Introduction
The Book

"The doctor of the future will give no medicine, but will interest his patients in the care of the human frame, in diet and in the cause and prevention of disease." - Thomas A. Edison

Peter Varley BDSc, FDSRCS, DFHom(Dent.).

“The doctor of the future will give no medicine, but will interest his patients in the care of the human frame, in diet and in the cause and prevention of disease.” —Thomas A Edison.

Dentistry has traditionally been an orthodox profession. Yet unwittingly dentists have introduced into the very heart of their structure the one holistic mechanism that escapes most health professions - the six monthly check-up. This unique opportunity to view people on a regular basis when healthy would be the holistic practitioner’s dream. Most dentists waste the opportunity by looking only for disease.

Disease becomes apparent to the practitioner through the presence of signs and symptoms. When we adopt a holistic philosophy we have the means to reverse disease before the symptoms manifest themselves and to fine-tune the body so that health is maintained. Health is more than just the absence of disease. Health is state of homeostasis; a balance of the spiritual, emotional, mental and physical aspects of the body. The holistic dentist, while recording the dental health of each patient, will also look at nutrition, check muscle and joint function, assess stress and the effect of toxic materials on the immune system. He will be listening to the patient, thinking laterally and looking to other complementary practitioners for support. He will be the regular pivot to support the patient’s health before disease manifests itself. He will be looking at the patient as a whole; not just their teeth.

Holistic practice equates with good practice. By their very nature complementary therapies require a thorough patient history, a detailed examination and an ability to listen. By providing these three criteria we are more than half way to practising a holistic approach. The good orthodox dentist may follow these criteria, but stops short of using complementary therapies. He does a thorough TMJ examination but fails to understand that the upper half of the joint is moving and that the muscles are attached to rhythmically moving bones. He fails to understand that the bones may be locked in an unbalanced position and if locked since childhood, growth may be compromised. He does not have the knowledge to treat these imbalances nor the infrastructure to refer to the appropriate therapists. The purpose of this book is to provide some of that knowledge to dentists as well as stimulating the complementary practitioner to acquire an understanding of dentistry and to encourage both to work together.

To aquire knowledge takes commitment. The holistic dentist has usually spent countless hours in postgraduate education, many days away from the practice and frequent weekends away from the family. This creates financial and emotional stress. Once the knowledge is there and the systems are in place he is rewarded with job satisfaction and the ability to provide a truly comprehensive treatment. The healthy, appreciative, reconstituted patient is the ultimate reward.

The use of complementary remedies is rising faster in Britain than in any other European country. In the UK a quarter of the population is using at least one form of complementary medicine at any given time.[1],[2] The NHS is spending £1 million a year on complementary practitioners. Nearly half of GMP’s are estimated to have referred patients for alternative treatments. The first full-time NHS aromatherapist was recently appointed in Sheffield. Private medical insurers have responded to the rising demand. BUPA includes cover for acupuncture, chiropractic, homoeopathy and osteopathy in all of its policies, provided referral is through a consultant. The economic impact of complementary medicine is enormous, with $12 billion being spent every year in the USA.[3] Now is the time for dentists to examine complementary medicine, embrace the concepts and integrate its disciplines into their profession.

The appeal of complementary therapies is related to the amount of time available, the use of touch, a non-invasive approach and a conviction in the methods used.[4] The arguments against complementary medicine are that it is unscientific, a placebo and a fringe activity. The scientific foundations of much in complementary medicine have not yet been substantiated, but research is changing this.[5],[6] No successful treatment can in itself be unscientific. If it does work it is the job of science to discover why, which may involve rearranging some cherished dogmas.[7] In historical terms the application of scientific method to medicine is relatively young and not all orthodox disciplines have a sound scientific base. It has been estimated that about 85% of orthodox medical therapies are not supported by solid scientific evidence.[8]

When complementary medicine lacks a sound scientific basis its followers tend to substitute a philosophy. Philosophies, like religions, cannot be proven right or wrong and are usually unscientific by nature. However one cannot say that a remedy associated with a philosophy is worthless. The history of medicine abounds with examples of effective therapies that were once used on the basis of a totally false rationale. Eventually the concepts are corrected and the effective therapy becomes part of established treatment.[9]

The success of complementary medicine can be puzzling to mainstream doctors. Its popularity is often said to be due to a placebo effect.[10] However compared to a placebo, some complementary remedies are very active, even to the extent that side effects may be a problem.[11],[12] In trials comparing remedy and placebo we must compare the response patterns over a given period.[13] We must assess how long a response lasts. Rabikin et al[14] suggest that patients relapse after ten days on placebo. Complementary therapies, if effective, will continue their effect over a longer term. Although complementary therapies may use the placebo effect to some extent, they do not carry a monopoly on this response. We cannot exclude orthodox treatments from using the placebo effect as well. Empathy and comfort can also be provided by mainstream doctors.

Since The Medical Act 1512 and the The Herbalists’ Charter 1542 orthodox and complementary medicine have worked side by side. Even today the public have a choice between the medical doctor or the lay practitioner. This choice has allowed patients to attend to their medical needs without ever seeing a doctor. Yet when it comes to their dental needs the public have no choice. The dental profession has organised itself so that only they can practise dentistry. This has led to a certain degree of complacency by many dentists. It is not unusual for patients to report that their dentist routinely prescribes antibiotics, uses only mercury fillings and insists on taking x-rays. There are many members of the public to whom this is unacceptable. They feel trapped and express it through non-attendance or by seeking out one of the few holistic dentists available.

The development of complementary medicine is changing this situation. The Council for Complementary and Alternative Medicine has celebrated its tenth anniversary, having been formed in 1986 in direct response to the British Medical Association’s highly critical review of complementary medicine.[15] Unlike five years ago, the question is no longer whether complementary medicine will be made available within mainstream health care; it has largely become a question of how such integration takes place. Although complementary therapies such as osteopathy and acupuncture are widely practised within the National Health Service, how these therapies are to be linked into the NHS on a national level is not yet clear. The Department of Health has agreed funding for pilot studies to assess how osteopathy and chiropractic should be made available on the NHS.

With the acceptance of complementary philosophy in mainstream medicine it is hoped that dentists will also embrace it. The dental profession must continue to question established thinking. Fundamental concepts in science, including medicine, have been changing. Physicists have been aware of it for some time, however those in the orthodox medical field have hardly started to take on board the implications of these changes. We are in the midst of a shift from Newtonian classical physics to Einstein’s quantum energy. The medical model is still disease and substance orientated, rather than health and energy related. Complementary medicine is based on the quantum perspective that everything, including our bodies, is energy. Homoeopathy works at this level. Until orthodox medicine catches up with physics and considers the effects of energy meridians on the mental, emotional and physical elements of the human energy system, it will not be able to obtain or understand total health for its patients.[16]

It took the Flat Earth Society some time to realise and accept that Columbus did not actually fall off the end of the world; he was simply somewhere else and temporarily out of sight.[17] The edge of one persons world is no more than the beginning of another’s. Our view tends to be entirely different depending on where we happen to be at a given moment in time. We hope that this book will contribute a little to changing that view.

References

  1. Fisher P, Ward A. Complementary Medicine in Europe. Br Med J 1194; 309: 107-111.
  2. A 1989 survey carried out for The Times by MORI revealed that 27% of the respondents had used non-orthodox medicine. This is a figure broadly in line with a 1991 Consumers Association survey which showed 25% of their members used complementary therapies.
  3. Eisenberg D M, Kessler R C, Foster C et al. Unconventional Medicine in the United States. N Eng J Med 1993; 328: 246-252.
  4. Brewin T. Fraternizing with fringe medicine. Br J Gen Pract 1994; 44: 243-244.
  5. Ernst E. Is Homoeopathy a placebo? Br J Clin Pharmacol 1990; 30: 173-174.
  6. Shekelle P G, Adams A H, Chassin M R et al. Spinal Manipulations for low back pain. Ann Intern Med 1992; 117: 590-598.
  7. Earl Baldwin of Bewdley. Letters to the Editor. The Times 11 April, 1996.
  8. Smith R. Where is the wisdom? Br Med J 1991; 303: 798-799.
  9. Goodwin J S, Goodwin J M. The tomato effect. Rejection of highly efficacious therapies. J Am Med Assoc 1984; 251: 2387-2390.
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  11. Soragna D, Montalbetti L, Bo P et al. Chiropractic Complications. Acta Neurol 1993; 15: 145-150.
  12. D’Arcy P F. Adverse Drug Reactions and interactions with herbal medicines. Adv Drug React Toxicol Rev 1993; 12: 147-162.
  13. Quitkin F M, Rabkin J D, Markowitz M J et al. Use of pattern analysis to identify true drug response. Arch Gen Psychiatry 1987; 44: 259-264.
  14. Rabkin J G, McGrath P J, Stewart J W et al. The follow up of patients who improved during placebo washout. J Clin Psychopharmacol 1986; 6: 274-278.
  15. BMA Report. Alternative Therapies. London: BMA, Chameleon Press, 1986.
  16. Beacon J. Electromagnetic Stress in the home. Positive Health 1996; 16: 34-36.
  17. Lewis K. Editorial. Dental Practice 1996; 34(16): 2.
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