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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.
Back to the book…
References
- Fisher P, Ward A. Complementary Medicine
in Europe. Br Med J 1194; 309: 107-111.top
- 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.top
- Eisenberg D M, Kessler R C, Foster C et
al. Unconventional Medicine in the United States. N Eng J
Med
1993; 328:
246-252.top
- Brewin T. Fraternizing with fringe medicine.
Br J Gen Pract 1994; 44: 243-244.top
- Ernst E. Is Homoeopathy
a placebo? Br J Clin Pharmacol 1990; 30: 173-174.top
- Shekelle
P G, Adams A H, Chassin M R et al. Spinal Manipulations
for low back pain. Ann Intern Med
1992; 117: 590-598.top
- Earl Baldwin of Bewdley.
Letters to the Editor. The Times 11 April, 1996.top
- Smith
R. Where is the wisdom? Br Med J 1991; 303: 798-799.top
- Goodwin
J S, Goodwin J M. The tomato effect. Rejection of highly
efficacious therapies.
J Am Med Assoc 1984;
251: 2387-2390.top
- Oh V M. The placebo
effect: how can we use it better. Br Med J 1994; 309:
69-70.top
- Soragna D, Montalbetti L,
Bo P et al. Chiropractic Complications. Acta
Neurol
1993; 15: 145-150.top
- D’Arcy
P F. Adverse Drug Reactions and interactions
with herbal medicines. Adv Drug React
Toxicol Rev 1993; 12: 147-162.top
- 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.top
- 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.top
- BMA Report.
Alternative Therapies. London: BMA, Chameleon Press,
1986.top
- Beacon J. Electromagnetic
Stress in the home. Positive
Health 1996;
16: 34-36.top
- Lewis K.
Editorial. Dental Practice 1996; 34(16): 2.top
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