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Peter Varley BDSc, FDSRCS, DFHom(Dent.)
and Stuart
Ferraris BChD, DGDP, DDFHom. (profile)
We can all use
complementary therapies in our practice, but like anything
new, we need the time and energy to learn. This
can add dimension to the postgraduate programmes we use to
support our every day orthodox therapies.
Setting the Environment
To run a holistic practice
it is necessary to create an environment conducive to the
type of natural therapies that you intend
to practise. It is necessary to consider:
- the preparation
of the patient,
- the ambience of the practice
- the attitude of the
team of which you are all contributing members.
Psychological
Preparation of the Patient
Psychological preparation of
the patient, before they see the health care professional,
is important. Rossi[1] in his book ‘The
Psychobiology of Mind-Body Healing’ discusses ‘the
power of optimism’, ‘the belief in
cure’ and ‘the placebo’. Research by Evans[2]
shows a placebo response, averaging 55% of all the analgesics
studied. These include Morphine, Codeine and Aspirin. The power
of psychological healing must therefore be a very important
part of all health programmes.
Practice Ambience
We need to adapt to the individual needs of each patient.
Some areas of the practice have to cut a more average path
eg decor and smell. Other areas to consider are the literature
generated by the practice, telephone personality of the staff
and treatment on arrival at the practice. The ‘feel good’ factor
can contribute to the initiation of healing. Paintings, flowers,
soft music and personal photographs are useful. They lend a
homely atmosphere. Austerity that can be associated with the
clinical setting is softened.
Colour
Colour can be a useful influence on
healing. Hunt R. The Seven Keys to Colour Healing[3].
Violet can be therapeutic for nervous and mental disorders
Blue is useful for teething.
Yellow is associated with cures for skin troubles. With the
rising number of allergies associated with latex gloves, perhaps
we should have yellow light shining on us over the hand basin.
White is definitely associated with sterility and the clinical
environment.
While blue is useful, it needs careful thought, for it can
be considered a little cold. Blue uniforms, for example, are
often quite acceptable and smart. Blue decor, paradoxically,
needs to be well chosen, if it is to avoid the cool emotional
message and effect.
Aromatherapy
Aromatherapy uses the smells of natural herbs and flowers
as therapeutic agents to treat differing pathologies. These
agents are reduced to essential oils and applied to the skin
as massage techniques or simply inhaled.
Smell is one of the most easily remembered senses. The smell
of the dental office, especially for the patient, is very characteristic.
The historical use of oil of cloves takes much of the blame
for this. Oils such as lavender are useful in the reception
and the surgery because of their calming properties. A cotton
wool roll with a subtle fragrance of lavender placed below
the patient’s nose,
Lemon oil, with its refreshing properties,
may be used in the staff area to keep the team alert! The
immune system gains
stimulation from oils such as tea-tree, cinnamon and thyme.
Aromatherapy oils can be used directly as ‘disinfectants’,
for treatment of ulcers, lacerations or in root canals and
cavities. Some of the conditions treated with aromatherapy
oils are listed below:
Music
If the wrong type of music is playing
it can increase the patients irritability and anxiety. There
should be a consensus
between the team and the patients. Popular classical music
of a relaxing nature is the usual choice.
Patient can be encouraged to bring their own music. This can
be played through earphones while they are being treated. The
privacy of their own world of music can often be as relaxing
to the patient as IV sedation.
Laughter
‘A merry heart doeth good like medicine; but a broken
spirit drieth the bones.’ King Solomon, Proverbs 17:22
Robert Holden[4] who established the first NHS Laughter Clinic
in Great Britain, feels that laughter ‘is the best medicine’ as
it has an ‘internal massage’ effect. Dr Robert
Willix5 who explains that happiness strengthens the immune
system, while stress, depression and unhappiness weaken it.
Stress generates a flash flood of free radicals.
Laugh with your team, laugh with your patients and most of
all laugh with yourself.
The Team
A positive staff attitude is essential in running any practice.
The team morale and motivation need to be supportive of the
practice philosophy. Education is all important.
Involve all staff with good in-house communication through
combined courses, shared literature and meetings. It is rewarding
to see how enthusiastically the staff enjoy the opportunity
to be part of holistic health.
Understanding each other’s individual
needs is fundamental to team morale and enables rapport to
develop between the team
and the patients. Ron Hubbard6 describes the balance needed
between affinity, reality and communication, in order to achieve
good understanding.
At the front desk staff have the opportunity to communicate
the practice philosophy. The philosophy is then reinforced
by the team in the clinical environment.
It is necessary to involve the staff in complementary therapies,
in theory and practice. Staff should be encouraged to use complementary
therapies at home. They should be given the opportunity to
experience treatment from the complementary practitioners used
by the practice.
It is often the caring way in which
the rest of the team supports the patient, that makes the
greatest impression. The nurse,
who holds the patient’s hand or places a reassuring arm
around the shoulder, wins hearts for the practice.
Other gestures that are appreciated
are a warm towel placed around the patient’s neck and a light blanket draped
over the patient. This is especially useful during long appointments,
where the patient’s core temperature may drop more easily
than that of the working team.
A consistent theme of dress suggests a team concept to both
the patient and the practice. The colour and nature of dress
should communicate a comfortable balance between clinical efficiency
and a relaxed happy atmosphere.
The Patient
The patient seeking a complementary practitioner is usually
well informed. These patients are not easily side-lined by ‘science’.
However they are ready to accept an orthodox solution only
if the practitioner can give an opinion based on an overview
of both orthodox and natural medicine.
Common Tools used Holistically
Mounted study models are a more holistic
than hand held models. They convey the message of the teeth
functioning in relation
to the joints. Using electronic apex locators during endodontics
avoids the over-use of radiographic exposure. Appropriate filters
should always be fitted to x-ray equipment. Fast x-rays and
lead aprons should be used and all associated equipment kept
at maximum efficiency and well maintained. Research indicates
that automatic developing film results are consistently better[7]
Computer assisted radiovisiography can further reduce radiographic
exposure.
Computer Programmes
Computer programmes are available to help the holistic practice.
They can be used to aid homoeopathic constitutional diagnosis
and nutritional analysis.
Vegadent
Uses the concept of energy meridians linking the individual
teeth to many other body systems.These relationships are worth
bearing in mind when considering a diagnosis based on all the
information gathered from your patient. The condition of each
tooth, either from abnormal occlusal loading, high amalgam
galvanism or an inadequate root treatment, could cause an interruption
in the healthy flow of energy along in the patient. This could
then be expressed as ‘dis-ease’ in a related organ,
which is not associated with teeth in an orthodox sense.
Holistic Treatment
TMJ, Migraine and Other Head Pains
To practise a holistic approach a dentist should have a thorough
knowlege of functional occlusion and its relationship to muscle
and joint pain and general body balance
It is important to give the patient advice on exercise routines,
nutrition, sleeping positions, relaxation and massage to assist
with the healing. Reassurance is an invaluable tool. Each patient
will need a programme tailored to their needs. A general exercise
that is attainable by most is regular walking. This needs to
be brisk to achieve good aerobic levels, which will mean at
least 20-30 minutes 5 times per week.
Periodontal Treatment
Why do some patients present with very poor oral hygiene,
but with little sign of corresponding periodontal disease?
Pasteur, accredited as the father of the microbial era, observed
on his deathbed, ‘Bernard was right. The germ is nothing,
the soil is everything.’ This fundamental consideration
is embraced in the philosophy of holistic health, whereas it
is given little credit in the orthodox circles where it originated.
By supporting the health of the individual holistically, the
immune system is our most effective challenge to diseases of
all kinds, including infection.
The story behind the birth of the germ theory makes for interesting
reading. In the 1870’s the silk industry in France was
nearly destroyed by a disease that attacked the developing
silkworm. Louis Pasteur was called upon to stop the disease
that he discovered was caused by a protozoan. He demonstrated
that the disease could be controlled by eliminating the microbe
from the silkworm nurseries.
However, Pasteur also noticed that it was not just the presence
of the germ but also the physiological state of the silkworm
that determined the susceptibility to infection.
‘If I were to undertake new studies on the silkworm
disease, I would concern myself with the ways of increasing
their general vigour. I am convinced that it would be possible
to discover techniques for giving worms a higher level of robustness
and thereby rendering them resistant to infection’.
Pasteur was aware of the importance of what he called the ‘terrain’ -
the environmental factors that determined susceptibility and
resistance to disease.
The holistic dentist will consider the patients general health,
ie. the patient’s ‘terrain’,. He will consider
nutrition, do a dietary analysis or take the patient through
the Basic Diet Experiment. He will consider stress. Not just
occlussal stress, but emotional and biochemical stress.
He will also support the practice of optimum oral hygiene
and high quality restorations.
Antibiotics
The question the holistic practitioner asks when faced with
an infection associated challenge is, ‘Has the individual
sufficient immune capability to clear the challenge naturally
or is there a gentle support option that can be recommended?’ Such
options could include a homoeopathic medicine or where appropriate,
a topical treatment such as propolis liquid. Very often just
reassurance is all that is needed.
Nutrition
Homo Sapiens was a hunter-gatherer until
communities developed around settled agriculture some 10,000
years ago[8]. As settled
communities we learnt both to control food production and to
cook more food. In evolutionary terms our physiology is still
best handling uncooked food, with a variety to supply adequate
and complex nutritional needs.
Pottenger suggests that it is unhealthy to consume cooked
animal protein. In his animal study, the group of cats on the
raw protein diet thrived over a 5 year period, while those
on cooked protein became sick and developed diseases similar
to those seen in human beings, including periodontal disease
and loss of teeth.
The holistic dentist is concerned with a
diet that will enhance normal dental arch development. Evidence
suggests that the
hunter-gatherer suffered generally fewer diseases and attained
better average heights than agricultural communities, with
the exception of the wealthy Western Nations[8].
Present day farming methods have impoverished the soil. Vitamin
and mineral supplements have an important role to play therapeutically
when the individual needs to nutritionally ‘catch up’.
They are also useful as additives to modern impoverished foods.
Financial Aspects
“God cures and the doctors send the bill”- Mark
Twain.
Fee Structure
Setting up a holistic practice can be expensive.
Whichever system is used, the fee level will have to reflect
the true
cost of the service provided. The holistic practitioner should
be prepared to increase fees rather than reduce time with the
patient. It is important to be confident of the service provided.
Patients pay for outcome and comfort. Team confidence is an
essential element of both[9]. Changes must always be made to
the ultimate benefit of the patient.
Time Management
The modern patient often rejects the impersonal way they are ‘time
managed’ under orthodox dental care. Most complementary
therapies, by their nature, need longer contact with the patient.
This enhances their added value for the person seeking caring
health attention.
To provide the time and to make the patients feel unhurried,
requires discipline. To be financially successful we need to
run an efficient practice that provides time for the patient.
We need to charge sensibly for that time.
Medico-legal Aspects of the Complementary Therapies in Dentistry
When groups of practitioners come together and form societies
with special interests in common, it is not unusual for them
to form protocols that become the bench-mark for practice within
that field.
The standard that is used in the United Kingdom
is that of the Bolam Test[10] which is based on what a reasonable
body of
opinion would consider to be appropriate. It is therefore important
to become members of recognised societies.
Conclusion
There are many useful therapies for the holistic dentist.
Armed with the philosophy of natural medicine, practitioners
can develop the therapies that complement their individual
personalities and those of the patients they serve.
Education, application, observation and continual evaluation
are the only ways to develop professionally. Armed with these
tools we can make a meaningful contribution to the well-being
of our patients, so that they feel happy and above all - healthy!
References
- Rossi E L. The Psychobiology of
Mind Body Healing. New York: W W Norton & Co, 1988.
- Evans F. Expectancy, Therapeutic
Instructions and the Placebo Response. In White L, Tursky
B, Schwartz G (eds). Placebo:
Theory, Research and Mechanism. pp 215-228. New York:
Guilford Press, 1985.
- Hunt R. The Seven Keys to Colour
Healing. San Fransisco: Harper & Row, 1982.
- Holden R. Laughter, the Best Medicine. London: Harper
Collins, 1993.
- Willix R D. You Can Feel Good All The Time. London:
Fleet Street Publications, 1994.
- Hubbard L R. The Components of Understanding. Los Angeles:
Bridge Publications, 1994.
- Rout P G J, Rogers S N, Chapman M, Rippin J W. A Comparison
of manual and automatic processing in general dental practice.
Br Dent J 1996; 181(3): 99-101.
- Diamond J. The Rise and Fall of
the Third Chimpanzee. Reading: Cox & Wyman, 1991.
- Robbins A. Awaken the Giant Within. p 378. New York:
Fireside, 1992.
- Dental Protection Ltd. The Safety of Amalgam Restoration.
Division of Medical Protection Society, 50 Hallam Street,
London W1N 6DE.
Stuart Ferraris BChD, DGDP, DDFHom.
Stuart graduated in South Africa in 1976. He travelled extensively
before settling in North Wales where he has developed a successful
holistic dental practice using a broad range of Complementary
Therapies.
He is a member of the British Homoeopathic Dental
Association, the British Medical Acupuncture Society, the
British Society
for Medical and Dental Hypnosis, the Foundation of Biological
Medicine, the Natural Medicine Society plus many other dentally
related societies, including the American Equilibration Society
and the Cranio Group.
In 1992 Stuart was awarded the Diploma
in General Dental Practice from the Royal College of Surgeons.
He has appeared on television,
published many articles on dental and natural health topics
and lectured both nationally and internationally on running
a holistic dental practice.
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