Holistic Dentistry – Dr. Vinograd’s Latest Lecture at The Gerson Institute

Daniel Vinograd

We’re going to learn a little bit more about the dental side with Dr. Vinograd and his assistant Dr. Christiansen. I think I said that right. Dr. Vinograd is a holistic dentist in San Diego and has been practicing since 1978. He founded a nonprofit to bring holistic dentistry to underserved populations in the Americas and received a bilingual secondary education teaching in 1992 from San Diego State University. He’s also been an associate instructor at the University of Southern California, and we are glad to have his knowledge with us here today. Please welcome Dr. Daniel Vinograd and his assistant Dr. Christiansen.

Daniel Vinograd: Can you hear me okay? Yeah. Okay. Well, hi, and I’m so glad to be with you all here today. I know a beautiful day like this, you could be anywhere, right? At the beach, but you’re here, so I want to commend you in really addressing taking care of your health, and more importantly, I commend you for actually taking responsibility for your health, right, which is not always the same thing.

So we’re going to talk to you about biologically aware dentistry. What does that mean, right? And the reason that I actually titled this lecture biologically aware dentistry is because as dentists, we are always taught to do technically very proficient procedures. And I have to say, since the advent of the industrial revolution, you know, like many other fields, the field of medicine and dentistry became very specialized. And so you go see a specialist for the knee and another specialist for the shoulder, so all of a sudden, everybody’s specializing, and that happened to us too in dentistry where we were actually becoming specialists in teeth and gums. And even though most dentists have a good working knowledge of physiology, anatomy, et cetera, you know, those are things that are studied a little bit, by the way. You only really bring into the picture the things that are applicable to your practice. The anatomy of the jaw, et cetera, et cetera.

But we have become so focused on the teeth and the gums that we’ve become a little bit more like engineers of the mouth, technical doctors, rather than really healers. And so biologically aware dentistry is taking a step back and saying, “Wait a second.” You know the song, right, the elbow is connected to the shoulder bone and the shoulder bone connects to the – whatever that goes. So it’s all connected, and the more that we practice dentistry, biological dentistry, the more we realize that a tooth can affect your liver and vice versa.

At first, because of the way we’re trained, that really didn’t resonate. But the more we’ve been practicing and the more we see the direct correlation between the mouth and the rest of the body, the more we believe in it.

Again, welcome to San Diego. How many people are from out of San Diego, from out of town? Wow, so, terrific. Terrific. You guys are really dedicated to your health, and again, you know, you could be visiting beautiful San Diego, and instead you’re here with me, so I thank you for that.

Now, whom do you trust? That is really an important question, because I still remember, you know, thirty years ago, I wanted to research what were the best schools for my kids, what are the best areas and so forth, and I had to pay an obscene amount of money for a company to research that for me. Gosh, we’ve really moved forward, and now we have more information than we know what to do with, right? I mean, the access that we have to the internet has opened up an immense amount of knowledge and information.

Well, having said that, is all the information that we get trustworthy? I mean, we get a lot of information. How do we know what to trust and who to trust, right? I think it’s a good question, because especially for you, all of you that are taking decisions in your lives, are here, are definitely proactive, right, when it comes to your health, how do you differentiate what’s good information and what’s not such good information?

Okay, so how do we get reliable information? And I think you always have to go back to source and motive. What is the source of this information, and what is the motive behind people that are giving you this information? I think if you always keep that in mind, you will uncover a lot of good information, and also some information that may not be quite as reliable.

And then once you have the right information, then you need to trust yourself. Why should be trust ourselves? Because we’re incredible pieces of machinery, of nature, creation, where every cell in our body has a billion and a half years of intelligence. If you really think about it, it’s mind-blowing, isn’t it? Every cell of our body, whether you’re a religious person or not, religious, you say every cell of my body is God-given and it has God knowledge. If you’re not religious, you could talk about, you know, the evolution, and obviously we aren’t going to get into that big discussion, that’s much bigger than this, but it doesn’t really matter. What’s important to know is that we have tremendous values and resources right here. We don’t have to go anywhere else often, and that once we have that really good information, we can then connect our – like the Chinese, we talk about heart and mind being one organ. We trust ourselves.

So can we talk a little bit about corporate America, or, you know, international corporations? Can we trust? I think people, at time, say, you know, [inaudible] doctors are bad, corporate doctors are good. Corporations are bad, you know, non-profits are good. That’s not really always true. There are corporations that are doing a lot of good out there, but in general, what is really the responsibility of a corporation, at least in the United States? There’s a great documentary that actually talks about the beginning of the corporations in the United States and how they became – they were giving a lot of benefits of the individuals, or the rights of the individuals, and so they started exploiting that, and they started growing, and under the protection of the government, they became very dominant. Today, corporations are more dominant than governments, even. Do you agree? No? Maybe. Okay.

But it doesn’t matter. They are dominant and they are strong, right? So mainly the responsibility of a corporation is to its shareholders. In other words, whatever’s good for the shareholders is what the corporation’s guiding light is. So can we really trust corporations to look out for us? Again, I’m not saying that all corporations are bad or that all corporations don’t speak truthfully. There’s a lot of everything, but we cannot rely on the fact that we’re going to get good information and that corporations are going to look out for our well-being.

Government agencies. Again, you know, I speak boldly here. You know, lately, especially in the United States, the Supreme Court has actually ruled that special interests can really contribute inordinate, obscene amounts of money to campaigns of candidates, so no matter what your political inclination, you have to understand that in order to get elected today, you’re beholden to a lot of special interests. So can we rely on the government? Again, sometimes yes, sometimes no. Is every aspect of the government sold out? No. Is every aspect of the government unreliable? No. But can we rely on the government as we maybe did many, many years ago to protect our interests? I would say we really have to consider that.

And then again, health professionals. When it comes to your health, you want health advice, right? So, you know, what is the health professional? Are they working for a corporation? Are they in a clinical environment? What is their priority? What is their training? What is their focus? Do they really understand what you want?

I get so many patients all the time who come to the office and say, “My God, finally I feel like I don’t have to be fighting my dentist. You know, I keep on telling my dentist I don’t want mercury amalgams in my mouth, and he says they’re not a problem. And I keep on asking dentists what kind of materials they’re using, and they say I’m too paranoid.” And so finally they come to a place where they don’t have to be fighting this. So you need somebody that’s going to be aligned with your core values, with your way of thinking, that can support your process, and that you’re not going to have to be really pushing to get the things that you believe in as acceptable.

Then we talk about the internet, and this is really an important source of information for us, right? I think most of us are good researchers, I would bet, and we go to the internet often. And again, in the internet, you have really good information, and really bad information as well. So how do we really separate? I get so many people coming over and saying, “You know what, Doc? I hear that metal is bad for you.” “How do you know?” “I read it on the internet.” Or, “All root canals are toxic.” “How do you know?” “I read it in the internet.” So when you said I read it in the internet, it’s almost like you are already given some kind of dispensation to call this the truth.

And again, you know, you have to understand where this information is coming from. Case in point, we’re going to talk a little bit about Dr. Weston Price, and I think many of you are probably familiar with Dr. Price, right? He did some wonderful work, and we’ll come back to that.

Now, why do we need to take responsibility of our health? And I go back to, you know, when I was in school and I had a good friend at UCLA, dental materials department, and they were actually studying all the dental materials, and he would say, “We found this great material, it’s got this much strength, this much compression strength, this much elasticity, so forth and so on, and at the end of the conversation, I would say, “You guys are forgetting you’re putting this in people’s mouths.”

And so the dental profession, unfortunately, has always been looking at dental materials in a very engineering like, without engineering like mindset. They’re really not thinking about the fact, as we spoke before, you know, we’ve actually become doctors from here to here, not thinking about that those materials are going to be in people’s mouths and people’s bodies. How is that going to affect them?

Dental amalgams, we’re going to talk extensively about dental amalgams. They’re fifty percent mercury. Formocresol. Who’s familiar with formocresol? It’s basically formaldehyde, and it’s used on children’s root canals. So, you know, I think this is, you know, coming close to criminal to use something like that on a child. And so our hope today is that we can provide you with good information so that you can actually make a good decision for yourselves.

So let’s talk a little bit about mercury amalgams and the history of it. In the early 1800s, it was brought in by a couple of Frenchmen, and by 1844, most of the great dentists in that time were in the east coast, and a good number of, almost 50 percent of them  were actually lauding amalgam as the next big thing and using it. There was a group, though, called the American Society of Dental Surgeons who actually began to think outside of the box, and this is what we do all the time, is we start questioning. We can’t just accept things the way they are passed on to us, and they started questioning, well, is it really smart to take a material that is fifty percent mercury and fifty percent metal and put it in people’s mouths? I mean, look at when that happened, right?

We’re not talking recently, we’re talking way, way back there, people beginning to have this awareness and saying, “Hey, I understand amalgam is very strong, and people love it because you put it in there and they feel it’s going to last forever,” right? But if you were going to belong to our group, and they were actually quite prestigious, you have to sign a contract promising that you will not use amalgam, mercury amalgams.

Unfortunately, this group actually disbanded. In its place in 1859, the amalgam, the American amalgam [inaudible] association became the foundation of today’s American Dental Association. Now, we talk again, you know, this is the third most toxic element known to humans, and it’s not me saying it, it’s the US government saying it. This is the third most toxic element that you can come across. Now, if this is the case, why are we putting this in people’s mouths? A lot of my colleagues thirty years ago kept on saying, “Daniel, you’re a little cuckoo, you know? You’re going over the edge here. You’re thinking too much.”

And so I started saying, “I think that you guys need to reconsider not using this.” I mean, if I tell you mercury’s the third most toxic material, would you put that on your child’s mouth? No, but it’s, you know, it’s bounded, and all this, you know, party line that we’re reciting. I said, “It doesn’t matter, you know? It may be bounded it, may not. What if in ten years you find that it is not bounded?” And this is mostly what I got.

But you don’t have to go too far. If you go to the manufacturers and just read the information, the warnings, really, you will be surprised. You will be surprised as to all the warnings they have on the amalgam. How it affects the nervous system, how it affects different organs of the body, and you know, if you ever have some time and want to look at that, I think you’re going to be really quite surprised.

I’m going to turn it over for a few minutes to my associate, Dr. Christiansen, and she’s going to talk a little bit about the amalgam.

Bree Ann Christiansen: I’m going to take the remote. Thank you. So I always say that my parents played a really funny game on me by giving me a really long first name to match my very long last name. So my last name’s actually Christiansen, not Christiansen, but I’m happy to let you all call me Dr. C or Dr. Bree, whatever’s easier to say for you.

Just while we’re talking about the dangers of amalgam, I’d like to share something interesting. This week, the American Dental Association put out a newsletter, and on the front page cover, first article in that newsletter, it says that they’re trying to get amalgam separators legalized and mandated in dental offices. So what it would do is it would take everything that’s collected in the vacuum, separate the amalgam out so it’s not released into our water, our sewer, to contaminate that water. But it’s okay to put it in your mouth. We just can’t have it in our water stream. So, interesting note.

I’m going to talk about what we see in our office every day. Who can tell me what looks wrong with that picture? Everything, right? These fillings are broken down, they’re over-contoured, they cause fractures in the teeth because over time, the metal corrodes. They expand as they corrode, and this is what causes these fractures. So the tooth left with this filling in for forever, I mean, anyone who has amalgam can say they’ve had them for 20 or 30 years. That tooth is really breaking down, and that filling on our right, I’d hate to see what the opposing tooth looks like, because that bite does not look good.

These are very toxic restorations. As he said, there are 50 percent mercury in the amalgam filling. Every time you bite or chew, eat, grind your teeth, and you hit this mercury, this amalgam, the mercury vapors are released into your body, and you can see where the filling meets the tooth, it’s very stained, it’s very leaky, they’re opened, and it’s very difficult to see on a radiograph how much decay is actually present because there’s so much scatter of the radiation.

So once we take these amalgam fillings out, what do we see? Tons of staining. Your tooth does not have a healthy response to these fillings at all. There’s a ton of staining, and in most cases, decay, but it’s up to us to decide which is healthy tooth structure and what’s decayed and not worth keeping.

You can also see on the picture on the right there’s a huge fracture going through the middle of the tooth. Once we find these fractures, we almost have to chase them to where they start, and also, every time you chew on this tooth with this fracture and the filling in it, it flexes, making that crack even deeper. And once this fracture goes into the nerve, then we have a whole slew of other problems.

So let’s get you back to a healthier state if this is what you have in your teeth. The best way to replace these amalgams is with porcelain onlays or porcelain crowns, but I’m going to let Dr. Vinograd talk more about the replacement methods.

Let’s talk about amalgam removal protocols. It’s very important if you have amalgam fillings to be aware yourself of what your dentist should be doing to remove these safely. There are a lot of different protocols you can find online, the Hal Huggins version. There are a lot of good ideas, and none of them are wrong. I’m just here to talk about what’s most important, okay?

So don’t take your eye off the eight ball. Did you want to see that slide again? Don’t take your eye off the eight ball. There’s one key feature in this protocol that is absolutely without a doubt extremely important: a sealed rubber dam. If you don’t have a sealed rubber dam, you have no protection from this mercury and amalgam that’s being removed from your tooth. This protects you from breathing in the vapors from your mouth, from any debris that’s released. This is by far, in a way, the most important thing for your dentist to do for you when they’re removing these amalgams.

The other basics, this is the best side to take a picture of if you’re going to take a picture of the slide. The basics are, obviously, a rubber dam first. Second, it’s advisable to go to an office where there’s good natural ventilation, windows, doors where they have opened so that the air in the office is constantly recycled. It’s very important that they use high powered suction to vacuum all of the fumes and debris released. Also, the rubber dam is there to catch it, but some of the particles just need to be caught in the rubber dam or the suction. It’s also advisable that your dentist has an electric hand piece that can be very precisely controlled with lots of water so that it doesn’t overheat the tooth and so that it properly [sections] the amalgam to remove.

In addition to these, we use the rubber dam, obviously. If anything you can get from what I’m telling you now, make sure they have a rubber dam. We use the rubber dam, we have good ventilation, our front door and back door creates a nice breeze. If you’ve noticed, usually in San Diego, there is a good breeze. Maybe not in here, but at our office for sure. We also use homeopathic tablets that are very good at helping your body with the detoxification process of getting these metals and mercury out of your body.

We also prefer to remove the amalgams in quadrants, so if we break your mouth into an upper two quadrants and lower two quadrants, if there are several mercury fillings in each of those quadrants, we want to get them all out at once so the amount of time you’re exposed to this being removed is minimal.

And now I’m going to turn it back over to Dr. Vinograd to go over how to replace these fillings and answer any other questions you may have. Thank you very much.

Daniel Vinograd: Okay, so you finally decide this is time to get all those amalgam fillings out. You’re convinced this is not the right thing for you, this is really not promoting good health. So the next question is – and I always try to go backwards, you know, when people, and we’ll talk about root canals and so forth, we always want to go backwards and say, “What is going to be the final result?”

So people kind of say take these amalgam fillings out, but we’re not looking at what are we going to replace them with, right? And I think we should look at that before we even decide to take the amalgams so you have good clarity as to what you want to do. And, you know, with this, with many other things, implants and so forth, many other things that dentistry has to offer, you have to decide what is right for you.

What is right for you may not be right for you, and what is right for you may not be right for you. Why is that? Because we all have different conditions, different challenges, health challenges, different anatomical situations that may or may not be manifesting. We’ll talk more about that as we go, but you need to understand that there’s basically two ways to actually – maybe three ways – to replace old mercury silver fillings.

First one is with composites. What is a composite? Is that filling material that is white that a lot of us have, that a lot of dentists use, but we have to have the awareness that basically what that is is a plastic with glass. That’s basically what a composite is. Plastic with glass. Most of them have BPAs, because it is a plastic, and some of them don’t have BPAs, but the ones that don’t have BPAs usually have small amount of fluoride in them.

So you have to understand that there are no absolutes and you have to make decisions that are right for you, but knowledge is what’s important here. If you have a very, very small amalgam and you replace that with a composite and you are basically healthy, that’s not quite as [inaudible] as if you have a very large amalgam, you have some health challenges, and you’re replacing that with plastic. Now you’re chewing on that plastic every day, right, and it’s not optimal.

Why doesn’t everybody just do porcelain? Mostly because of the cost. Porcelain is considerably more expensive. But if you would want to say “I want just the very best, I don’t want to compromise at all,” you would not be using composites in your mouth.

The next couple of ways that you can actually replace a filling, a mercury filling, it with either onlays, inlays, and crowns. Onlays and inlays are basically partial crowns. We basically just remove the silver filling, clean it, reshape it a little bit, and then replace that with a porcelain piece. What is the different between the porcelain and a composite? A little bit the same thing as eating out of a plastic plate that has been chemically put together or a porcelain plate that has been baked. Also, they’re very, very large restorations, sometimes full crowns have to be placed.

Now, as far as crowns, inlays, and bridges, you have different kinds of materials. When it comes to crowns, we have crowns that are – what was used for many, many years was just a metal fused to porcelain. That is really the old-school crown, where you always have a [coping], a metal [coping] underneath, and that metal could be non-precious, which I don’t recommend anyone has in their mouth, which includes nickel, chromium, and beryllium, precious, which is gold, platinum, or semi-precious, that’s what metal can go underneath, and then you bake the cake and put on the icing, which is the porcelain. So you’re really looking at nice, white teeth, but many of us still have the metal [copings] inside. In our office, we basically use no metal anymore in our crowns.

But even with metal crowns, a lot of people get a little confused, you know? There are zirconia crowns, there are aluminum oxide crowns, there are all kinds of crowns, and basically, what a no metal crown is usually a core of zirconia, and baked on top of it, you will have a layer of porcelain. That’s usually how a typical crown is made. Now, a lot of people say, “Well, I don’t want aluminum oxide in my mouth or zirconia oxide in my mouth,” but keep in mind that this is baked and this is stable. It’s like saying, you know, there’s aluminum oxide in a dish, a porcelain dish, but the dish has been stabilized and has been baked. So there’s a big difference between free-flowing aluminum and aluminum oxide, which is actually bound and baked.

Is it perfect? No. The most perfect thing is to keep your own teeth, right, and to keep them healthy, but this is probably as least invasive as you get, with the exception of the all zirconia crown. It’s called a Bruxzir crown. That’s a little bit like calling a copier a Xerox machine. So Bruxzir is the name of the company that actually brought this to market, but it’s really a pure zirconia crown, and that would be probably the purest kind of crown that you could have in your mouth.

The only disadvantage with this crown is that you could take this crown and put it down on a slab and hit it with a hammer and it won’t break. Why is that a disadvantage? Advantage because it’s going to last you a long time, but disadvantage also because it’s going to be a little bit hard on your chewing. So as I say, every case is different, and you have to select what is going to work for you.

Okay. The most important thing now is that after thirty years, I see more and more patients demanding a different kind of care from their dentists, and as with everything else, when the public demands something, people acquiesce, right? You bring products. So a lot of the people in the [inaudible] are beginning to follow the lead now.

Okay. Any questions up to now? Okay. As I was saying, we actually started with the industrial revolution and becoming really experts on teeth and gums, and we really stopped thinking that it’s all connected, but in reality, we’ve now found that particularly heart disease is intimately connected to gum disease. And often, I see patients that come to my office, not all the time, but very, very frequently, and they have a history of heart disease, and I can almost bet looking into their gums they’ve either had a past gum condition or present gum condition, periodontal condition.

So these are the initial stages of gum disease, when you see a little redness around your gums, inflammation, a little bleeding, and these are more advanced stages, where you’re beginning to develop a lot of gum pocketing, space between the gum and the tooth. And you can see the inflammation and then gum recession and so forth.

Now, what is happening here is in this side, we actually have very healthy gum. There’s really very little pocketing here. If you actually would take an instrument and probe in here, you would maybe get a millimeter or two millimeters of space, which is what we can actually access with our toothbrush, or we’re going to talk a little bit more about water picks and so forth.

Once you start having some gum disease, the bone [retreats], and you start have four, five, six millimeters of pocket depth. At that point, you’re beginning to have gum disease. You’re having billions of bacteria going into this area, unable to be touched right here by your floss or your brush. Your brush would probably just access to here. So they’re throwing a big party here, having a great time, and actually getting all that bacteria into your bloodstream. So gum disease is one of the biggest sources of systemic problems.

Funny enough, and wouldn’t you know it, they have found the same bacteria inside those pockets as in diseased heart and pancreas. Actually, a research that came out a couple of years ago that shows actually pancreatic cancer having some of the same bacteria that is found in the pockets in the gums.

So how do you address periodontal disease? First, like everything else, awareness. Second, traditional hygiene. This is still true. You’re brushing, you’re flossing. This is still true. And you want to make sure you’re actually brushing your gums, not only your teeth, and getting into those pockets and cleaning them out. I often, even though what we advocate is that you make your own toothpaste, sometimes we advocate patients that they start without even toothpaste, just water, so they can spend enough time cleaning those pockets, and then go into their toothpaste and brush their gums – I mean, their teeth.

Now, we also, you know, brought something for you to see here, and you can actually physically see what we’re talking about. We’ve developed this protocol where we actually started seeing ozone being very effective in controlling oral disease. Why? Most of the bacteria in the mouth that is pathogenic, they’re anaerobics. What does that mean, anaerobics? They hate air. They hate oxygen, right? And you see, there’s some research that comes out that we have about an equal amount of aerobics and anaerobics in our mouth on a healthy mouth. As soon as you start seeing some kind of gum disease or decay, advanced decay, they anaerobes go like this and the aerobes go like this, which indicates to us that really the anaerobes are the ones that are very prolific during gum disease.

Now, a lot of dentists lately have been using [inaudible], all the types of antibiotics. They actually put little antibiotic pellets in people’s gums to try to kill this bacteria, which is really, to my way of seeing it, a little bit ridiculous because you’re going to have that pellet for how long? And then afterwards, you still have the same physical problem. Bacteria come right back in, and all you did is desensitize your body to the antibiotic.

So if we could find something that could kill that bacteria that was not antibiotics, that would be great, right? Well, there it is. O3. Ozone. Ozone is wonderful because it’s natural. It’s oxygen. We love it, anaerobic not only hate it, but they die on contact usually. So one of the problems that we were having, if we go back to this, is that sure enough, if you swish with the ozone, you’re going to kill a lot of the surface bacteria, but how do we get to the bacteria down here? This is really the problematic bacteria, right? How do we get here?

So we needed a device to deliver that deeper into the gums, and we found that the water pick, a water irrigator, was the perfect instrument for that. So, many, many years ago, I had a patient that came, had seven, eight millimeter pockets full of pus. This really traditionally was a case to remove the teeth and look for an alternative way of restoring them. The teeth were basically gone. Some ability and lots of, lots of inflammation, bleeding, and pus. I said, you know, “I’m sorry Mrs. So and So, we really can’t save your teeth any longer. And this is a tremendous problem for you, it’s a source of infection, all kinds of [inaudible] infection here.”

So she said, “Doc, I really like you, but my teeth aren’t going anywhere.” So what do we do? So this is the first patient I tried this on, and she started using the water pick with the ozone religiously once a day. I saw her three months later. The nine millimeter pockets were down to about six or sevens. The sevens were down to about five or fours. Did everything disappear and suddenly, magically the pockets were gone? No. Because this is not what this would do. Some of the inflammation being reduced reduced the size of the pockets, but basically, she was actually keeping those pockets clean without bacteria. There was no pus. There was no inflammation. There was no bleeding. She still has her teeth, I would say six, seven years later.

Is this optimal? Not necessarily, because you’re swimming against the current here. But we started using this protocol with a lot of our patients, and I would say about eighty percent of the patients that before used to be referred for gum surgery are no longer going to the [inaudible] for gum surgery. This is also incredibly effective for kids that have a problem with decay, you know, anything that has to do with infectious disease. Great protocol.

If you’re going to actually use an ozone generator, which is now quite reasonable. It used to be thousands of dollars. They’re much more reasonable. Make sure you use it in a well-ventilated area, because ozone in the air is very irritating. You want a corona discharge, preferable a thousand milligrams, anywhere between 600 and a thousand milligrams of output, and you want a sealed box around the elements. I know there are people who make home versions of them. I would really not get one of those, because there could be a lot of leakage.

So just in case you’re interested, I actually had my son, there was a company I had, so this is a disclaimer, I had him actually get some ozonizers that are available, but it really doesn’t matter where you buy them, you know? It only matters that you have – that’s why I put the right kind of specifics here so that you can actually get your own ozonizer if you choose to go that way.

And as far as the water irrigation device, the water pick, I think most of you know we can get them just about anywhere. They’re fairly inexpensive, and it’s a great tool. Now, the first time that some of the patients use the water pick, it ends up all over the bathroom, you know? Water in the mirrors and everywhere, but after you try it for a few days, it has a learning curve, but most people get very comfortable with them.

Now, you want the water pick to have a separate container. There are some that are actually very narrow, has a very small amount of water capacity. You want one that has a large reservoir. And, you know, you don’t need a lot of bells and whistles. Just basically a container with a delivery unit.

And, you know, the other thing you can do for your health is make sure that you, every so often, go to the dentist. Make sure that they are probing you. If your dentist is not probing you, or the hygienist is not probing you, you should look for somebody else. This is key, and I think most competent dentists will do this for you and keep track of what your pockets are. It’s not only about the pocket depth, but also about the fact that you don’t want any bleeding and you don’t want any inflammation there as well, but that is key. I’ve had patients that have come and said, “I’ve had a dentist for 20 years and I just found out I had six, seven millimeter pockets. When did that happen?” You know, well, you have to really stay on top of that.

Another thing you might want to consider is if there’s a low of crowding, the crowding is really unhealthy for your gums, because it’s very hard to get in between and clean those teeth. We traditionally find a lot of pocketing in teeth that are crowded, so you can either work really hard at it, or you can consider invisible braces. Most of the companies out today are actually making BPA free trays.

Okay. Root canal controversy. This is one of the big ones, right? Root canals or no root canals? Do we leave it? How much time do I have? Got you. Biggest controversy I think on the internet, because a lot of people are saying no root canals ever, under any circumstances, right? And I was one of those people that said no root canals ever, under any circumstances, based on a lot of the research that was done by Dr. Weston Price. Is everybody familiar with his work? So he placed actually extracted root canal teeth subcutaneously on rabbits, and the rabbits got sick. So he said, you know, root canals are unhealthy. I stopped practicing. I did not do root canals for many, many, many years because of this research, and then we started thinking, well, is it the root canals, or is it the way the root canals are being performed?

So through investigation, we found that the materials – let me see if we – the materials that were being used inside the canals to seal the root canal were actually hydrophobic. That means that they contract, and as they contract, they create micro spaces for bacteria to actually host themselves, host colonies in there. So we now have different methods where we can use different materials that don’t create this kind of a situation.

So, question. Once you have either a tooth that requires a root canal or you have a root canal, what do you do? Do we treat it with biocompatible materials, do we leave it, do we extract it?

So as I said, you have to really evaluate your case individually. What is your health like? What is your situation in your mouth? I had a patient that called me, she was in Toronto, she wanted to come over because she went to a holistic dentist and he said “We’ve got to pull nine teeth and have root canals on them.” I said, “Well, send me your X-rays.” We saw there was one tooth that was [unsaveable]. I said, “Have him take this one out, and then see what that feels like, and then multiply times eight, and then you’re going to know what it is to miss eight of your teeth.” Was that the wrong thing to do, to pull all eight teeth? Maybe not. But all I’m saying is we have to start thinking, right? Where are we going with this? What are we going to replace these teeth with? That’s important to know, right? So, you know, missing eight teeth is going to really decrease the quality of your life, especially if you don’t replace them, right?

Now, for example, we have sometimes root canal teeth that are focal points of infection. We’ll actually connect them with a tooth-organ relationship. A couple of months ago, we had a patient that said she, after 20 years, they finally discovered a benign tumor on her liver. And when we took a look at the X-rays, we saw that she had an infected root canal on tooth number 13, which would be similar to number 4 on the other side. And those teeth were related to her thyroid, which she had trouble with, and her liver.

Now, I see a patient that has some kind of a problem that a root canal is manifesting in the body, same channel, then at that point, we make a decision. We probably don’t want another root canal. We don’t even want to re-treat that root canal. We probably want to get that out and maybe replace it with a bridge. That patient had no symptoms at all. Healthy patient. NO big challenges, no cancer. I would have considered re-treating the root canal. So again, every case is different, and we have to really keep in mind the long term outcome.

Now, what is a root canal? It’s basically removing infected tissue from inside the room here, cleaning that out, and actually filling it with some kind of a material. It’s actually like a filling inside of the root canal, right? Many people think that the root is all gone. It’s not. The root is still in place, but the canal is actually cleaned, relieved of any infection, any of the nerves or little vessels that it has, and based on Dr. Price’s research, he found all root canals are toxic and are dangerous, and he was right. And 99 percent of the root canals being done today are still being done with hydrophobic materials that shrink. So he’s still right. Most root canals are really not conducive to good health.

And one of the problems with traditional root canals, [inaudible] gutta percha point, which is rubber that’s inert, and a sealer, which is toxic and hydrophobic and it shrinks. So you’re creating micro pockets inside there. So all of his research was based on that, but his research was 30 years ago, so when you’re reading on the internet all root canals are bad, and they’re based on this research, they’re right, based on traditional root canals.

Now, what is a biocompatible? No gutta percha [root canal], no hydrophobic and toxic sealers. We use hydrophilic points, which actually expand, with a sealer that is actually based on calcium that actually expands and is [osteogenic] aside from being hydrophilic. So now you have a material that’s going to actually expand and really seal that canal quite a bit better. Is it perfect? No. And I’ve been doing these root canals for probably about nine, ten years, and I’ve not had a single failure yet, which is, to me, incredible.

And again, you cannot – research C points instead of gutta percha. I don’t really have enough time to go into this right now, but that is the point that is actually, the C points are [inaudible]. C points. And then, you know, the study actually shows the increased dimension of the C points, how it expands with water, which we all have inside of our bodies.

And then we get [a nice] much better seal without those micro pockets that are creating the problem. Again, am I advocating root canals? Not at all. I’m just giving you information that makes sense to you so that you can see what your situation is like and see whether you [leave a root canal] be, whether you re-treat it, or whether you extract it.

And, most importantly, if you decide that you [inaudible] root canal [extracted], what are you going to replace it with, right? I mean, it’s an easy decision to say “I don’t want this root canal, take it out, Doc.” Okay. What’s going to go there?

Okay, so here are our options. Implants, fixed bridges, removable bridges, Maryland bridges. Implants. What is an implant? We have actually three different kinds of implants. We place the three in our office depending on the situation. They’re basically mostly titanium. Now, is all metal toxic to the body? No, not necessarily. Is metal going to disturb a little bit of our [inaudible] flow? Yes. So if you have a large piece of metal in your mouth, it’s probably going to disturb the flow of your energy much more than if you have a very small piece.

The titanium, per se, has been used, I see it in my practice, it’s mostly welcomed by the body, very well integrated most of the time, so I don’t see the titanium being a terrible problem. A lot of people call my office and they want to see about the possibility of zirconia implants. So this is a traditional titanium implant with a crown. This is a traditional zirconia implant. Now, people say “Why not use zirconia instead of titanium?” Because you know, you don’t want all that metal in your mouth. The problem with zirconia is that they are still not well-developed, they’re very big, very aggressive, you have to take a lot of bone out, and they’re usually a single piece. They just came out with a different one that has other problems. And because they’re a single piece, you can never get them aligned perfectly, because the bone doesn’t always align with the teeth, and you have to grind them, which creates micro fractures. So they have their problems. If I have a patient with perfect bone conditions that I can get a perfect [inaudible] profile, then I can use zirconia. But again, you need a knowledgeable doctor, and you need to be knowledgeable about what the differences are.

And these are also implants that we place, they’re called [bicons], they’re bioceramically coated, very, very tiny, but they actually work pretty well as well. Again, if I was a patient and I check the [inaudible]a and that patient is manifesting some kind of disease on that [inaudible], I will not put an implant. I will look for other options. I will not keep a root canal. Other patients, healthy, no manifestation on their organ tooth chart, then we can have –

Removable bridges. A lot of people use those because they are less invasive, but honestly, they’re a terrible quality of life. You know, in and out, and they actually take a toll on the teeth as you’re brigning them in and out, so I would consider this last resort.

Fixed bridges, we do a lot of those when we don’t want to be invasive into the bone area when we have a root canal, when we have a patient that is compromised, a cancer patient. Then we’ll use no metal, and what we do is we actually put crowns on the two adjacent teeth, and then put a fixed bridge that gets bonded there permanently. The disadvantage of this is that you actually have to grind the two adjacent teeth. Sometimes that’s okay. It’s a better option than the other options, depending on your situation.

Maryland bridge, less aggressive. You see the adjacent teeth don’t get fully ground down. The problem with this is that they tend to come unglued. They tend to come off, and so you have to be visiting your dentist a couple times a year to replace them. So again, pluses or minuses to everything. And that’s the design of a Maryland bridge.

So again, every case needs to be evaluated for who you are. Are there systemic manifestations on the meridian of that tooth? Are there life threatening health challenges? Will this intervention improve or decrease the quality of your life or your health? So it’s not only about what you don’t want, it’s about what’s going to happen afterwards.

And again, you know, we have, for example, tooth number nine is related to a lot of the bladder, it’s related to some of the genital organs and so forth. If you have a root canal and you have those symptoms, then you need to reconsider. Maybe something needs to be done with that.

Again, best health decisions are made when you take responsibility and you surround yourselves with a good team. If you have any questions beyond what you’re able to ask here, feel free to contact us.

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Dr. Daniel Vinograd, DDS |
10450 Friars Rd, San Diego, CA 92120 |
Phone: 619-630-7174    •    Dr. Vinograd, DDS, is a Dentist in San Diego, CA, offering services as a periodontist, and providing teeth whitening, dental crowns, invisalign, implants, lumineers, dentures, root canals, holistic, family and cosmetic dentistry.

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