In recent years, the medical community has made significant strides in understanding the intricate connections between oral health and overall systemic health. However, as we delve deeper into this crucial relationship, it's becoming increasingly clear that we've only scratched the surface. While the focus has primarily been on the effects of periodontal disease and tooth decay, there's an elephant in the room that demands our attention: the potential systemic impact of poor quality or outdated dentistry.
The Hidden Dangers of Outdated Dentistry
What’s often overlooked is the quality and longevity of dental work itself.
Dental restorations, such as fillings, crowns, and implants, are many times made with the best intentions to last a lifetime but unfortunately are not able or even designed to last forever. Over time, these materials can degrade, leak, or fail, potentially releasing toxins into the surrounding tissues and bone marrow. Given that teeth are directly connected to the bone, this creates a direct pathway for harmful substances to enter the bloodstream and affect various bodily systems. Moreover, failing dental work can cause low-grade, chronic inflammation – a condition we now know can have far-reaching consequences throughout the body. This inflammation can potentially seep into the neural network via the trigeminal nerve, which innervates the lower teeth and jaw. The implications of this are profound, as chronic inflammation has been linked to a myriad of health issues, including cardiovascular disease, diabetes, and even certain types of cancer. An increasing number of patients are also exhibiting signs of metal hypersensitivities and intolerance due to residual metal alloys in crowns and bridges. Metal galvanization can lead to disruptive physiological reactions in sensitive individuals. Additionally, many patients are potentially impacted by poor diagnostic practices since not all dentists utilize advanced technologies like 3D CBCT due to cost considerations. Furthermore, a prevailing attitude among some practitioners may lead them to overlook complications associated with their work unless they manifest as clear mechanical or aesthetic failures. Emphasizing immunology in our discussions about dental materials and their systemic effects is crucial for modern dentistry.
Panoramic of a patient undergoing chemotherapy. Neither the patient or medical team knew about the infected teeth.
The Need for “Revision Dentistry”
In orthopedics, it’s standard practice to perform revision surgeries on joint replacements after 15-20 years. This process involves removing the old components and replacing them with newer, more biocompatible materials. However, in dentistry, we lack a similar standardized approach to revisiting and updating past dental work. I propose that it’s time to introduce the concept of “revision dentistry” into our field. This practice would involve regularly assessing and, when necessary, updating or replacing older dental work to ensure optimal oral and systemic health. Just as we wouldn’t expect a hip replacement from the 1980s to function optimally today, we shouldn’t assume that dental work from decades past is still serving patients’ best interests.
The Challenges of Implementation
Implementing a widespread practice of revision dentistry faces several challenges:
- Awareness: Many patients and even some healthcare providers are unaware of the potential long-term risks associated with outdated dental work.
- Diagnostics: We need improved diagnostic tools to accurately assess the condition and potential systemic impact of existing dental work.
- Cost: Revising dental work can be expensive, and many insurance plans may not cover these procedures if they’re deemed “cosmetic” rather than medically necessary.
- Training: Dentists will need additional training to properly evaluate and revise older dental work using the latest techniques and materials.
- Research: More studies are needed to definitively link specific types of outdated dental work to systemic health issues.
Moving Forward: A Call to Action
As dental and medical professionals, we have a responsibility to address this overlooked aspect of patient care. Here are some steps we can take:
- Increase awareness: Educate patients, general practitioners, and specialists about the potential systemic effects of outdated dental work.
- Improve diagnostics: Develop and implement advanced diagnostic tools to assess the condition and potential toxicity of existing dental work.
- Advocate for coverage: Work with insurance providers to recognize the medical necessity of revision dentistry in appropriate cases.
- Enhance training: Incorporate revision dentistry techniques into continuing education programs for dental professionals.
- Conduct research: Initiate and support studies that explore the long-term systemic effects of various dental materials and techniques.
- Collaborate across disciplines: Foster stronger relationships between dentists, physicians, and other healthcare providers to ensure a holistic approach to patient care.
Conclusion: A New Frontier in Oral-Systemic Health
The concept of revision dentistry represents a new frontier in our understanding of oral-systemic health connections. By acknowledging and addressing the potential long-term impacts of outdated dental work, we can take a significant step forward in improving overall patient health. As we continue to unravel the complex relationships between oral health and systemic well-being, it’s crucial that we look beyond the obvious and consider all potential factors. The silent epidemic of what I call “toxic dentistry” may be contributing to a wide range of health issues, and it’s our responsibility as healthcare professionals to bring this to light. By implementing revision dentistry practices, improving diagnostics, and fostering greater collaboration between dental and medical professionals, we can work towards a future where oral health truly supports and enhances overall systemic health. The mouth is indeed the gateway to the body, and it’s time we ensure that gateway is as safe and health-promoting as possible.
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*Originally published here.
