WHAT IS BIOLOGICAL DENTISTRY?
- International Academy of Oral Medicine &
- Nov 19, 2015
- 3 min read
Oral Medicine, Dental Toxicology – An Introduction to Biological Dentistry
Oral medicine can be conceived in several ways. One way would be dentistry for people with medical illnesses, such as palliative treatment for mucositis in people undergoing cancer chemotherapy, or preoperative screening for heart surgery or joint replacement, to rule out infections that could threaten the outcome of the procedures. Another way to conceive of oral medicine would be to concentrate on the connection between oral conditions and the health of the rest of the body. The effects of periodontal infections on markers of systemic inflammation and cardiovascular health are the best known examples.
A third way to conceive of oral medicine is to consider the effects of dental materials and dental procedures themselves on the overall health of the body. For those of us who perform our healing functions by implanting foreign or synthetic materials in people’s bodies, the constant challenge is to understand the toxicology, the immunology, the microbiology of our work, and to minimize its impact on the biological terrain of our patients.
“Do no harm,” goes the injunction. But how can we ever be certain that a negative biological response to our work, something unforeseen, will not occur, whether in the whole population or in a single individual patient? We can only be vigilant for new information we can use to refine our techniques, and sensitive to new discoveries that call into question previously accepted views. Until we can replace body parts, like teeth, with all “self” materials, the concept of biocompatibility will always represent an approximation, and a work in progress.
We are the 4%
In a 2001 readers’ survey, the Clinical Research Associates Newsletter asked an interesting question: “What is your most deciding factor in choosing a dental filling material?” The answers were not unexpected: durability, 47%; patients’ preference, 22%; esthetics, 12%; ease of use, 10%; biocompatibility, 4%.
Why is biocompatibility such a low priority? We dentists are clearly most concerned that our work is comfortable, good looking and long lasting. The majority of dentists appear to believe that the biocompatibility of dental materials and procedures is a settled issue. It turns out, though, that our customary materials and procedures range from very benign to frankly toxic. Some of our all-time favorites, mercury and fluoride, have a therapeutic ratio of about one to one — their toxic effects can be detected when they are used “properly.”
By making distinctions – some obvious, and some subtle – among the available materials and procedures, we can reduce the impact on our patients’ biological responses. Our sense of duty to the well being of our patients should make biocompatibility a high value. The fact that there are now so many ways to make the dentistry work gives us the opportunity to do so.
A more biocompatible approach is the hallmark of “biological dentistry.” In using that term, we are not attempting to stake out a new specialty for dentistry, but to describe an attitude that can apply to all facets of dental practice, and to health care in general: to always seek the safest, least toxic way to accomplish the mission of treatment, to do it while treading as lightly as possible on the patient’s biological terrain.
The International Academy of Oral Medicine and Toxicology (IAOMT) is an organization for that group of dentists, physicians, and allied researchers who consider biocompatibility to be their first concern, and who demand scientific evidence as their key criterion. Members of this group have, since 1984, examined, chronicled and supported research into the distinctions that can make dental practice more biologically acceptable. The “biological dentistry” attitude can inform and intersect with all topics of conversation in health care, where the health of the mouth is an integral part of the health of the whole person.
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