Archive for Dentistry

Use of Dental Appliances in the Management of Tourette Syndrome

Editor’s note: This Science Based Medicine blog post is another collaborative effort between Grant Ritchey and Clay Jones. Not only have they previously co-authored an SBM post on fluoride, their partnership has recently expanded into other areas of science journalism. Since the departure of Dr. Jason Luchtefeld as co-host of The Prism Podcast, Clay has joined Grant as the new co-host. To this end, Clay and Grant have added a Science Based Medicine segment to each podcast episode, in which recent SBM blog posts are reviewed and discussed with the authors themselves. Check them out on iTunes or your favorite podcatcher.

"We'll remove that headgear when your tics improve."

“We’ll remove that headgear when your tics improve.”

One of our primary goals is to promote the concept of scientific skepticism and the importance of prior plausibility when interpreting new research. On the pages of this website, and in extracurricular activities like our various podcasts and personal blogs, we often call upon these two load-bearing pillars of science-based medicine when investigating implausible and unproven claims championed by well-meaning true believers and outright charlatans. What our collective experience has revealed time and time again is that both will often hope that a gullible public will put their trust in a warped version of science, while relying on emotional responses to anecdotes and testimonials.

In our post today, we will walk readers through our investigation of thus far unproven claims involving the treatment of a complex neurological disorder, Tourette syndrome (TS), with a fitted dental appliance aimed at improving the alignment of a patient’s jaw. From the perspective of a dentist (Grant) and a pediatrician (Clay), there aren’t any obvious connections between the jaw and this childhood-onset neuropsychiatric disorder, but proponents believe that there is one and that these appliances can significantly reduce the severity of symptoms. Although impossible to enter into an investigation such as this completely free of emotion or bias, we truly attempted to keep an open mind throughout the process.

First up, a disclaimer:

Clay was diagnosed with Tourette syndrome when he was 7 years old. As both a pediatrician who has now cared for a number of patients with TS and someone who has personally experienced many of the negative physical and social sequelae associated with the condition, this is a topic that Clay takes rather personally. Although his symptoms are now on the milder end of the severity spectrum, and are far from debilitating, they do often serve as a source of frustration in his day-to-day life. The thought of children with Tourette syndrome being taken advantage makes him angrier than that time somebody switched out his regular coffee for Colombian decaffeinated crystals.

Without hesitation, we would love for there to be another effective treatment option for Tourette syndrome in our armamentarium, especially one that would be essentially risk free and relatively inexpensive. Again, as scientific skeptics we are open to new evidence as it emerges. But before we get to the claim and the research being used to back it up, we will give a primer on the scientific consensus on TS so that readers can better assess for themselves the prior plausibility of this proposed treatment.

Posted in: Critical Thinking, Dentistry, Medical devices

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Mercury amalgam fillings and you

Filling removal dentistry small

Dentists removing an old plutonium-based filling.

Note this special guest post submitted by Maddaz A. Hatter, D.D.S. Thanks Dr. Hatter!

Also, on an almost-completely-unrelated note, skeptical dentist, haberdasher extraordinaire, and sometime-guest-blogger Grant Ritchey recently moderated debate between SBM regular Clay Jones, and pediatrician-who-has-yet-to-be-coerced-into-blogging-with-us Raymond Cattaneo, about the pros and cons of firing families who refuse to vaccinate according to the recommended schedule. I’m told Clay wins the debate through a swift blow to the throat, but it happens at the very end so you’ll have to listen to the whole thing! Located at the Prism Podcast via this tasteful and refined link.

In England during the 1700s and 1800s, felt hats – very fashionable at the time – contained trace amounts of mercury, and many of the workers in the hat factories that produced them succumbed to mercury poisoning over time. Symptoms of mercury poisoning include dementia and other neurological complications, from whence came the term “Mad as a Hatter.” We’ve known for quite a while that quicksilver in large enough quantities does not do a body (or brain) good.

This brings up a point. It seems that a recurring theme at Science Based Medicine is that we are always defending what legitimate health care providers want to put into a human body to prevent, cure, or manage disease, or to improve health or quality of life. Conversely, we critique those who want to put things in us that are of no demonstrable benefit or which may cause harm. To wit: vaccines – good, coffee enemas – not good. Fluoride (at appropriate doses) – good, colloidal silver – not good. This is an ongoing tug-of-war that will likely continue until our sun supernovas and consumes our planet, after which all arguments will probably be moot.

In the dental field, the two biggest battles we seem to continually wage deal with the safety of fluoride and the use of dental amalgam. Fluoride and fluoridation has been written about many times before on Science-Based Medicine. I have also discussed it several times on my podcast, The Prism Podcast, but I’ve never written about amalgam fillings before. Harriet Hall wrote an excellent SBM post on the matter way back in 2008, but after all these years it’s probably time to revisit the topic. (more…)

Posted in: Dentistry

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May the Floss be with you?

Toothbrush...lightsaber...toothbrush...lightsaber...which removes more plaque?

Toothbrush…lightsaber…toothbrush…lightsaber…which removes more plaque?

I’m beginning this blog post under the assumption that the average Science Based Medicine reader is more intelligent, more motivated, and more health conscious than your typical Jane or Joe Blow. As such, most of you probably visit your friendly neighborhood dentist for cleanings and checkups twice a year just like the toothpaste manufacturers American Dental Association recommends. And if you’re like 99% of the patients my dental hygienists and I see in my practice, you get encouraged/chided/scolded to floss more. Because we all know no one flosses like they’re supposed to and that flossing is absolutely the best thing a person can do for his or her oral health, right? We even have posters that have witty quips like “Only Floss Those Teeth You Want To Keep!” Pretty clever, huh? You have to get up pretty early in the morning to be funnier than a dentist. (more…)

Posted in: Dentistry

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Weston Price’s Appalling Legacy

Weston A. Price Foundation: Not recommended

Weston A. Price Foundation: Not recommended

One of our readers requested a post about the Weston A. Price Foundation (WAPF). I knew it was not a trustworthy source of medical information, but I had not imagined just how atrocious it really was. After spending some time on the website, I realized that it is not just a cornucopia of false information about dentistry and nutrition, but is full of anti-vaccine propaganda and bizarre and dangerous health advice that could result in serious harm to patients.

The purpose of the Weston A. Price Foundation

It is a non-profit, tax-exempt charity founded in 1999 to disseminate the research of Weston A. Price, who “established the parameters of human health and determined the optimum characteristics of human diets.” (He did no such thing!) It publishes a journal “dedicated to exploring the scientific validation of dietary, agricultural and medical traditions through the world.” That statement reveals how poorly they understand science. The purpose of science is not to “validate” traditions and beliefs; it is to ask “if” those traditions offer any demonstrable benefits, and if the beliefs correspond to reality. (more…)

Posted in: Dentistry, Nutrition, Vaccines

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(Dys-)Functional Medicine Comes to Dentistry

Now there is some functional dentistry!

Now there is some functional dentistry!

The great philosopher Deepak Chopra wrote: “I do not believe in meaningless coincidences. I believe every coincidence is a message, a clue about a particular facet of our lives that requires our attention.” So when SBM author extraordinaire Jann Bellamy emailed me last week with an article about so-called “Functional Dentistry” with the comment “Blog fodder?”, I looked it over with interest and then promptly filed it away in my brain along with other things that I might get around to doing but probably won’t. The very next day, Dr. Clay Jones – also an SBM bloggist extraordinaire – asked me if I’d mind pinch-hitting and write a blog post for his upcoming Friday morning time slot while he was away on vacation.


Personally, I find it more plausible that Jann and Clay secretly conspired to have me write this article in order to lure me into a rage spiral, than the notion that The Universe was sending me a message about a particular facet of my life that required my attention. But we are at Point B now, are we not? Regardless of whether the first domino was pushed by The Universe or by Jann and Clay, I suppose it is now incumbent upon me to share with the SBM readership yet another way where pseudo-scientific practices and deceptive branding and marketing tactics have trickled down from medicine into dentistry.

In this blog post, I will review what Functional Medicine (FM) is, what is wrong about it and what is right about it (yes, there are aspects of FM that are legitimate, if not admirable), and how it has infiltrated (some say contaminated) the field of dentistry. I think you’ll find that, when you pull back the curtains, the reality of FM as a “new and improved” medical/dental paradigm is vastly embellished and overstated, and the Great and Powerful Functional Medicine Oz is really just an old geezer pulling the levers of spin and hyperbole and pushing the buttons of pseudo-science. (more…)

Posted in: Dentistry, Science and Medicine

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Learning quackery for Continuing Medical Education credit



The Integrative Addiction Conference 2015 (“A New Era in Natural Treatment”) starts tomorrow in Myrtle Beach, SC. Medical doctors, doctors of osteopathy, naturopaths and other health care providers will hear lectures on such subjects as “IV Therapies and Addiction Solutions,” given by Kenneth Proefrock, a naturopath whose Arizona Stem Cell Center specializes in autologous stem cell transplants derived from adipose tissue. Proefrock, who was disciplined for using prolotherapy in the cervical spine without proper credentialing in 2008, claims that stem cells treatments are an “incredibly versatile therapy” and uses them for variety of conditions, such as MS and viral diseases. At the same time, he admits that they are not FDA approved and he is not claiming they are effective for anything (and he’s right), which leads one to wonder why he employs them.

Proefrock also offers a typical naturopathic mish-mash of services, from oncology to urology to “naturopathic endocrinology,” and claims he specializes in treating influenza, high blood pressure and kidney stones, as well as addiction. In other words, he doesn’t seem to be the sort of expert you’d find speaking at a science-based conference on addiction medicine.

You’ll find similarly troubling bios of some of the other speakers, as well as dubious treatments for addiction, on the conference website. Here, for example, are speaker Giordano’s and Eidelman’s websites.

Dalal Akoury, MD, is the “Title Sponsor” of the conference and appears to be running the show. Although she is listed by the S.C. Board of Medicine as board certified in pediatrics, she is the founder of the “Integrative Addiction Institute” and runs the “AwareMed Health and Wellness Resource Center” in Myrtle Beach. Like the Arizona Stem Cell Center, it offers a range of treatments that defy categorization as any particular specialty: addiction recovery, “adrenal fatigue” treatment, stem cells, “anti-aging,” weight loss, “functional medicine” and “integrative cancer care“. Yet, only Akoury and one licensed practical nurse are on the staff of the Center. Again, it is questionable whether she is has sufficient qualifications in addiction medicine to run a conference on the subject. (more…)

Posted in: Acupuncture, Cancer, Chiropractic, Dentistry, Diagnostic tests & procedures, Energy Medicine, Homeopathy, Medical Academia, Medical Ethics, Naturopathy

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Cochrane Review on Community Water Fluoridation

Fluoridated water: Panacea or poison? Probably neither.

Fluoridated water: Panacea or poison? Probably neither.

One of the overriding themes of the Science Based Medicine blog is to use rigorous science when evaluating any health claim – be it medical, dental, dietary, fitness, or any other assertion put forth with the intention of improving one’s health. Once the scientific evidence is evaluated as to efficacy, there are other criteria which must be taken into consideration, such as ease of administration, costs, possible adverse effects, and so on. Benefits have to be carefully weighed against risks to properly determine any appropriate course of action. For example, if a new pill is developed which is significantly better at , say, managing hypertension than existing medications, but it kills 10% of patients taking it, it obviously would not be the drug of choice. Conversely, if a proposed treatment, say homeopathy, is touted as being 100% safe with no side effects, but has absolutely zero benefits, it too would not be a recommended treatment. It’s a complicated and often ambiguous algorithm, and is imperfect due to the impossibility of attempting to quantify non-quantifiable values and qualities. (more…)

Posted in: Dentistry, Science and Medicine

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Dr. David Villarreal’s “Holistic Dentistry:” Full of Holes?

Screenshot of the "BioDental Healing" website showing the "Meridian Tooth Chart".

Screenshot of the “BioDental Healing” website showing the “Meridian Tooth Chart”.

I get a lot of e-mails from publicists offering suggestions for articles and interviews with their clients. I quickly delete most of them, but one recently caught my eye. It said that patients travel from as far as Europe and Africa to have California “holistic dentist” Dr. David Villarreal remove the old silver fillings that are damaging their health. He has removed 20,000 of them in his 30-year career; removing fillings accounts for 75% of his practice. It said your dental fillings could be killing you – and not just the mercury in your “silver” fillings. Dr. Villarreal says that filling materials that are not compatible with your particular body chemistry can suppress immune responses, leading to a host of illnesses from frequent colds to autoimmune diseases to far worse conditions. He performs a blood compatibility evaluation to pick the right material for your body. He picks the right composite to maintain optimum health and help heal the immune system. (more…)

Posted in: Acupuncture, Dentistry

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Fluoride: Still Not Poisoning Your Precious Bodily Fluids!

We dentists are an evil group of sociopaths. When we’re not trying to kill you or give you chronic diseases such as multiple sclerosis with our toxic mercury saturated fillings, we are advocating for the placement of rat poison/industrial waste (i.e. fluoride) in your water supply by our governmental overlords. What is up with us?


The problem is, we’re failing miserably. Even after more than 150 years of placing silver amalgam restorations in our patients, thereby saving untold numbers of teeth, reducing pain and suffering, and improving chewing ability for millions upon millions of people, there is still no evidence worth a damn that shows any correlation or causative effects for any known disease or condition. And with fluoride, after adjusting fluoride levels in municipal water supplies throughout the U.S. and in many places world wide for over sixty years, after adding fluoride to toothpastes and mouthwashes, and giving fluoride treatments to patients in our offices, the only nefarious result we have obtained is the significant reduction of dental decay with its concomitant savings of billions of health care dollars and untold pain and suffering for our patients. Man, we can’t do anything right.

Now, with the help of the American Academy of Pediatrics (AAP), there’s a new strategy.


Posted in: Dentistry, Public Health, Science and Medicine

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Dental Management Of Obstructive Sleep Apnea

[Editor’s Note: I’m pleased to announce that Grant Ritchey has agreed to join SBM as a regular. He’ll be writing about dental science and pseudoscience every four weeks on Sunday. (I swear, we’ll get up to seven day a week publishing if it kills me—or the other bloggers.) Grant will be starting with science, but I’m sure he’ll soon be discussing all the sorts of claims about dentistry and dental disease that are—how shall I put it?—less than science-based soon enough.]

Obstructive sleep apnea (OSA) is a sleep-related breathing disorder in which the airway is partially or completely blocked during sleep. Although little or no air is flowing, the person continues to attempt to breathe. Typically, cessations in breathing last longer than 10 seconds per episode, but can last over a minute and usually occur multiple times during sleep. This can lead to poor sleep quality and precipitous drops in blood oxygenation levels over an extended period of time. This potentially life-threatening condition is frighteningly prevalent, especially in adults over 40, and it is estimated that 80-90% of OSA goes undiagnosed, further compounding the problem.

When a person experiences multiple apneic episodes during the night, the brain responds by alerting the body, resulting in increased efforts to breathe, gasping, and arousal from sleep. These frequent waking events, combined with lowered oxygen levels, can lead to the signs, symptoms, and sequelae of obstructive sleep apnea. Typically, OSA sufferers snore loudly, then are silent for 10-30 seconds as the airway is blocked. This is followed by choking, snorting, or gasping sounds when their airway reopens.

Posted in: Dentistry, Surgical Procedures

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