Holistic dentistry, sometimes called biological dentistry, is not a recognised registration category in Australia. Anyone practising under that description is a registered dentist, held to the same standards as any other, who has chosen a particular emphasis in how they describe their work.
The term is self-chosen, and practices using it vary widely. Organisations such as the International Academy of Oral Medicine and Toxicology promote what they call biological dentistry, which they describe as seeking the safest and least toxic way to achieve the goals of modern dental care. In practice, the term covers a wide range of positions, from ideas that are entirely mainstream to claims with little supporting evidence. It is worth separating them.
The Parts That Are Simply Good Dentistry
Several principles associated with holistic practice are not controversial at all, and most careful dentists would recognise them in their own work.
Treating the person, not just the tooth. Medical history, medications, diet, stress and sleep all affect oral health, and a thorough examination should take them into account.
Minimally invasive treatment. Preserving tooth structure wherever possible, monitoring early lesions rather than drilling them immediately, and choosing the smallest effective restoration are standard contemporary approaches.
Prevention first. Reducing risk so treatment is needed less often is the foundation of preventive care for adults, not an alternative philosophy.
Biocompatible materials. All dental materials used in Australia must meet regulatory requirements, and material choice for patients with known allergies or sensitivities is routine clinical practice.
The mouth and general health. The link between periodontal disease and conditions such as diabetes is well established, and gum and periodontal treatment is part of looking after general health as well as teeth.
If this is what someone means by holistic, there is nothing to argue with.
The Claims That Need More Scrutiny
Other positions associated with the term are not supported by current evidence, and it is reasonable to ask for the basis of any of them.
Routine Removal of Amalgam Fillings
Some practices recommend replacing all amalgam fillings regardless of their condition, on the basis of mercury exposure. Australian regulators and major dental bodies have found that amalgam fillings in good condition are not a health risk for the general population, and that removing sound fillings unnecessarily exposes patients to more mercury vapour during removal, as well as removing healthy tooth structure.
There are legitimate reasons to replace an amalgam filling: it is fractured, worn, leaking, or there is decay beneath it. Appearance is also a valid patient preference, provided the trade-offs are explained. Replacing sound fillings as a health measure is a different claim, and the evidence does not support it.
Australia is phasing down amalgam use for environmental reasons, and in our practice a new filling is a tooth-coloured white filling in almost all cases, which is now standard rather than alternative.
Opposition to Fluoride
Fluoride has one of the largest evidence bases in preventive health, and its role in reducing decay is well documented at the concentrations used in toothpaste and water. Concerns are usually based on studies of exposures far higher than those involved.
Claims About Root Canal Treatment
A persistent claim links root canal therapy to systemic disease. It originates in research from the early twentieth century that has not held up to later scrutiny, and current evidence does not support avoiding root canal treatment for that reason. The alternative, removing an otherwise restorable tooth, carries its own consequences.
Cavitation Surgery and Related Procedures
Some practices offer surgery on areas of jawbone described as cavitations, said to harbour hidden infection. The diagnostic criteria and clinical benefit are not well established, and the procedures are invasive.
How to Judge Any Dental Recommendation
This applies to every practice, including ours:
- Ask what the evidence is, and be comfortable asking twice
- Ask what happens if you do nothing for now
- Ask whether a more conservative option exists
- Ask what the recommendation costs, in money and in tooth structure
- Be cautious about any practice recommending extensive work across many healthy teeth at a first visit
- Seek a second opinion for anything major, which is normal and should never offend anyone
A recommendation that cannot be explained plainly is worth questioning, regardless of the philosophy attached to it.
Our Position
We are not opposed to the values behind the term. Conservative treatment, careful material selection, attention to general health and a focus on prevention describe how we try to work.
Where we differ from some interpretations is that we follow the evidence, and we are willing to say when a popular idea is not supported by it. If you have questions about materials, fluoride, amalgam or anything else, raise them at your check-up and clean. You will get a straight answer rather than a sales pitch in either direction.
Materials and Sensitivities
Questions about materials are reasonable and come up often, so here is how we approach them.
All dental materials used in Australia are regulated, and adverse reactions are uncommon but not unheard of. If you have a known allergy, a history of reactions to metals, or a condition that makes you cautious, tell us. We can discuss what each restoration contains and choose alternatives where they exist.
What we will not do is claim that a particular material causes unrelated health problems without evidence, or recommend replacing sound restorations on that basis. Where a genuine sensitivity is suspected, allergy testing through a medical specialist is the appropriate route rather than assumption.
Talk to Us
If you are weighing up advice you have received elsewhere and want a second opinion, we are happy to look and explain what we see. Call Precision Dental on (07) 3852 1160 or book online.
