11/13 Lecture: Holistic Dental Health (Transcribed) P2

Daniel Vinograd

Just ask your dentist to read the labels on the packaging from the amalgam manufacturers. It scares you.  If you read that, it really scares you. It talks about toxicity, how it can affect your nervous system, your liver, your kidneys. In the state of California, for most of you that are from here, we now have a proposition where a dentist has to disclose to a patient, if they’re going to use amalgams, that there could be birth defects, especially for women of child-bearing age.  This is what I see in my office every day. People say, “But doc, I’ve had these amalgams in my mouth since I was 12.”Yeah, I know.  I know.

So, some of the problems with amalgams when they’re first placed in, the fresh amalgam, the fresh mercury, is very, very active. This is when I’m most concerned.  There’s a period that could be called a period of inactivity, relatively speaking.  I think it’s always a problem to have those things in your mouth.

Then, as the amalgams start getting older, the amalgams start oxidizing.  The margin starts opening up, and the amalgam has the tendency to swell up with time. Why does that happen? Just from a mechanical point-of-view, forget about the biocompatible point-of-view, they start actually creating cracks on the teeth. Again, I must do a few crowns a week from people that have had amalgams and have had cracks from the amalgam. So, even if you don’t feel that this is a problem with your health, on a biocompatible perspective, just from a physical perspective, it’s not a good material.

So, I think those are incredibly toxic restorations.  So, if any of you still have amalgams, I would take a look at it, see what they look like, talk to your health practitioners about them. Run some tests.  See how toxic you are with heavy metals. Those are a lot of things that could influence your health. Now, this is what I find under the amalgams.   That’s very typical.  You can see on this side what the amalgam has created. That’s after the amalgam has been removed.   It’s actually interacted with the tooth in a significant way.  You can see, on your right, the crack line, very, very clearly there between those two spaces. That’s very typical, and we see that often. This is not a seldom case.  This is something that we see all the time.

So, after we’ve restored the teeth, obviously much cleaner, much healthier,

and obviously, the opportunities for those teeth to be lost due to cracks diminishes tremendously. So, a lot of people that come to the office ask me, “Well, doc.  I get it.  I really shouldn’t have the amalgams in my mouth, but what do I do?  How do I take them out?” I often talk to them about how would you talk any toxic material out of a building. Asbestos was big, right, in the 60s?  In some buildings, they have special people that come and actually take the asbestos out.

So, there is a certain protocol as to how we can take the amalgams out of your mouth and how we can do it safely because that’s very, very important. To have your amalgams taken out in an unsafe way, it really subjects you to have a lot of that material reintroduced to your body and lodge in some of your fatty tissues like your liver, like your brain. So, a lot of people that have gone to the internet have read and have asked me, “Well, doc.  What kind of protocol do you use? Do you use Huggins Protocol?  Do you use the International Academy of Oral Medicine and Toxicology? Do you use,” I don’t know.  There’s probably seven, eight different varieties. All of those protocols are good, but here’s where you have to start thinking. Here’s where you have to start developing trust in your health professional. A lot of times, because we get so involved in our head and we forget to really feel or trust or really get guided by something other than just our thoughts or the internet, we tend to choose the person who has the best protocol, but, really, you don’t take the eye out of the eight ball. What does that mean? The most important thing about a protocol is the practitioner behind it.

How meticulous is this person about implementing the protocol? A lot of people say, “Well, Dr. Huggins says you should never do this on Tuesdays and Thursdays.” Well, maybe. I’m not disputing that, but it’s much more important that you have a practitioner that’s going to put a rubber dam and make sure it seals really well. So, again, the important thing is that you have somebody you can trust that will do a good job for you, that you know is meticulous, that you know has your health as their primary concern.

So, the basics really is that the rubber dam is the key to this all, and has anybody had a rubber dam placed on them? Right, and so a rubber dam is just a physical barrier, and in our office, we actually place the rubber dam and then put a seal around each tooth in addition to that. Then, we actually pour water on the rubber dam to make sure nothing is really coming through. Once you’ve done that, and this is something you can ask your dentist to do.  “Could you check?  Could you put some water there to see if anything is leaking? before the amalgam gets taken out.

Then, the second part is a lot of the powder, a lot of the gas that is being produced with the heat of the drill, you also want to be protected about inhaling it. So, that’s again what I’m talking about is you guys using common sense, understanding what’s going on. It’s less important that you read on the internet that somebody has such protocol and more that somebody’s actually using oxygen, protecting what you’re inhaling, and protecting what’s going behind.

You can read the rest. So, a lot of the really proper protocol is to segment the amalgam so you’re not grinding it whole and taking them out by pieces. Some people have equipment that allow them to do that. In our office, we additionally use some homeopathy and some natural ventilation,  nutritional guidance, and we do quadrant dentistry. So, we place the rubber dam, and we actually remove everything by quadrants so we don’t have to be revisiting the same area over and over.

So, one of the interesting things is, well, you’re going to take them out.  You made that decision, “I’m taking my amalgams out” or “My amalgam’s out”.  “What am I going to replace them with?” This is a very interesting part of the process because there are basically two major way to replace an amalgam restoration. One is with composites and the other one is with some kind of a casted piece, and I will explain. The composites are basically powder, glass, and plastic. That’s what a composite restoration is. Those white fillings that are put in your mouth is basically powder, glass, and plastic. Most often than not, and so far in my research, I have found that just about every composite has BPAs with the exception of one, and I’ll talk about that one.

Then, the other possibility is the only one that does not have BPAs is a mix of a composite, what we call glass ionomer cement. Glass ionomer cement is a very, very good material. The only problem with that material is that it has fluoride. Now, here I’m being honest with you.  I’m talking candidly with you about what the options are. We live in an imperfect world,and you have to make good decisions. You’re going to have to make a decision about whether you’re going to go with the composite. Are you going to go with a composite that has BPAs or a composite that has some fluoride? No other option’s in the market.   So, when you’re making your decisions, you have to really understand there’s no perfect world.  There’s no perfect solutions when you’re using a composite.

As much as I am totally against the use of fluoride, here’s no fluoride in my office, the effects that I’ve seen with BPAs are quite a bit more devastating I think than the very minute amount of fluoride that is one this material, and the fluoride stays active for a short time. Then, it stops being active.  What do we use?  Which one of the two do we use? Well, it depends on you, your situation.

It depends on your condition, or do you not want to use either?   Well, you have another option, which is inlays and onlays. The advantage of an inlay and an onlay is that it’s a baked porcelain, significantly more stable, no BPAs, no fluoride. The big problem with that?  Yeah, they’re quite a bit more expensive.

Now, when you have a large restoration, in my book, there’s no choice. You can’t put a large composite that you’re going to be grinding down all the time. So, basically, that’s why. Then, when it comes to your inlays and onlays, there are different kinds of porcelains that you can use.  There are indirect composites, which are baked composites. Then, you have pure ceramic restoration, which is called bruxor crown.  Then, you have some combination porcelain inlays and onlays. So, when it comes to the onlays and inlays, here are your different choices. You have porcelain.  This is onlays and inlays as well as for crowns when you have to have a crown. You can have a porcelain fused to metal.   The different metals that you have is non-precious.  You can see what the non-precious contains, which is something that I would definitely not recommend. Precious, which people think is all gold, and it’s all grey. It also has some additional metals mixed into it. Gold by itself is a bit too soft, and semi-precious.

Today, I hardly ever use metal in the mouth.  would say that would be a very rare case when I would be forced to use a metal, and in that case, I would probably use just a metal, just a pure titanium, but most of the time, we don’t need to do them. We have bilayer type of restoration, which either are aluminum or zirconia oxide with veneer porcelain on top, or we have pure zirconia bruxor crowns, which are just pure zirconia crowns, which is really the advent of dentistry. This is the newest type of crown.

Any of this perfect?  No, and this is where I’m asking you guys to really understand what’s going on so that you can make good choices. I would say that if I had to use something in my mouth, I would definitely use either an onlay or a crown made of pure zirconia. That’s probably the cleanest material that you can find at this point. So, because patients are now demanding different materials, better materials, more biocompatible materials, dentists are responding.   People respond to demand.  Demand and supply.  If people start demanding biocompatible materials, biocompatible materials will be going through the pipeline.

So, more and more dentists are abandoning the old guard Okay, any questions about this so far? Okay, we’ll move on then.  Yeah?  Mixing of amalgams, of metals in the mouth? You mean having one tooth with one and one with a different kind of metal? Yes, that’s really not a good idea because the saliva will conduct electricity between them. It’s called galvanism.  So, to have two types of different metals, to have metals, in general, is not a great idea in your mouth. Two kinds of different metals is even worse.  So, thanks for bringing that up. Yes?

Yes, all those materials can be applied except, of course, the composites are only for fillings but the crowns and bridges can all be done with metal, metal fused to porcelain,  and porcelain by itself or pure zirconia, which is the bruxor crown. That is the different.

Yes.  Actually, when we remove the amalgam, you have a choice of either using composite or any filling can be replaced with a porcelain piece instead of composite. So, that would be the optimal, but obviously you have to factor in the cost at some point.

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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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