Beware of needless dentistry

Newsletter: Beware of Needless Dentistry - March, 2004

Volume 2, Issue 3, March 2004

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Feature Article

Beware of Needless Dentistry

Upcoming Speaking Event: Featuring Dr. Breiner, Dr. Breiner & Dr. Handwerger (No, you're not seeing double) - a dental/naturopathic afternoon

Note From Dr. Breiner

On a personal note, the Breiner household has been very busy with wedding plans! Our younger son, Justin, has recently become engaged to our future daughter, Sarah. We are very excited about this event. My one wedding request - no amplification for the band. My wife informs me that my opinion is duly noted, and most probably will be ignored by one and all.

I am on-the-road this week traveling to Arlington, VA to attend the Mid-Year scientific symposium for The International Academy of Oral Medicine and Toxicology. I hope that the health practitioners receiving this e-zine are planning to attend or have joined the Academy's mailing list for future updates (doctors, please let me know if you would like more information on the IAOMT).

On the weekend following my return from Virginia, I will be speaking at the Natural Food Association's meeting on Sunday, April 4th in Wallingford, Connecticut. This is a full afternoon, and in addition to my presentation, my son, naturopathic physician, Dr. Adam Breiner, as well as naturopathic physician, Dr. Bronner Handwerger will also be speaking. The public and NFA members are invited. See below for lecture details and further information.

I had originally planned to present an entirely different focus for this month's ezine; however, my emotions got the best of me and I changed the topic at the last minute. Here's a candid look into some of the dental scenarios I see on a daily basis.

The information presented is for educational purposes only. You should consult a qualified dentist or health practitioner for diagnosis and treatment.

Feature Article

Beware of Needless Dentistry

I get very upset when I see too much dentistry being done or recommended when a more conservative approach would better serve the patient.

Below are just a few of the cases I've seen in the last few weeks.

Patient #1 - Child - Recommended Treatment - Root Canals, Crowns for 9 Year-Old Child

On a Saturday afternoon I got an emergency call. The mother was frantic. She was told that her 9 year old son needed two root canals, an extraction, a number of fillings and some crowns. The cost was going to be over two thousand dollars. She wanted my opinion. I told her to call the office Monday morning. Monday afternoon I saw her son. He actually had been a previous patient but the mother went elsewhere because she thought my fees were too high! Upon examination I agreed that one extraction would be necessary. A few teeth did have decay that could be fixed with composite fillings. There was absolutely no reason to do any root canals or crowns.

Patient #2 - Small Fillings - Recommended Treatment - Replace With Crowns

The husband of a patient came in at his wife's urging. It seems he had been told to crown his two lower right molars. These teeth had small mercury fillings on just the chewing surface of the teeth, which could easily be replaced with small composite bonded restorations. There was no reason to mutilate these teeth for crowns.

Patient #3 - Headaches - Recommended Treatment - Orthodontics & Crowns

A new patient came in because of terrible head pain which she had for several years. All possible medical conditions had been ruled out and she had been diagnosed with temporomandibular joint problems (TMJ) by several dentists. In fact she had been treated by one of the top TMJ specialists in the country for over a year. His treatment did not relieve the pain, yet he told her to have orthodontics and crown all her posterior teeth! If treatment with an appliance to reposition her lower jaw did not help, why would orthodontics and crowns to reposition the jaw give a different result? It made no sense. A few injections into her wisdom teeth area did take the pain away, indicating that cavitations(see November 2003 and December 2003 e-zine issues - e-mail your request for these issues ) were the underlying problem.

Patient #4 - Shallow Periodontal Pockets -Recommended Treatment - Extensive Periodontal Treatment

A thirty-three year-old woman came in for a second opinion. It seems she was told to have a series of several visits with the hygienist because she had periodontal disease. Upon examination I found a few areas with some very shallow pockets, but in general, her gums looked to be in good health. Taking a plaque sample from the shallow pockets and looking at it under a microscope confirmed that her gums were healthy, and she just needed her regular hygiene maintenance visit.

Patient #5 - Esthetics - Recommended Treatment - Orthodontics, Bridge

While doing a new adult patient exam, I noticed a baby tooth where the upper right permanent eye tooth should be. It was also not in alignment with the other teeth. The patient related that she was told by her previous dentist to extract the baby tooth, undergo 18-24 months of braces and then have a bridge made to replace the missing tooth. I asked if the esthetics of the malpositioned baby tooth was a problem for her. She said, "No, not at all." I said, "So why go through all that treatment?" "That's the way I feel, but the dentist was pressuring me to have the treatment."

Patient #6 - Old Crown - Recommended Treatment - Prophylatic Root Canal

When her old crown had fallen off, a patient of mine decided to go to a dentist closer to home; she lives over an hour from my office. Told to have a new crown and a root canal, she came in for my opinion. Upon examination I found that the tooth was vital and in good health except for some decay. It seems the dentist wanted to prophylactically do a root canal. Removal of the decay and a new crown took care of the problem.

Three Contributing Factors

These are just some of the patients I have seen over the past month. Why does this sort of thing happen? In my opinion it is probably due to several factors: 1) when a dentist accepts insurance as the sole payment; it usually costs the dentist money to do a filling. The only procedures covered by insurance companies that pay enough to generate some profit are crowns and root canals; 2) seminars or courses that tout "How to do more root canals in less time" or a "Crown prep in "90 seconds", or "Hygiene as the area for greatest profit"; 3) Dentists not knowing about Whole-Body Dentistry, hence not realizing the potential systemic effects of root canals, mercury fillings, etc.

Unfortunately, I see over-treatment or unnecessary new treatment recommended far too often.

Further Thoughts

Knowing the possible systemic effects of root canals, I certainly do not want to prophylactically recommend one. To do a crown, one has to mutilate the tooth which increases the odds that the tooth could die in the future, thus necessitating a root canal or extraction. Thus, I only do a crown when there is absolutely no other choice. There are much more conservative options because of the bonding materials available today.

There are seminars touting 4-5 visits with the hygienist as a way to make the hygiene "department" the ultimate profit center. There are times when a patient does need such intensive treatment. Unfortunately, I have seen a number of patients scheduled for this type of treatment who do not need it, as illustrated above. Without the use of a microscope, I feel a dentist or hygienist is working in the dark, but more on this in a future e-zine.

I am sorry if I seem down on dentists or dentistry, I am not. Most dentist are very ethical. What I am concerned about is the lack of knowledge of the systemic effects of dentistry. This may lead to erroneous treatment recommendations that in the long run may be dangerous to a patient's health.

My Personal "Whole-Body" Point of View

Personally, I want to do the least amount of dentistry compatible with good function, esthetics, and overall health in conjunction with what the patient wants. From a Whole-Body point of view, dentistry can be dangerous. I caution everyone to be careful with dental treatment that may seem "over-the-top". Get a second opinion if that little voice inside of you says, "Something doesn't seem right."

© 2004, Mark A. Breiner, DDS

Don't Miss The Upcoming Afternoon Talk at the Natural Food Association (NFA) gathering which will be held on Sunday, April 4th. The NFA, a 50 year old educational organization, has members across the US and 32 countries worldwide, and is the nation's oldest and largest non-profit natural health consumer's group. The Connecticut Chapter traditionally hosts programs that inform and educate their members and the public about topics that include preventive medicine, nutrition, and natural alternative therapies. The guest health speakers featured at April's meeting are - Mark A. Breiner, DDS, Adam Breiner, ND and Bronner Handwerger, ND.

Dr. Mark Breiner's presentation will address, "Whole Body Dentistry®: Still sick? The dental component to whole-body health and wellness" - Wonder why you can't get better despite natural and conventional treatment? Learn how dentistry can impact on your whole-body health.

Dr. Adam Breiner will lecture on "Hyperbaric Oxygen Therapy: Its Use in Brain Injuries, Lyme Disease, MS and more". Learn how oxygen under pressure can bring health to stubborn conditions.

Dr. Bronner Handwerger will discuss "Modifiable Risk Factors For Staying Young"- Learn how state-of-the-art genetic and functional testing can reveal risk factors that can be changed to promote longevity.

With two naturopathic physicians and our "whole-body" dental authority, this will be an "information packed" afternoon not to-be-missed and best of all...admission is free. The NFA meeting is scheduled for Sunday April, 4th at the Wallingford Elk Hall, 148 South Main Street (behind the Red Cross office), in Wallingford, CT. Speakers will begin at approximately 2:15p.m. (be sure to set your clocks one hour ahead for daylight savings time). You may call Jim Mascia at 203-269-9091 for further information. Jim can provide directions and other details about pre-meeting activities that are available.

About Dr. Breiner:

Whole Body News Update expert, Mark A. Breiner, DDS, FAGD, FIAOMT, is a leading authority and pioneer in the field of holistic dentistry. He is the author of the popular consumer education book, Whole-Body Dentistry, a guide to the "dental connection" to whole-body wellness. With more than 30 years experience, Dr. Breiner has helped patients from across the US and other countries attain a higher overall level of dental health and general well-being. Dr. Breiner is currently serving as President of The International Academy of Oral Medicine and Toxicology.

"Whole-Body Dentistry is more than whether your teeth are healthy; it's whether you are healthy!" - Dr. Robert C. Atkins, M.D.

Attention Meeting Planners:

Need an expert to talk about dentistry and whole-body health for your group or organization? Dr. Breiner, a popular speaker, addresses both lay and professional audiences. Call 203.371.0300 or send an e-mail inquiry to DoctorBreiner@wholebodydentistry.com

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Whole Body News Update is your free monthly e-zine to stay up-to-date on many dental health issues as well as other important alternative health topics; featuring articles, interviews with experts, actual patient stories, Q&A on holistic health topics, with emphasis on the "Dental-Whole-Body Health Connection". This e-zine is designed to help you become a knowledgeable participant in your health care choices.

If you would like to offer feedback or suggestions for future topics for this e-zine please e-mail Dr. Breiner at DoctorBreiner@wholebodydentistry.com
To learn more about Dr. Breiner and Whole-Body Dentistry, visit www.wholebodydentistry.com