in most of the clinics they investigated, “indoor mercury levels exceed far above the permissible limit, recommended for safe physical and mental health.” Research published earlier this year found that dental workers, compared to control groups, routinely exposed to mercury, had more health problems, “often involving the central nervous system.”

Much of that contamination comes courtesy of the drilling needed to remove the amalgam. In the current study, once procedures began, mercury levels shot up as high as 8500 ng/m³ – more than 20 times higher than at the start.

And things didn’t improve much after removal.

15 min. after total removal of amalgam from the mouth, the values obtained were between 2,000 and 5,000 ng/m³.

These are incredible leaps in exposure. But it can be hard to appreciate the extent of the problem through numbers alone. So let’s take a look at what this vapor release looks like, as shown in the powerful documentary Evidence of Harm:

This is why we insist on safety measures that protect our patients, ourselves, and our planet. This is why Dr. Wall is certified in the SMART technique for safe amalgam removal.

We believe mercury has no place in dentistry. Yet even if amalgam were universally banned today and biocompatible materials were the new norm, we would still be dealing with mercury amalgam’s effects for many generations to come, thanks to the countless mouths still harboring countless toxic fillings.

It’s why mercury safety is a must – and one thing we will never, ever compromise on.

Originally posted 2017-10-26 07:02:34.

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Composite Equal to or Better Than Amalgam, New Study Shows

One of the most common defenses of mercury amalgam fillings you still hear these days is that they last so much longer than tooth-colored composites. This statement from Delta Dental is typical:

With more durable resin material available for only a decade, resins haven’t stood the test of time in teeth where grinding and chewing result in heavy wear; by contrast, the durability of amalgam fillings is well documented — the average life span of amalgams is 8 to 10 years, but many last 20 years or more.

Considering that those fillings continuously release toxic mercury vapor, longevity is hardly a virtue here.

But we digress.

While this durability argument may have held true back in the early days of composite, new research shows that today’s materials can hold their own against amalgam.

Consider the study on fillings published just last week in Frontiers in Medicine. Wanting to see why some fillings fail, researchers screened nearly 5000 patient records from the University of Pittsburgh School of Dental Medicine and looked at the outcomes of over 8000 fillings.

A few factors seemed to make failure more likely: smoking , tobacco use, alcohol use, and a difference in the gene for matrix metalloproteinase (MMP2). This is an enzyme found in teeth that can degrade all kinds of proteins in the extracellular matrix secreted by cells. The new research suggests that it may be able to degrade the bond between a filling and its tooth surface, as well.

Either way, as noted in a news release on the study,

the results suggest that personal factors for each patient appear to influence their chance of filling failure, rather than the filling material their dentist used.

And here’s where things get interesting. “Our data,” note the authors,

also show that direct composite resins perform similarly (and maybe slightly better) to amalgam in posterior teeth up to 5 years and are suitable substitutes for their metallic counterparts, making it feasible to completely replace amalgam in dentistry. The justification of using amalgam due to its lower costs alone in contrast to the potential of eliminating an environmental hazard has become harder to support now that direct composite resins can perform at acceptable levels.

They go on to emphasize that most of the composites placed were by beginning dentists – a fact that also speaks to the virtues of modern composites.

The statistically significant lower failure rate of posterior composite resin versus amalgam restorations with 5 years follow-up in our study, despite the fact that direct composite resins are more technique sensitive than amalgam, further suggest that the first can replace the latter.

In our view, toxicity concerns alone are enough of a reason to stop using this out-of-date material, with respect to personal and environmental health alike. These latest findings only stress the fact that there’s no good reason to stick with this material. There are better options out there.

Those are the ones we choose to use in our practice.

Originally posted 2017-11-16 07:01:34.

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Taking a Holistic Approach to Oral Health

One of the first things new patients notice about our office is all the greenery. We have about 200 plants in all – an expression of Dr. Wall’s love for seeing life flourish, and not just in plants but people, too.

After all, all life is connected. That’s been the essence of holism since the term was first coined back in the 1920s – an offshoot from the Greek term holos, meaning “whole.” It signals the basic interconnectedness of everything.

Traditionally, dentistry has been anything but holistic. Even today, dentists are largely taught to view the mouth in isolation. They’re trained to fix problems, like a plumber or a mechanic, without considering the effects their fixes may have on the whole.

This is how you wind up dealing with problems like mercury amalgam “silver” fillings, for example, or fluoride, a known neurotoxin.

Yet science has shown us that, indeed, what happens in the mouth can have wide-ranging effects. Perhaps nowhere is this more clear than in the case of gum disease, which is now linked to an ever-growing list of related inflammatory conditions. These include heart disease, stroke, diabetes, rheumatoid arthritis, Alzheimer’s, and some cancers.

So we look way beyond the usual things like oral hygiene and limiting sugar. We look at the diet as a whole and stay alert to nutritional deficiencies that may be compromising your health. We consider your exercise, rest, and sleep habits. We consider your stress levels, lifestyle, and environmental exposures to toxins.

Every factor that can impact your overall health can impact your teeth, too. The health of the mouth depends on the health of the body, and vice versa.

Because of this interconnectedness, we do dentistry that addresses the health of the whole, as well as the teeth.

That starts with favoring the least invasive, most conservative treatment possible. When treatment is called for, we make sure that the materials we use will be safely accepted by the body. Biocompatible materials such as BPA- and fluoride-free composite for fillings or ceramic for implants are a must.

We also use powerful, non-invasive therapies such as ozone to battle harmful bacteria and cold lasers or biomodulation for chronic pain. We use digital imaging only to minimize the amount of radiation you’re exposed to when x-rays are necessary for Dr. Wall to correctly diagnose a problem and create a sensible treatment plan for you.

But perhaps most of all, we’re devoted to giving you the information you need to understand both your current health – oral and systemic alike – and how to get it to the level you’d like it to be at. We want your health choices to be informed ones.

And that’s why we’re starting this blog – to share this kind of information with all who might benefit from what our team can teach.

As we go forward, we look forward to connecting with you. Are there specific oral health issues or holistic dental treatments you’d like to know more about? Let us know in the comments!

Note: We can’t comment on specific health situations or offer advice in this forum. But if you have personal questions about your oral health, we’d be glad to talk with you by phone: 801-685-1197.

Originally posted 2017-09-07 07:09:47.

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When It Comes to Dental Implants, Metal-Free Is Your Best Bet. Here’s Why

When you need to replace teeth, you’ve got three options: a bridge, dentures (partial or full), or implants.

Bridges look great and work well, but they’re not exactly ideal. Most types require the dentist to cut down perfectly healthy teeth on either side of the gap to be bridged so the prosthetic can be attached.

Dentures are a better option: aesthetic, functional, and reasonably priced. And with the lightweight, thermodynamic materials available today, even one-tooth partials or “pop-ins” are a possibility. But there’s no bond between the denture and gums, which can cause problems like slippage or constantly trapped food. And if it doesn’t fit right, it can cause discomfort and even make it hard to speak normally. Additionally, with full dentures, you can expect bone loss over time, which affects the appearance of your lower face and mouth.

By far, implants are your best option. They look and work just like natural teeth. They integrate with your jawbone.

But not all implants are created equal. In fact, recent research has begun to highlight the problems with titanium implants in particular.

Currently, titanium is the norm for implants, largely because the metal has been considered stable, durable, and nonreactive. This is turning out not to be the case.

For one, they’re seldom made only with titanium. Other metals such as nickel and aluminum may be used – metals that are both highly toxic and prone to cause galvanic currents in the mouth when other metal restorations are present. Allergic reactions are also a possibility.

Other research has suggested that titanium itself “can induce toxicity” or allergic responses, especially in patients who already have sensitivity to metals.

Another issue is the fact that the metal itself can corrode, releasing metals into the body. This corrosion may be caused by bacteria around the implant, as well as exposure to substances such as fluoride and hydrogen peroxide.

That there may be harmful bacteria around an implant is no surprise, really. Most extractions happen due to infection, usually gum disease. If that infection isn’t controlled or if the bone at the extraction site isn’t properly cleaned, it’s bound to proliferate once the gums have healed.

Corrosion of the titanium simply aggravates inflammation around the implant, which can result in a condition known as “peri-implantitis.”. Only now are researchers beginning to understand just how big of a concern this is. Research recently presented at the California Dental Association’s CDA Presents 2017 meeting suggests the scope of the problem.

Peri-implant mucositis is found in 43% of implants and peri-implantitis in 22%,

* * *

However, about 10% of implants will have peri-implantitis after five to 10 years in 19% of patients, according to another systematic review and meta-analysis (Journal of Periodontology, November 2013, Vol. 84:11, pp. 1586-1598). Dr. [Mark] Reynolds discussed. Mucositis was found in 31% of implants and 63% of patients.

Peri-implant mucositis indicates inflammation without the loss of bone you see with peri-implantitis. Often, that loss of bone means ultimate loss of the implant.

Ten years ago, professionals said the condition didn’t exist. But now it is on the rise, as increasing numbers of people have replacement porcelain crowns with titanium roots. Half-a-million adults have at least one dental implant, according to the latest Adult Dental Health Survey.

Studies have suggested that one third of patients will be infected. “We’re sitting on a time bomb,” says Dr Stephen Jacobs, a past president of the Association of Dental Implantology and well-respected implant surgeon. “We are going to be seeing more and more cases.”

One of the first treatments a dentist might recommend for this condition is ultrasonic scaling – a very deep cleaning using a device that creates tiny bubbles that help disinfect areas below the gumline. According to research in Scientific Reports, this scaling may actually make the peri-implantitis worse.

How? By releasing yet more metal from the implants, increasing inflammation and triggering bone loss. That loss, noted the authors, “is unlikely to be reversible.”

Because of such problems, we use only biocompatible ceramic (zirconium) implants. They’re entirely metal-free and less likely to encourage the kind of bacterial growth that leads to peri-implantits.

Not only are they the safer option, they’re more aesthetic, too. In patients with thin or receding gums, the gray titanium can become visible. White ceramic retains a far more natural look.

Are ceramic implants for everyone? Of course not. No treatment is. But when it comes to replacing teeth and retaining normal mouth functions, they certainly can’t be beat.

Corrosion image Dr. Sammy Noumbissi

Originally posted 2017-09-21 07:12:44.

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Stress Is Your Friend – Until It Isn’t (with Tips for Managing It Before It Gets Out of Control)

Although you might think of stress as something oppressive and unwanted, it’s actually an important survival mechanism. It’s your body’s automatic response in the face of a threat. All systems go into fight-or-flight mode, marshalling resources to help you either eliminate the threat or get away from it as quickly as possible.

As Hans Selye, the doctor who first identified the stress response, once wrote, “To eliminate stress completely would mean to destroy life itself.”

Trouble is, we live in a world in which the stressors we face are more numerous and far different than those our ancestors faced. An angry boss, a dangerous driver on your commute, financial pressures, social media flame wars – these kinds of things are far less lethal than, say, meeting up with a hungry mountain lion or facing an enemy in battle.

Yet our physiological response is just the same.

And it’s often constant in our 24/7, always “on” culture, where we can be treated to incessant streams of bad, frightening, or difficult news just by glancing at our phone. Chronic stress means the body is always on red alert, always ready to react.

This has major consequences for your health. For one, it fuels chronic inflammation. Under normal circumstances, like stress, inflammation is a good thing. It’s a sign that your body is fending off a threat, such as an infection, or healing from a wound. But if it keeps on keeping on even when there’s no threat present, it lays a foundation for a wide range of health problems, including heart disease, stroke, diabetes, and cancer.

Research has shown that chronic stress actually causes the body to lose its ability to regulate the inflammatory response.

“Inflammation is partly regulated by the hormone cortisol and when cortisol is not allowed to serve this function, inflammation can get out of control,” said Cohen, the Robert E. Doherty Professor of Psychology within CMU’s Dietrich College of Humanities and Social Sciences.

Cohen argued that prolonged stress alters the effectiveness of cortisol to regulate the inflammatory response because it decreases tissue sensitivity to the hormone. Specifically, immune cells become insensitive to cortisol’s regulatory effect. In turn, runaway inflammation is thought to promote the development and progression of many diseases.

And that includes gum disease.

Indeed, over the years, science has delineated a clear relationship between chronic psychological stress and gum disease. In fact, chronic stress is one of the major risk factors for periodontitis. (The others include exercise, as we saw last week, diet/nutrition, sleep loss, and, above all, smoking/tobacco use.)

And like all other risk factors, it’s a behavior you can change – and, by changing it, lower your risk. Here are some tips to get you started:

• Practice mindfulness – focusing on what’s going on right now, without judgment. Research has consistently shown that it can do wonders for lowering stress and anxiety (not to mention improving your general health).

• Exercise. Practices such as yoga and tai chi are especially well-suited for lowering stress, but any kind of exercise you like can help reduce both stress and inflammation.

• Include prayer or meditation in your day. Not only can it enrich your spiritual life; it’s been scientifically shown to offset the negative health effects of stress.

• Schedule time for yourself to regularly do something relaxing and fun. Making it part of your schedule gives it more priority than just doing something relaxing when you’ve got the time.

• Spend time with your pets – or if you don’t already have one, contact an animal rescue to foster or adopt. Pets are fantastic for helping us chill, bringing us to calm.

• Develop tools and strategies for grappling with stress right now, in the moment.

• In a pinch, herbal remedies such as Valerian root, Kava Kava, lemon balm, and lavender can be used for quick calming. Homeopathics such as Calms Forte or Rescue Remedy can also be helpful.

For more tips on reducing stress naturally, see this and this and this.

Image by Andrew Imanaka, via Flickr

Originally posted 2017-10-12 07:01:59.

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Why You Want a Dentist Who Uses Ozone

Keeping your mouth healthy, as we’ve said, is largely a matter of controlling the billions of bacteria that live there. A good many of them are actually helpful, but others aren’t so nice: S. mutans. P. gingivalis, F. nucleatum, Actinomyces…and the list goes on.

A healthy mouth means more of the good, less of the bad.

Brushing, flossing, and the like is just one part of keeping your oral flora in balance – and a key part. Another is what you eat. Pre- and probiotic supplements can be helpful, too, as can antimicrobial herbal tinctures.

But what about when harmful bacteria get out of control? While there are times when pharmaceutical antibiotics make good sense, they can have serious consequences for your overall health. They also can only kill bacteria, not viruses or fungi; nor can they help heal the tissue damage done by the pathogens.

Fortunately, holistic dentistry has an excellent tool for dealing with oral pathogens: ozone.

Now, if you’re not familiar with therapeutic ozone, you might be thinking of something like the ozone layer of our atmosphere, which protects us from UV radiation. Or maybe you’re thinking of it as a pollutant, the smoggy result of interactions between the sun and carbon monoxide, VOCs, and other emissions.

Medical grade ozone is different. Concentrated and pure, it’s a powerful disinfectant. This power comes courtesy of ozone’s molecular structure: three oxygen atoms bonded together.

Now, the oxygen you breathe comes in molecules of two atoms – O2. It’s extremely stable. Ozone – O3 – is not. It really wants to lose that third atom and become “regular” oxygen. But that third atom also gives it a negative charge, and negative particles naturally seek out those with a positive charge – particles such as bacteria, fungi, and viruses.

Ozone destroys them.

A new research review reinforces the many roles ozone can play in dentistry, from treating gum disease and tooth decay to supporting the healing of surgical sites. As the authors put it,

Its unique properties include immunostimulant, analgesic, antihypnotic, detoxicating, antimicrobial, bioenergetic and biosynthetic actions. Its atraumatic, painless, non invasive nature and relative absence of discomfort increase patient’s acceptability and compliance thus making it an ideal treatment choice specially for pediatric patients.

Here, you can see all the many ways we use it in our office.

There’s even evidence that it can help in the treatment of pain in the chewing muscles, often caused by TMJ dysfunction. According to a study published earlier this year in the Journal of Oral Rehabilitation, while both ozone and placebo group patients experienced improvements, the

Bio-oxidative ozone application appeared to be superior to sham bio-oxidative ozone application and differences were significant.

Patients in this group reported less intense pain and showed a higher pain threshold than those in the placebo group.

Other research suggests that ozone may even be effective in treating TMJ disorders themselves. In fact, ozone is well known for stimulating the healing response by delivering much needed oxygen to damaged cells, allowing them to repair. This is why it’s so ideal for surgical applications, including the treatment of cavities.

Truly, ozone is becoming indispensable to holistic dentistry, providing a powerful yet safe, non-invasive and inexpensive way to control those “bad bugs” and support your body’s natural healing response.

Bacteria image by Bob Blaylock, via Wikimedia Commons

Originally posted 2017-11-09 07:01:48.

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