What is a Holistic Dentist?

Advertising for ‘holistic’ dentists has proliferated over the years but there is significant confusion about what the term actually means.

It’s important to look at this misunderstood catchphrase and explore whether all dentists are holistic dentists.

First of all, I’ve always felt that being a good dentist is being a ‘holistic’ dentist.

I actually looked up a definition as it intrigued me what ‘ holistic ‘ dentistry was;

ho·lis·tic
[ hō lístik ]
1. analyzing whole system of beliefs: characterized by the view that a whole system of beliefs must be analyzed rather than simply its individual components
2. considering all factors when treating illness: taking into account all of somebody’s physical, mental, and social conditions in the treatment of illness.

Therefore, holistic practitioners diagnose the whole system rather than simply it’s individual components. Dentists shouldn’t just be about the teeth but rather the whole oral environment and what other issues are patients having that are causing oral problems. They also consider what signs and symptoms they have orally which indicate there may be a more significant medical issue that needs addressing. These include:

1. How are the teeth.

This is the basic dentistry 101. Are there any decaying (teeth with holes), fracturing or fractured teeth. What is the wear of the teeth like, does the patient have good function, do you have enough to function (chew) successfully. This is dentistry 101, the basics.

2. Periodontal (gum) conditions.

What is the patients oral hygiene standard? Do they need education about how to improve their daily oral hygiene rituals so as to improve oral health in general?

3. Doing oral cancer checks.

Are there any signs of tissue change, lumps, bumps, red or white areas of concern? With the increase of research connecting the Human Papilloma Virus not only to cervical and anal cancer, but also to oral and throat cancer, it has become even more important for the dentist to check oral tissues. A biopsy or referral for biopsies can be completed to rule out HPV related tissue growths of the mouth, as this could lead to early intervention of a major life threatening issue. Are there any changes to the tissues that need biopsy, monitoring, or on referring to an oral medicine specialist. What is the patient’s smoking and drinking history etc.

4. Asking questions about respiratory issues in case you have sleep apnoea.

If you grind your teeth, is this related to tension or sleep apnoea? Should you seek a specialist opinion and have a sleep study carried out? Do you need a snoring appliance, CPAP machine or just a grinding guard? Do you have Temporo-Mandibular Joint disorder or are you just stressed and clenching and grinding your teeth?

5. Checking size and shape of throat, size of tonsils if present.

The size and shape of your throat and amount of soft tissue present plays a role in the possibility of having sleep apnoea.

6. Are there any cosmetic concerns.

Are there any gaps, crowding, discoloured or broken teeth the patient wants corrected.

7. Do you need or want orthodontics.

8. What are your overall treatment options for any type of dental work you need.

9. Medications and procedures.

Are you on any medications or what medical conditions do you have? What medical procedures are you going to have and how are these issues going to impact on the oral environment, should we be doing some preplanning, some education, speaking with your specialist teams, (especially with radiotherapy of the head and neck and chemotherapy treatment). Is the patient suffering from a condition that makes them immuno-compromised.

With our aging population we also have an increasingly medicated population as well. A lot of medications affect the oral environment and the biggest issue is hyposalivation (reduced saliva flow, dry mouth). This is generally easily managed and the effects can be easily controlled and the oral environment can be made more comfortable for patients, but your dentist needs to be aware of these issues and think about them.

So let’s go back to the beginning.