Peter Varley BDSc, FDSRCS, DFHom(Dent.), and Richard Fischer DDS, FAGD. (profile)

Introduction

Homeopathy is a medical system that enjoys a long and rich heritage of scientific literature and a world-wide reputation for safe and effective therapeutics. Although its basic tenets go back to Paracelsus and Hippocrates, it was codified into a systematic medical science in 1789 by Dr Samuel Hahnemann, a German physician. Hahnemann had his primary text, called 'The Organon', published in 1810 and he based this science on three fundamental principles.

Principles of Homeopathy

Law of Similars

The first principle of homeopathy is the Law of Similars. Homeopathy is 'a natural pharmaceutical science in which the practitioner seeks to find a substance that would cause, in overdose, symptoms similar to those a sick person is experiencing. When the match is made, that substance is given in very small, safe doses, often with dramatic effects'.

This law is also used in allopathic medicine. Immunizations are based on the Law of Similars. Modern pharmacology has rephrased this principle into the Arndt-Schulz Law, 'Every drug has a stimulating effect in small doses, while larger doses inhibit, and much larger doses kill'.

It must be recognized that symptoms are, in reality, manifestations of the organism's attempt to heal itself - to regain homeostasis. When a person has a systemic infection, he will develop a fever. The fever is not the disease, but the body's attempt to rid itself of the infection. The homeopathic approach is to respect the body's attempts to heal itself and gently support the fever.

Minimum Dose

The second principle is the minimum dose. Medicines given in material doses carry with them adverse side effects. Hahnemann, in order to minimize these undesirable effects, serially diluted the medicine to determine the minimum dose which would work. These dilutions are called potencies.

Single Remedy

The last tenet of classical homeopathy is the use of the single remedy. The actions of medicines are tested on healthy human subjects one medicine at a time. These tests are called 'provings'.

Homeopathic Prescribing

Vitality of the Patient

The first factor to consider when prescribing is the vitality of the patient. In general, the higher their vitality, the higher the potency you can use. Most of the remedies for acute situations in a dental office would be used anywhere from 6C to 200C.

Emotional vs Physical

The second factor to consider is whether the symptoms are more emotionally or physically based. When more emotionally based (an anxiety state for example), they reflect a higher plane of pathology. Homeopaths rank the emotional and spiritual levels at the highest plane of pathology. Below that is the mental, and then below that the physical. The higher the plane of pathology, the higher the potency you may use.

Acute Vs Chronic State

The third factor to consider in potency selection is the acuteness of the problem. Usually acute ailments with intense symptoms warrant higher potencies.

Correct Remedy

The fourth factor is your own certainty that you have the right remedy. The more certain you are, the higher the potency you might use.

Frequency of Repetition

The more acute the condition, the more frequently you may need to repeat the remedy.

Specific Conditions in Dental Practice

Below are some of the acute or specific conditions that occur in the dental surgery and how homeopathy may be used to treat them.

Anxiety

Aconite
The anxiety remedy used most frequently is Aconite. This kind of fear is exhibited by sudden panic, dry mouth; the fidgety type of patient.

Gelsemium
Anxiety with the Gelsemium patient is the one that is drowsy, weak-kneed and trembling. They are usually a bit nauseous or have a nervous diarrhea. This is the kind of fear you may have experienced walking into a final exam, when you are feeling unprepared.

Trauma

Arnica
For blunt trauma, bruises and soft tissue injuries - the primary remedy is Arnica. Most people who have used homeopathy probably started with Arnica. Arnica is for a tooth extraction, a crown preparation, haematomas, adjusting orthodontic wires, a blow to the jaw - anything of that nature. It has been said that if homeopathy had nothing but Arnica to offer the world, it would be a priceless medical art. Arnica helps with the pain, swelling and bleeding due to any bruising types of injuries. Arnica also works on an emotional level. So if there is 'mental trauma' following a long and stressful dental appointment Arnica is wonderful in helping the patient cope with that.

Hypericum
Hypericum is specifically for trauma to nerves; such as a deep filling that is close to the pulp, after root-canal therapy, for fractured incisors where you have a near exposure or exposure of the nerve, for paraesthesias following a mandibular third molar extraction. Hypericum is called the 'Arnica for the nerves'. Any time you have a nerve injury, Hypericum is the first remedy you think about.

Magnesia Phosphorica
It is used for muscle pains and muscle spasms. The key notes with Mag phos are better from warmth, worse from cold, and better from pressure. A patient who has an acute TMJ flare-up and wants warmth, and holds their hand over the masseter muscle to provide some relief; needs Mag phos. This type of muscle spasm may result from an injury (such as an injection), or simply may result from having a patient hold their mouth open during a prolonged dental visit.

Bone Trauma

Ruta graveolans
If Hypericum is the 'Arnica of the nerves' then Ruta is the 'Arnica of the bones'. For any kind of periosteal injuries or bone surgery, contusions, apicectomies or when you are lifting a flap in periodontal surgery. Another indication for Ruta would be when orthodontic patients get their braces tightened or their spacers put in. The soreness resulting from spreading of the teeth usually responds to Arnica, but when Arnica does not work, Ruta usually will.

Ruta is also a good remedy following endodontic therapy where the file is overextended through the periodontal ligament into the alveolar bone. Ruta is the first remedy to think of for dry sockets. Sometimes a dry socket may initially call for Belladonna, if it has that acute, throbbing type of pain. However Ruta is usually the remedy that is going to help bring the healing to completion.

With any of these pain remedies a dose every half hour to an hour is recommended initially. That may be every fifteen minutes for some people, it may be three times a day for someone else, depending on their tolerance and the level of pain.

Bleeding

Phosphorus
When we think of the great bleeding remedies, Phosphorus is certainly the most impressive; not only because it works so well, but because the bleeding with a phosphorous patient is so very red. This is indicated for bright red (arterial) blood flow.

Teething

When the child is fractious and whining, wishing to be carried or petted, consider Chamomilla. Where there is excessive salivation or halitosis, consider Mercurius solubilis.

Oral Ulcers

Natrum muriaticum
Certain constitutional types are more prone to outbreaks of oral ulceration. Nat mur, for example, will often discourage those kinds of people from taking too much salt in the diet.

Propolis tincture applied topically to the ulcerated tissues, takes the pain away within seconds. This can also be used as a mouthwash if the ulcers are at the back of the tongue or throat, where you can not otherwise reach.

Herpes Labialis

For the treatment of the predisposition to cold sores, constitutional therapy is indicated. The key remedies to be considered are Nat mur, Sepia and Sulphur. Long term zinc (15-30mg daily) and vitamin C (1-2g daily) supplementation may also be helpful.

Abscesses

Belladonna
Belladonna is a remedy for the acute endodontic abscess, if the symptoms fit. Where there is intense throbbing pain which comes on rather rapidly and is aggravated by any kind of pressure or movement, try Belladonna.

Hepar Sulph
Hepar sulph is for the chronic periapical abscess, where there may still be a little cold sensitivity in the tooth (or the patient may be chilly in general). With Hepar sulph, potency selection for endodontic lesions may be particularly critical. Low potencies (6C or below) tend to promote the abscess to point and drain, higher potencies (30C or above) tend to suppress and shrink the abscess.

Silica
Silica is useful in the management of the draining periapical abscess. It helps support the drainage of these abscesses, typically when there is a sinus draining into the buccally sulcus. It also helps the body throw off foreign bodies.

Bacterial Endocarditus

For the prevention of bacterial endocarditis when appropriate antibiotics are unavailable, or where the patient refuses to take them, consider Pyrogen 30 twice daily, for one day prior to and seven days after the procedure.

Chronic Dental Prescribing

Myofascial Pain Dysfunction Syndrome

An intractable condition occurs when a person may not respond to conventional treatment. The stress levels will not allow the patient to relax. This results in aching of the muscles or damage to the related jaw joints. Addressing the stress levels through constitutional prescribing will improve the patient's response to conventional treatment.

Any patient suffering acute stress or depression following a major life event such as bereavement, divorce or redundancy may benefit from a constitutional assessment. Disorders of the joint cause such profound and diverse sequelae in the patient's overall health, they serve as a good vehicle to illustrate the indivisibility of oral and systematic health. The various signs and symptoms of TMJ disorders fully permeate one fourth of the pages of Kent's Repertory. They include headaches, earaches, grinding and popping noises in the joint, vertigo, pains in the neck, shoulders, and back, indigestion, poor balance, unstable posture and many others.

Periodontal Disease

The patient with unexplained advanced periodontal disease, who does not respond to conventional treatment, may be suffering from mild immune deficiency. A detailed history is taken to discover which remedy applies to their phenotype. The aim of this remedy is to give their whole body a 'kick-start' to revitalise their immune response.

In addition to the conventional therapies of Oral Hygiene Instruction, scaling, root planing and periodontal surgery, different constitutional remedies may be used for different patients with the same advanced periodontal disease. A few of these include:

• The weak, pale blonde with acne and catarrh - Hepar sulph.
• The intransigent brunette - Thuja
• The pale, retiring, hard-working waif - Silica
• The pale, blue-eyed, shy blonde - Pulsatilla
• The tall, fiery red-head - Phosphorus
• The impulsive, irritable worrier - Argent Nit

The use of nutrient supplements and general dietary advice is another area that the homeopathic dentist would be considering to support these patients.

Conclusion

This article presents a brief overview of the role of homeopathy in dentistry as it relates to acute and chronic prescribing. Correct homeopathic prescribing for dental maladies will frequently provoke salutary systemic effects. This is simply a reflection of the natural law of cure and illustrates the fact that the dental apparatus is an indivisible component of the integrated whole person. It cannot be otherwise; and for this we should all be grateful - doctor and patient alike.

Bibliography

Lessell C B. A Textbook of Dental Homeopathy Saffron Walden: The C W Daniel Company Ltd, 1995.

Associations

Courses

Courses are held in London and Glasgow.

The Foundation Course, Parts 1-5. A five day introductory course for Doctors, Veterinary Surgeons, Dentists, Pharmacists, Nurses, Midwives, Podiatrists and Para-medical disciplines.

The Intermediate Course - Parts 6-10. A five day course for Doctors, Dentists and Vetinary Surgeons. Three days are Multi-disciplinary and, for dentists, 2 days specialise in Dental Homeopathy This course is in preparation for the Diploma in Dental Homeopathy Examination held once a year by the Faculty. Details can be obtained from the Faculty of Homeopathy (address above).

Richard Fischer DDS, FAGD.

Richard is in general dental practice near Washington DC. His practice has developed a holistic approach to dentistry over many years, with an emphasis on homeopathy He has lectured throughout the United States and internationally. He has appeared on National Radio many times and published a wealth of papers on dental homeopathy In 1984 Richard was appointed Vice President of the National Board of Homeopathy in Dentistry as well as Course Director of Dental Seminars for the centre. In 1994 he addressed the British Homeopathic Dental Association's Annual Conference in London.