My Concerns about “Holistic” and “Biological” Dentistry

Stephen Barrett, M.D.
August 3, 2022

A Wikipedia article suggests that the terms holistic dentistry, biological dentistry, unconventional dentistry, and alternative dentistry are “the equivalent of complementary and alternative medicine for dentistry.” [1] Searching with Google indicates that “holistic” and “biological” are by far the most commonly used of these terms. Although the holistic/biological dental community is diverse in its practices and approaches, I have found that the most common thread is opposition to the use of amalgam fillings. This article responds to this concern and evaluates pseudoscientific practices that many of these dentists use.

Historical Perpsective

Much of “holistic dentistry” is rooted in the activities of Weston A. Price, D.D.S. (1870-1948), a dentist who maintained that sugar causes not only tooth decay but physical, mental, moral, and social decay as well. Price made a whirlwind tour of primitive areas, examined the natives superficially, and jumped to simplistic conclusions. While extolling their health, he ignored their short life expectancy and high rates of infant mortality, endemic diseases, and malnutrition. While praising their diets for not producing cavities, he ignored the fact that malnourished people don’t usually get many cavities.

Price knew that when primitive people were exposed to “modern” civilization they developed dental trouble and higher rates of various diseases, but he failed to realize why. Most were used to “feast or famine” eating. When large amounts of sweets were suddenly made available, they overindulged. Ignorant of the value of balancing their diets, they also ingested too much fatty and salty food. Their problems were not caused by eating “civilized” food but by abusing it. In addition to dietary excesses, the increased disease rates were due to: (a) exposure to unfamiliar germs, to which they were not resistant; (b) the drastic change in their way of life as they gave up strenuous physical activities such as hunting; and (c) alcohol abuse.

Price also performed poorly designed studies that led him to conclude that teeth treated with root canal therapy leaked bacteria or bacterial toxins into the body, causing arthritis and many other diseases. This “focal infection” theory led to needless extraction of millions of endodontically treated teeth until well-designed studies, conducted during the 1930s, demonstrated that the theory was not valid [2,3].

Melvin Page, D.D.S. (1894-1983), one of Price’s disciples, coined the phrase “balancing body chemistry” and considered tooth decay an “outstanding example of systemic chemical imbalances.” Page ran afoul of the Federal Trade Commission by marketing a mineral supplement with false claims that widespread mineral deficiencies were an underlying cause of goiter, heart trouble, tuberculosis, diabetes, anemia, high and low blood pressure, hardening of the arteries, rheumatism, neuritis, arthritis, kidney and bladder trouble, frequent colds, nervousness, constipation, acidosis, pyorrhea, overweight, underweight, cataracts, and cancer. Page also claimed that milk was “unnatural” and was the underlying cause of colds, sinus infections, colitis, and cancer.

The human body contains many chemicals, ranging from water and simple charged particles (ions) to complex organic molecules. The amounts vary within limits. Some are in solution and others are not. Legitimate medical practitioners may refer to a specific chemical or a balance between a few chemicals that can be measured.

But the idea that “body chemistry” goes in and out of balance is a quack concept.

Proponent Organizations

The Price-Pottenger Nutrition Foundation of La Mesa, California, was founded in 1952 as the Santa Barbara Medical Research Foundation, became the Weston Price Memorial Foundation in 1965, and adopted its current name in 1969. It has about 1,200 members. Its Web site describes it as “the source for quality information on the origins of health through nutrition and lifestyle.” Its newsletter, book catalog, and information service promote food faddism, megavitamin therapy, homeopathy, chelation therapy, and many other dubious practices. It is also the repository for many of Price’s manuscripts and photographs. In March 2015, its online directory listed 79 dentists as professional members.

The Weston A. Price Foundation, of Washington, D.C., is another membership organization founded to promote Price’s principles. Founded in 1999, it opposes fluoridation, vaccination, and pasteurization and advocates holistic dentistry, organic farming, homeopathy, raw (unpasteurized) milk, and many questionable dietary strategies.

The Holistic Dental Association was founded in 1978 to provide a forum for developing and sharing of “health-promoting therapies that were not taught in dental schools.” In March 2015, its online directory included 254 dentists.

The American Academy of Biological Dentistry (IABD) was formed in 1985 and was renamed the International Academy of Biological Dentistry and Medicine (IABDM) in 2005. IABDM’s founding mission statement says: “The IABDM supports dentists, physicians and allied practitioners committed to integrating body, mind, spirit and mouth, and caring for the whole person.” [4] Its seminars have promoted “mercury-free dentistry,” “detoxification, “cavitation surgery,” electromagnetics, sound, light, acupuncture, homeopathy, herbal therapy, nutrition, and “an integrated approach to body, mind and spirit, with diagnosis and treatment of the whole person.” In March 2015, its online directory listed 161 dentists and 18 members from other professions in the United States.

The IABDM Web site refers to its members as “dental physicians” and states:

  • A dental physician is a health professional who promotes public awareness of whole-person health by focusing on the role of the mouth in systemic health and disease.
  • A dental physician subscribes to the goals of relieving the body of burdens such as infections, toxic chemicals and metals, electromagnetic disturbances and radiation, food allergens and nutritional deficiencies, biomechanical imbalances, and psycho-emotional distress and dysfunction, in order to restore natural biological function, mind-body vitality, and the ability to self-regulate and maintain homeostasis.
  • A dental physician is trained in the identification of existing and evolving dental co-factors in medical symptoms, as well as in the recognition and assessment of systemic co-factors in dental pain and disease.
  • A dental physician applies his/her dental skills to safely and effectively remove dental co-factors clinically, and works with physicians and all complementary and alternative medicine practitioners in systemic disease prevention and reversal by rendering the oral cavity energetically neutral whenever possible.

The International Academy of Oral Medicine and Toxicology (IAOMT) was founded in 1984. Its activities are centered around its concepts of biological dentistry. Nearly all of its members are dentists. In March 2015, its online membership directory listed about 700 dentists, most of them in the United States. Its primary target is dental amalgam. Its 2014 position statement on amalgam claims that, “Minimizing or eliminating mercury exposure can potentially result in improvement and/or decreased risk of disease/illness/health impairments” for all patients with existing amalgam fillings [5].

All of these organizations claim (improperly) that water fluoridation is ineffective and unsafe.

Dubious Practices

Many dentists who identify themselves as “holistic” or “biological” claim that disease can be prevented by maintaining “optimum” overall health or “wellness.” John E. Dodes, D.D.S., an expert on dental quackery, has remarked that “wellness” is “something for which quacks can get paid when there is nothing wrong with the patient.

Many “holistic” and “biological” dentists use approaches that are not only unsound but involve procedures and body areas that are outside of the legitimate scope of dentistry. Some practitioners use hair analysis, computerized dietary analysis, a blood chemistry screening test, or muscle-testing, as a basis for recommending supplements to “balance the body chemistry” of their patients. Hair analysis is not a reliable tool for measuring the body’s nutritional state [6]. Computer analysis can be useful for determining the composition of a person’s diet and can be a legitimate tool for dietary counseling. Dentists receive training in the nutritional aspects of dental health. However, few are qualified to perform general dietary counseling, and computerized “nutrient deficiency tests” are not legitimate. The blood chemistry tests, usually obtained from a reputable laboratory, are legitimate but misinterpreted. Instead of accepting the laboratory’s range of “normal” values, “holistic dentists” use a much narrower range and tell patients that anything outside that range means they are out of balance and need treatment. Muscle-testing is a feature of applied kinesiology, a pseudoscientific system of diagnosis and treatment based on the notion every health problem can be related to a weak muscle and nutritional imbalances [7]. Variations used by dentists include behavioral kinesiology and autonomic response testing (ART). Some biological dentists also use neural therapy, a bizarre approach claimed to treat pain and disease by injecting local anesthetics into nerves, scars, glands, trigger points, and other tissues.

Disorders of the TMJ (jaw joint) and facial muscles can cause facial pain and restrict opening of the mouth. Clicking alone is not considered a problem. Allegations that TMJ problems can affect scoliosis, premenstrual syndrome, or sexual problems are not supported by scientific evidence. Scientific studies show that 80% to 90% of patients with TMJ pain will get better within three months if treated with nonprescription analgesics, moist heat, and exercises [8]. Correction of a “bad bite” can involve irreversible treatments such as grinding down the teeth or building them up with dental restorations. The most widespread unscientific treatment involves placing a plastic appliance between the teeth. These devices, called mandibular orthopedic repositioning appliances (MORAs), typically cover only some of the teeth and are worn continuously for many months or even years. When worn too much, MORAs can cause the patient’s teeth to move so far out of proper position that orthodontics or facial reconstructive surgery is needed to correct the deformity.

Proponents of “cranial osteopathy,” “craniosacral therapy,” “cranial therapy,” and similar methods claim that the skull bones can be manipulated to relieve pain (especially TMJ pain) and remedy many other ailments. They also claim that a rhythm exists in the flow of the fluid that surrounds the brain and spinal cord and that diseases can be diagnosed by detecting aberrations in this rhythm and corrected by manipulating the skull. Proponents include dentists, physical therapists, osteopaths, and chiropractors. The theory underlying craniosacral therapy is erroneous because the bones of the skull are fused to each other, and cerebrospinal fluid does not have a palpable rhythm [9]. In one study, three physical therapists who examined the same 12 patients diagnosed significantly different “craniosacral rates.” [10]

Homeopathy is a pseudoscience based on 200-year-old notions that (a) substances that produce symptoms in healthy people can cure ill people with similar symptoms and (b) infinitesimal doses can be highly potent [11].

Some practitioners use procedures based on traditional Chinese medicine (TCM) theories that relate health and disease to alleged imbalances in the flow of “vital energy” (“chi”) through imaginary channels called meridians. A few dentists use a quack “electrodiagnostic device” that supposedly detects these imbalances.  These devices actually measure skin resistance to a low-voltage electric current, which the practitioners claim is related to “electromagnetic energy imbalance.” The procedure is commonly referred to as electrodermal testing, galvanic testing, or electroacupuncture according to Voll (EAV). It typically leads to multiple false diagnoses, unnecessary tooth removal, and/or the sale of useless dietary supplements and/or homeopathic products [12].

Some dentists who espouse TCM theories claim that areas of the body are “represented” by the tongue and the teeth, These claims have no anatomical basis and should be regarded as preposterous.The diagram to the right is from the Web site of a “holistic” dentist. I have also seen diagrams that relate each tooth to one or more of the body’s internal organs [13].

Auriculotherapy espouses the notion that the body and organs are represented on the surface of the ear. Proponents claim it is effective against facial pain and ailments throughout the body. Its practitioners twirl needles or administer small electrical currents at points on the ear that supposedly represent diseased organs. Courses on auriculotherapy are popular among “holistic” dentists. Complications from unsterile and broken needles have been reported. There is certainly no scientific evidence or logical reason to believe that fiddling with someone’s ear can modify a disease process at a remote part of the body [14]

Several hundred dentists—including a substantial percentage of IAOMT members—claim that the mercury in amalgam fillings is toxic and causes a wide range of health problems, such as multiple sclerosis, arthritis, headaches, Parkinson’s disease, and emotional stress. They recommend that mercury fillings be replaced with either gold or plastic ones and that vitamin supplements be taken to prevent trouble during the process. However, scientific testing has shown that the amount of mercury absorbed from fillings is only a small fraction of the average daily intake from food and is insignificant. In 1992 an extensive review by the U.S. Public Health Service concluded that it was inappropriate to recommend restricting the use of dental amalgam [15]. The American Dental Association considers amalgam to be a “valuable, viable and safe choice for patients” [16] and its Council on Ethics, Bylaws, and Judicial Affairs states:

ADVISORY OPINIONS
5 A.1. DENTAL AMALGAM AND OTHER RESTORATIVE MATERIALS.
The ADA has determined that the removal of amalgam restorations from the non-allergic patient for the alleged purpose of removing toxic substances from the body, when such treatment is performed solely at the recommendation of the dentist, is improper and unethical. . . .

5.A.2. UNSUBSTANTIATED REPRESENTATIONS.
A dentist who represents that dental treatment or diagnostic techniques recommended or performed by the dentist has the capacity to diagnose, cure or alleviate diseases, infections or other conditions, when such representations are not based upon accepted scientific knowledge or research, is acting unethically [17].

The most outspoken advocate of amalgam toxicity has been Hal A. Huggins, D.D.S., of Colorado Springs, Colorado, who described himself as one of Page’s students. Huggins promoted “balancing body chemistry” so vigorously that in 1975 the American Dental Association Council on Dental Research denounced the diet that he recommended. Another Price follower is George A. Meinig, D.D.S., whose book Root Canal Cover-up Exposed was published in 1994.

In the mid-1980s the FDA forced Huggins to stop marketing mineral products with false claims that they would help the body rid itself of mercury. Huggins also claimed that root canal therapy can make people susceptible to arthritis, multiple sclerosis, amyotrophic lateral sclerosis, and other autoimmune diseases. As with amalgam fillings, there is no objective evidence that teeth treated with root canal therapy have any adverse effect on the immune system or any other system or part of the body [18]. Huggins’s dental license was revoked in 1996. During the revocation proceedings, the administrative law judge concluded: (a) Huggins had diagnosed “mercury toxicity” in all patients who consulted him in his office, even some without mercury fillings; (b) he had also recommended extraction of all teeth that had had root canal therapy; and (c) Huggins’s treatments were “a sham, illusory and without scientific basis.” [19]

Huggins, who died in 2014, also maintained that facial pain, heart disease, arthritis, and various other health problems are caused by “cavitations,” within the jaw bones, that are not detectable on x-ray examination or treatable with antibiotics. Advocates now call this condition “neuralgia-inducing cavitational osteonecrosis (NICO” and claim they can cure the patient by locating and scraping out the affected tissues. They may also remove all root-canal-treated teeth, most of the vital teeth close to the area where they say a problem exists, and even parts of the jawbone. Worse yet, the surgery may result in severe infections and a lifetime of pain [20].

Huggins’s Web site stated that, “Cavitations are hard to find. They require lots of skill, years of experience, and most of all, a vivid imagination to spot them on an X-ray film.” Vivid imagination may well be the basic requirement of holistic and biological dentistry.

One of Huggins’s followers was Gary L. Jacobson, D.D.S., who practiced dentistry in Bloomington Minnesota. In 1983, in response to a complaint that he had made an improper statements about amalgam he agreed to stop representing to patients that amalgams will result in their having a pound of mercury in their mouth.” [21] In 1996, when faced with charges that he had inappropriately treated more than 30 of his patients, he surrendered his dental license. Some of the patients had undergone testing by the Huggins Diagnostic Center, The dental board noted that he routinely advised patients to replace their amalgams and remove their teeth that had undergone root canal treatment [22],

In the mid-1990s Huggins, his clinic, and one of the clinic’s contract dentists were sued for malpractice by a woman who had been who had her amalgams and root canals removed after being frightened by reading one of Huggins’s book and seeing him on a “60 Minutes” TV program. The jury awarded her $26,716 for the negligent treatment by the dentist plus $132,216 (including punitive damages of $50,000) for Huggins’s role as director of the clinic and in promoting his false ideas. However, an appellate court concluded that Huggins’s opinions expressed through the media were protected by the First Amendment and because he had not personally advised or treated the woman, she was not entitled to collect damages from him [23].

The scope and dangers of biological dentistry at its worst can be seen by reading the complaints against Alireza Panahpour, D.D.S., a California dentist. He has been sued for fraud and/or malpractice at least eleven times by patients who charged that he had subjected them to inappropriate treatment that left them with severe discomfort and a need for expensive corrective procedures [24-33]. At least six of the patients alleged that he had removed amalgam fillings unnecessarily. At least nine said that he had used autonomic response testing. At least seven said that he had used neural therapy, including three women who said he administered injections into their breasts. In 2018, the Washington Dental Quality Assurance Commission charged Panahpour with unprofessional conduct in his treatment of a patient. The board’s complaint notes that (a) he performed four “cavitation” operations on the patient’s upper and lower left jaw even though a panoramic x-ray showed no infection or other abnormal findings, and (b) during one of the operations, Panahpour injured a nerve in the jaw that caused the patient to have long-term numbness [34]. In 2019, the authorities concluded that Panahpour’s care of this patient hasd been substandard and revoked his license for a minimum of five years. It also ordered him to reimburse the patient for all fees and pay the State of Washington a $5,000 fine plus $18,000 for the cost of the disciplinary proceedings [35]. In order to reinstate his license, he must pay these assessments and pass several competency tests. Quackwatch has a comprehensive summary of his activities [36].

The Bottom Line

My advice is simple. Regardless of what they call themselves, steer clear of dentists who use or even recommend any of the dubious practices described in this article.

Disciplinary Actions against Holistic or Biological Dentists
References
  1. Holistic dentistry. Wikipedia, accessed March 26, 2015.
  2. Easlick K. An evaluation of the effect of dental foci of infection on health. Journal of the American Dental Association 42:615-97, 1951.
  3. Grossman L. Pulpless teeth and focal infection. Journal of Endodontics 8:S18-S24, 1982.
  4. Founding mission statement. IABDM Web site, accessed Feb 3, 2008.
  5. Kall J. and others. International Academy of Oral Medicine and Toxicology (IAOMT) position statement against dental mercury amalgam fillings. April 2014.
    for medical and dental practitioners, dental students, and patients.
  6. Barrett S. Commercial hair analysis: A cardinal sign of quackery. Quackwatch, Aug 30, 2018.
  7. Barrett S. Applied kinesiology: Muscle-testing for “allergies” and “nutrient deficiencies.” Quackwatch, Aug 3, 2014.
  8. Okeson JP (editor). Orofacial Pain: Guidelines for Assessment, Diagnosis, and Management. Hanover Park, IL: Quintessance Publishing, 1996.
  9. Barrett S. Why craniosacral therapy is silly. Quackwatch, Feb 11, 2018.
  10. Hartman SE, Norton JM. Interexaminer reliability and cranial osteopathy. Scientific Review of Alternative Medicine 6(1):23-34, 2002.
  11. Barrett S. Homeopathy: The ultimate fake. Quackwatch, Aug 25, 2016..
  12. Barrett S. Quack “electrodiagnostic” devices. Quackwatch, Fwb 14, 2018.
  13. Barrett S. Bizarre tooth charts. Dental Watch, Nov 9, 2014.
  14. Barrett S. Auriculotherapy: A skeptical look. Acupuncture Watch, Feb 2, 2008.
  15. Benson JS and others. Dental Amalgam: A Scientific Review and Recommended Public Health Strategy for Research, Education and Regulation. Washington, D.C., 1993, US Public Health Service.
  16. Statement on amalgam. ADA Council on Scientific Affairs, Aug 2009.
  17. Principles of Ethics and Code of Professional Conduct. American Dental Association, revised 2012.
  18. Barrett S. The “mercury toxicity” scam:
    How anti-amalgamists swindle people    . Quackwatch, March 2, 2006.
  19. Administrative Law Judge’s conclusions about Hal A. Huggins, D.D.S (1999)., Quackwatch, Dec 23, 1999.
  20. Barrett S, A critical look at cavitational osteopathosis, NICO, and “biological dentistry.”Quackwatch, July 15, 2018.
  21. Agreement between Gary L. Jacobson, D.D.S. and the Minnesota Board of Dentistry, Dec 6, 1983.
  22. Stipulation and order for voluntary surrender of license. In the matter of Gary L. Jacobson, D.D.S., before the Minnesota Board of Dentistry, Nov 6, 1996.
  23. Decision. Bailey v. Diagnostic and Rehabilitation Center.3 Colorado Court of Appeals, Case No. 96CA0586, Feb 23, 1998.
  24. First amended complaint. Ripsime (Rita) Filikyan vs. University of Texas Houston Health Science Center and others. Los Angeles Superior Court Case No. BC 355412. The case was settled out of court with a nondisclosure agreement.
  25. Complaint for damages. Jill Cresap vs. Alireza Panahpour, South Coast Center for New Medicine, and Leigh Erin Connealy. M.D. Orange County Superior Court Case No. 30-2008-00114601, filed Nov 12, 2008. In 2010, shortly before the case was tried, Connealy and her clinic (where Panahpour had worked) settled for a modest undisclosed sum. At the trial, the jury ruled in Panahpour’s favor.
  26. Complaint for damages. Anne Harrison Stone vs. Alireza Panahpour and others. Orange County Superior Court Case No. 30-2008-00114750, filed Nov 14, 2008. The case was settled for an undisclosed sum.
  27. Complaint for damages. Andre Vaillancourt vs. Alireza Panahpour and others. Los Angeles County Superior Court Case No. SC 100818, filed Dec 3, 2008. The case resulted in a judgment for $273,506. Panahpour appealed, but the Court of Appeals upheld the judgment except for $500.
  28. Complaint for damages. Ardis and Henry Morschladt vs. Alireza Panahpour and others. Orange County Superior Court Case No. 30-009-00323131, filed Nov 24, 2009. Panahpour agreed to settle for $19,999.98 but later asked the Court of Appeals to vacate the resultant judgment. I doubt that it will.
  29. Complaint for damages. Jeaneen Bauer vs. Alireza Panahpour and others. Orange County Superior Court Case No. 30-2009-0329075, filed Dec 17, 2009. Panahpour was discharged when he filed for bankruptcy. The other defendants settled with nondisclosure agreements.
  30. Complaint for damages. Sarah Haynes vs. Alireza Panahpour and others. Orange County Superior Court Case No. 30-2010-00344946, filed Feb 18, 2010. The case was settled with a nondisclosure agreement.
  31. Complaint for damages. Chelsea Bibb vs. Alireza Panahpour and others. Orange County Superior Court Case No. 30-2010-00355539, filed March 22, 2010. Panahpour was discharged when he filed for bankruptcy. The other defendants settled with nondisclosure agreements.
  32. First amended complaint for damages. Pamela Mc Greevy vs. Cavitat Medical Technologies, Alireza Panahpour, and others. Orange County Superior Court Case No. 30-2010-00368271, filed Nov 3, 2010. The case was settled with a nondisclosure agreement.
  33. Barrett S. Alireza Panahpour, D.D. S. loses another malpractice suit. Casewatch, July 10, 2018.
  34. Statement of charges. In the matter of Alireza Panahpour. Washington Dental Quality Assurance Commission Master Case No. M2017-927, May 1, 2018.
  35. Findings of fact, conclusions of law, and final order. In the matter of Alireza Panahpour. Washington Dental Quality Assurance Commission, Master Case No. M2017-927, April 30, 2019.
  36. Barrett S. A skeptical look at Alireza Panahpour, D.D.S. Quackwatch, July 10, 2018.

This article was revised on August 6, 2019.