Holistic Approaches in Dentistry: Navigating the Fluoride and Mercury Debates

Hi everybody, I'm Dr. Sanda Moldovan, periodontist and nutritionist. Welcome to the Holistic Dentistry Podcast, the show that gives you the tips and tools to detoxify your mouth for a healthier body as we explore together the root cause of disease. Remember, you're not healthy until your mouth is healthy, so take care of it in the most in a natural way. Everyone, welcome to another episode on the Holistic Dentistry Podcast. I'm your host, Dr. Sanda Moldovanova, and with me today is Dr. Jack Kahl. I had the pleasure of meeting Dr. Kahl years ago. He's a biological dentist and a fellow of the Academy of General Dentistry and a past president of the Kentucky chapter. He's an accredited master of the International Academy of Oral Medicine and Toxicology. IAOMT, and since 1996 has served the chairman of its board of directors. He also serves on the Bioregulatory Medical Institute board of advisors. He is a very busy man, and I'm so glad that, you know, he's taking the time today to be with us to tell us about the latest happenings in biological dentistry. Dr. Kell, welcome to the show.

Thank you for having me. I'm looking forward to this.

Awesome.

Okay. Okay. You got your—

I'm gonna take this and move it to the beginning. Great.

And I graduated from dental school in 1977. And in 1983, I was taking a lot of, uh, continued education courses, doing a lot of reading, and I was really into nutrition and I was reading this book called Why Raise Ugly Kids by Dr. Hal Huggins, one of the pioneers of biological dentistry and with the focus on mercury fillings at the time. I was reading my junk mail and saw an advertisement by a hygienist for like nutritional counseling, something really unique, at least for where I live here in Louisville, Kentucky. And So I called her up. I said, so what are you into, the 4 major food groups or what? And she laughed and said, well, have you ever heard of a guy named Hal Huggins? I said, oh my gosh, I'm reading his book. And so we met for lunch. One thing led to another. She ended up getting Dr. Huggins to come to Louisville, put on a conference. Not a lot of us attended. Fortunately, I brought my my wife and my couple of assistants. I mean, I hadn't been outta school that long, just building a practice from scratch. And so, so I thought the, the one-day course was gonna be about nutrition. And yeah, the first hour was, but then he started talking about amalgams, the mercury fillings and how mercury comes off of them. And he starts showing a little research. There was not much research back in 1983 published in any journals. And so it was quite extraordinary what he was telling us and just hard to believe because you know how we're trained in school to think a certain way. So, um, he, long story short, he did interviews with the TV, local TV station, the switchboard lit up, all these people calling in wanting to know who to go to to get this testing done that was part of his deal. So did that, and, um, that was my beginning, all focused on, on the mercury filling issue. Of course, continued my education in, in nutrition. About a year later, the IAOMT was founded. So I, I joined immediately and we started having several conferences a year. And as the years went by, We started talking about fluoride, problems with that. We started talking more about periodontal disease, gum disease, and, you know, the nutritional influences on that. As the academy grew and, and expanded its horizons, obviously I did as well. And over the years, then we added on concerns about root canal treatment. So here we are today. My wife used to kid me. How could you be a dentist? You don't like mercury fillings, you don't like fluoride, you don't like root canals. It's like, what's left? Well, of course, what's left? Now we've gotten into all the sleep disordered breathing and airway issues in dentistry and, and still really into the nutritional aspects, as I know you are. Uh, that's, yes, your, one of your areas of expertise. So, so over these years, biological dentistry has evolved, although a lot of people call it holistic dentistry, integrative dentistry. Really, I think they're all pretty much the same thing. Depending on what word you use, there might be a little more emphasis on one, one dimension compared to another, but we're all pretty much on the same page.

Yeah, you're absolutely right. I'm glad you brought this up. The definition because, um, you know, people are always confused and I always get asked this question. Well, what's the difference between holistic and biological? Yeah. And you're right. Yeah. At the base of it, we all want, we, we're conscious about the mouth because we know it gets to the body. Yeah.

And we want, we want materials and techniques that we use to be biocompatible. That's, that's crucial. And we add a dimension to dentistry that unfortunately a lot of our traditional peers don't embrace, and some of it is the business part of it because of the insurance industry, the way that's influenced dentistry. You know, there was an old saying, I don't know if anybody uses it anymore, but what type of practice you have, and it was drill, fill, and bill. You know, it was just the mechanic and being more like tooth carpenters. But, you know, our patients come in. I just had a new patient here an hour or two ago, and just a lot of complexities. And it takes time to, I guess, peel through the layers of the complexities of that individual, where they are in their life. You know, this individual under a lot of stress, we started talking about the sympathetic, parasympathetic nervous system, the influence that that has. On our overall health. I think you and I have talked a little bit about that root cause protocol concept. Yeah. You know, I bring that up, that's the nutritional angle and just acknowledging, you know, what's going on in the body when the body's exposed to these toxins, when there's all this stress involved and anxiety and how you work through that. And We wanna be true to the needs, the dental needs of our patients. Obviously, if there are, um, structural issues with their teeth, tooth decay, broken teeth, whatever, you know, those need to be repaired and restored to good function. Uh, and, and then of course gum disease and, and those issues. Yeah, those are still core aspects of dentistry. But when you add the, the holistic, the biological integrative, we're adding now dimensions that take into consideration that person's entire being and, and what's going on in their life systemically. And, and sometimes it's those systemic things that are impacting what's going on in the gums, but it's a two-way street, that whole oral systemic connection is, is what now we are really known for. And I think there's more of a movement. There's leaders in the field. I don't know if you've heard of Dr. Miguel Stanley from Portugal. He's been lecturing. He was, uh, invited to lecture at the, uh, Yankee Dental Congress up in Boston, uh, the other year. And, um, he does a great job of explaining to traditional dentists, uh, what, what is missing at times in assessing our patients and helping our patients and understanding. So by, by casting our, our net wide and far, I think we're able to optimize our patients' health by including all these other parts of, of the puzzle, putting it all together. And a lot of times working with their physicians, you know, hopefully they're getting connected with their fe— uh, functional medicine, integrative medicine practitioners that that, that then we can work together as a team.

Yeah, absolutely. I work with quite a few physicians myself, and I love that you mentioned your class protocol. I had Morley as a guest. So for those of you listening, you can tune in to that episode. Yes. With Morley. Now you mentioned biocompatible materials. Do you feel, or do you, in your practice, do you test for these materials or you just choose certain materials?

Well, interesting you bring that up at this moment in time. I'm a bit frustrated because for a long time there had been a test available. The individual who started and developed that passed away. The company was purchased by a physician researcher, and he was looking to improve the test, and in doing so came to a situation in which it's very labor-intensive. With the way he was trying to improve the test, and right now it's not available. There is another test that was very similar to the first one, just Clifford's testing. And so yeah, there is a blood test that can be done for those patients that want a little more of guidance, particularly those who have a lot of chemical sensitivities. Some people use muscle testing. That's, that's, uh, that can be beneficial and helpful at getting some feedback as far as what our patients tolerate. But, you know, in a general view of compatibility, we biological dentists make an effort to stay away from metals. Metals just inherently have another complicating aspect called galvanism, the electrical activity. And actually, I don't know if you've ever met or heard of Dr. Scott Schroeder. He is a foot and ankle surgeon. He was, he'll be, he'll be presenting at an IOMT meeting coming up, although he, he did get to present at the Istanbul conference we just had in May, our, our big international conference over there. And I met him at an FDA hearing about 6 years ago that had to do with metals in medicine and dentistry. I was there to talk about the mercury filling issue to the FDA, but they spent a whole day talking about metals in and particularly implants. So a lot of our dental implants have traditionally been some type of metal, usually titanium alloy. And fortunately, we now have our ceramics to, to offer our patients. But this foot surgeon, Dr. Schroeder, he was noticing these unusual electrical occurrences with all the pins and plates and screws that he was using to reconstruct and repair the bones in the feet and ankle. And it's at some point had linked up with a biological dentist and started doing testing as far as the galvanicity and the interaction between metals in the feet and even in the mouth. Wow. And actually metals are used in a number of medical devices. Those that have various surgeries on bones, neck, back, the vertebra. Sometimes there's fusions with screws and plates. Placed. There are these mesh devices for bladder and pelvic floor control. That was actually a very hot topic at, at that particular hearing because a lot of the members of the public that had had medical problems induced from the implantation of these medical devices were there to ask the FDA to take those things off the market because of the problems they were having. And so sometimes there's just a localized problem, but sometimes there's this interaction between metals in the body.

Yeah.

And so it behooves us to keep that in mind. Uh, and again, looking beyond the realm of the mouth, being alert and aware. I mean, frequently I'll be asking my patients, do you have metal implanted in other parts of your body? And I'll start rattling up, because a lot of people forget about them. They've been in 10 years. Maybe they didn't think there was an issue. Maybe it was just a screw somewhere and they've long forgotten about it. So back to biocompatibility, you got that electrical component, which I went down that rabbit hole, but then there's just what the materials are made of, you know, with our, so we've gotten away from the mercury fillings. That's great. Um, but then the question becomes, well, are the composites really compatible?

Great question.

The concern, the concern with the BPA, which there are just, I know there's one brand that does not have any BPA in it.

Yeah, we use a brand at the office without BPA, but, but still we use a brand at the office without BPA. It has nanoceramics instead.

Yeah.

But also then the bonding still has some BPA.

Depending on the, on the bonding agent. Yeah. There's a tendency there. It just is hard to find that perfect product and combination of products that, that work together. So we do the best we can with what we've got to work with. And, uh, and just have that awareness with our patients that if there's any kind of problems ongoing after some dental treatment's done, we need to, we need to be alert with that. There's even this newly recognized condition that's typically a person's had a tick bite and they now have become sensitive to meat. Have you heard about this?

Not heard this.

Yeah. And there's been a little bit of, of public— of couple articles about it and, and just very little research, but they, there's some type of, of cross-sensitivity with the, with some dental materials, like some of the composites. And it can be a real frustrating problem trying to then identify what material would be compatible. So, um, it's so important to have, you know, real complete, I guess, health history of our patients to know and pay attention to these things. It's just amazing how things are, can be related to each other.

Speaking of the health history, you know, in the initial exam about, you mentioned you're spending time understanding the patient. Like how about, what is the length of your exam with your patient?

Yeah, typically an hour and a half. And, uh, you know, we start off the assistants, uh, doing some basic information gathering, reviewing the health history and kind of getting an executive summary ready for me. And that's just a way for the patient to ease into things. I mean, I've had colleagues, you probably have too, where, where the, they have the patient meet the, the doctor first and, and start off with that. It's whatever works for your, your style of communication, but I like I like to start off most typically with, with the exam, which I'm analyzing what's going on with the teeth. Of course, the big bugaboo these days is x-rays. Our patients don't want x-rays, but we need x-rays to properly diagnose. So, you know, one thing I, I, well, I don't know if you've been exposed to this concept, but, uh, you know, there's the 8 forms of vitamin E. The 4-tocopherols and the 4-tocotrienols. And there's, the delta-tocotrienols are actually protective against radiation. And I know Dr. Barry Tan years ago was teaching us about the, the qualities and properties of the, the delta-tocotrienols. And he was very instrumental in, in helping me understand how it can be protective. There's actually the government, federal government actually has a patent on using the Deltatox trinol to, to protect against radiation to, to their troops. Instead of from, from a, a dental x-ray or something, now we're looking at radiation from other sources. But bottom line is you want to prevent that damage to the DNA that is potentially problematic. Of course, with most of our dental x-rays now that we're, I think most everybody's digital, the amount of radiation dosage has dropped tremendously. I mean, I see estimates of 90%. And, you know, we're very careful and, and we personalize our recommendations as to how often we do a risk assessment. You know, let's, let's look at, well, how long has it been since this person had tooth decay? We like to look at their historic x-rays, what things look like 2 years ago, 5 years ago. Uh, patients are constantly asking, hey, you know, I've been told I got these cavities. Maybe they come in for a second opinion. Sure enough, you look and you see the slightest little bit of de— evidence of demineralization, that little shadow there, and, and what to do about that. They wanna know what toothpaste, rinses, whatever to be using. So there's a whole regimen there that we can follow, but it's, it gets real tricky because the, one of the worst things that, that we would ever have to say to a patient is, sorry, but that decay or that problem is so bad, you're either gonna have to have root canal treatment to save the tooth or have the tooth extracted.

Yeah.

Two really poor options. You know, we're all about preventing our patients ever getting to that point. And, and so if somebody's inclined that they just don't want to have the dental x-rays, they gotta realize that that could increase their risk for hearing that choice. But then again, it's all about, you know, do, uh, uh, an office, uh, that you're comfortable with, you go regularly so we can monitor things. And you know, we've got patients that have very seldom had a cavity. They're very low risk, their diet is such, and they're, flossing and doing all the things they should. And yeah, with those patients, everything looks great on a set of x-rays. You can probably go 3, 5 years without getting into trouble. Yeah. But we just gotta do that risk assessment and that takes a little extra effort to do that. There is a new product that maybe the viewers haven't heard about. It's called Curadont. It was developed in Europe. It's a peptide. Peptides are very new to dentistry in that respect. Our medical colleagues have been having their patients inject them for a lot of different conditions.

Yes.

But what this peptide does, it's in a liquid form and it prevents the dentist from having to numb or drill on the tooth. So when we identify this slightest little area that's demineralized and we see this tiny little shadow, We can clean that off and typically the assistants would apply it, helps keep the cost down. And it, again, it's liquid, so it's painted onto the, the tooth area. Typically it's the in-between, but it can be used anywhere on the tooth. And as that peptide penetrates the surface and is absorbed by the tooth structure, which is, we, we've done a procedure called etching to make that more robust and, and get that peptide deeper into the enamel. And then follow up with having a patient ideally use using at a minimum some kind of hydroxyapatite paste or something called MI Paste, which is a calcium phosphate mixture, Recaldent, to, to help provide more minerals. Because even without that, the mineral in the saliva, the calcium and phosphate floating around, are going to be attracted to that peptide to help remineralize the area. Now, the one big negative, I said it was developed in Europe. And it was a nice clean product. And when they presented it to the FDA for approval here in the States, the FDA made them put some fluoride in it.

Now, that's the bad news.

Kind of okay news is that, well, it's not 30,000 parts per million like, like dentists that use these fluoride varnishes in very high concentrations of fluoride. This is around 250 parts per million. Which is a whole lot lower.

Yes.

And for one application in a limited period of time that I just tell my patients, look, full disclosure, this is what's in it. It does have the potential to stabilize that demineralization and get you more, a better remineralization. And you know, if you're avoiding fluoride from all the other sources and hopefully your, your iodine intake is adequate. Because that can be a little bit of an antidote to fluoride exposure, then yeah, you could probably tolerate it without any, any issues of concern. But personal choice, leave it to the patient to decide.

That's a great option for patients with, uh, with small lesions. Do you have to do one application specifically, or do you find that you need several applications?

You know, it, it hasn't been around long enough to where we've got really good guidance from research on that. So typically, The approach is, let's say we just took the bitewing X-rays, saw the demineralized areas. We have the conversation. We, the patient elects to have us use the Curodont. And then the next step is to take new X-ray, probably about a year. I mean, you could do it at 6 months, but again, you know, we want to be cautious about the X-rays. So the, the strategy is see what it looks like in a year. Now we've got some patients, we've been using the product just a little over a year, and we've had the conversation. We've had some patients elect to do a second application just to hedge their bets, try to make sure that things are stable. And, and what we're seeing, we're, we're seeing good results. We're seeing that in patients that, that we take the new, and, and the only way to evaluate, you've gotta have The X-ray, the radiograph, because it's an area we cannot see. There is no other metric that we have in dentistry to give us any indication of whether that, that remineralization strategy is, is working or not. And again, we certainly don't want that to turn into a cavity that now has gotten so deep that we got a nerve problem.

Yeah. So, so true. I'm glad you brought this up with x-rays because I've even had a patient who reported, oh, I heard that x-rays cause cavities. I'm like, wow, that's a new one. I've never heard of that. So it is.

Yeah. There's been, and, and obviously the, the greatest exposure is when we have to do the CAT scans, which eventually we might be talking about root canal treated teeth and monitoring those. And that's the gold standard. Monitoring a root canal-treated tooth is with a CAT scan. So getting back to that delta-tocotrienol, we, um, we recommend, um, product to our patients to take. You know, there's no set rule of thumb. It's not like there's been a ton of research, but a patient would, would go on this. Would you want me to show you a bottle or is it you want to stay away from products?

No problem.

Okay. I got it right over here.

Yeah, this is a great tool. You know, I like a, a product that's a homeopathic product called the Radinex, which is also helpful with radiation. And I'm glad you brought this up. Nutrition is so, so important. This is, my guess is delta-tocotrienol is, um, uh, extract, Annatto E. Yes. From Designs for Health. It's a great company, professional company.

Yeah, a great company. And actually the, the sourcing of the delta-tocotrienol in here is from something, this is in really small print. I don't know if it'll show Delta Gold.

Yeah, Delta Gold.

Well, that's the company that Dr. Tan had created to fabricate this delta-tocotrienol in a high-quality formula that is sourced from the natto plant and provides that protection. And you can get it. This was a 150-milligram capsule The tricky thing about this is, is you don't want to take it with normal vitamin E or any foods that have. And normal vitamin E is the alpha-tocopherol because that will interfere with the absorption of the delta-tocotrienol and also certain other minerals. So, it's best to take this probably before you go to bed where you haven't eaten for hours, aren't taking any other minerals at the same time. So no multiple vitamins, no, no magnesium or, or, um, zinc at the same time because those can interfere with the absorption. But our protocol is to take, take this starting 4 days before and 4 days after. Now, if somebody wanted to take, and the dosage, um, because it comes in a bottle of 30. And it's 150 milligrams, request they take 4 of those.

Yeah.

So that would be 600 milligrams. You know, you can do it just once a day, 4 days before, 4 days after. Of course, the, the other thing, we keep this in the office cuz sometimes patient comes in, they don't have the luxury to, of doing this ahead of time, particularly if they're driving long distances. We say, look, it's better than nothing. You know, we give 'em a loading dose while they're here in the office and then they'll take it just finish the bottle out here over the remaining weeks.

Yeah.

With the high dosage.

And there's so much radiation everywhere nowadays. There's so much radiation from so many sources. We should probably be taking this all the time.

If, if you're an airline pilot or a flight attendant, you probably ought to be taking this stuff every day. 'Cause, uh, you know, you certainly get your exposure whenever you fly.

Yeah.

Dr. Sanda Moldovanovan.

Okay. I want to talk about a topic here. I know you were recently in a hearing on fluoride. You know, it's such a hot topic today. I'm excited to see a couple of states already taking fluoride out of their water. That's Utah and Florida. And I would love to hear from you, like, where are we? What's the status that you can—

Yeah, well, there's, you know, I was talking to the executive director of FAN, the Fluoride Action Network just the other day. And he said that what's going on throughout the country is a lot of the local municipalities are voting to get rid of the fluoride. And, and so already this year, there's been probably a reduction of tens of millions of people fewer that are now being exposed to water fluoridation. And this, this is just local communities, smaller communities that are voting to get it out of the water. Now, unfortunately, I live in one of the 16 states that has a mandate that forces— a state mandate that forces all the water companies in our state to add fluoride. So yeah, yesterday I was testifying to support a bill that would remove that mandate. We had discussions about a ban bill, but there's the concern that we're, that the legislators just aren't quite ready for that. Of course, that maybe that'll change when they're in session next January, we shall see. But they're more familiar with removing the mandate. And there's actually, it passed the House last session, but the Senate, it was new to them. They didn't understand the issue. So hopefully this year around, we can at least get rid of the mandate. So that's what's going on. The localities, the states, we're not the only state trying to get rid of the mandate. State, there are others. But then on the national level, this is where it gets really frustrating. You know, there was the federal lawsuit that was settled a year ago in which the court ruled that, and I'm just going to grab my slides that I printed out from yesterday.

Yeah.

So I quote this accurately, but the court finds that fluoridation of water at 0.7 parts per million, which is typically what any water company adds to the water and is considered optimal, that it poses an unreasonable risk of reduced IQ in children. And it further states the scientific literature in the court record presented during the trial provides a high level of certainty that a hazard is present. Fluoride is associated with reduced IQ. So the judge made that ruling, and then it was up to— and this lawsuit was against the EPA. So the EPA had a choice of either to go along with the ruling and do something to reduce this risk, which really was undetermined. The court didn't say, oh, you have to do such and such. Just like, you gotta do something to address this problem of the risk. Well, in a lot of our opinions, it would be, well, just say, okay, stop putting fluoride in the water. That'd be the easy thing. Although they could have chosen to do some kind of an analysis, or the other choice would be to appeal the ruling. And that could take years to work its way through the courts. The part that gets really frustrating though, this was— ruling was last September, and then we had an election and a change of administrations in January. With, as many of you know, Bobby Kennedy, the Secretary of HHS, has been vocal in his opposition to water fluoridation.

Yeah.

Problem is he's not in a position of regulatory authority unless something were done through the FDA. Interestingly enough, the FDA had an unusual type of, of hearing a few months ago relative to these fluoride supplements. Which have never been approved by the FDA. They kind of worked away— worked their way into our availability through, I guess, the supplement aspect of things that people can purchase and consume. Now, although there's— well, although the weird thing is people have to have a prescription from their dentist or physician to get those fluoride supplements. But, but anyway, what we've been hearing is that there's a high probability that very soon FDA will issue a stop and desist of manufacturing those fluoride supplements, which is a, a systemic way, you know, of in the past where people thought it was a good idea to get fluoride systemically that no longer will be available. Well, you can make the same argument if you're adding something to the water to prevent a disease that meets the definition of a drug. And who has authority over regulating drugs? The FDA. So we'll see how this all develops with these fluoride supplements. But in the meantime, the EPA with its new administrator, Lee Zeldin, the, the sense that I have in talking to a lot of experts in how these political and legal matters work their way out is the EPA is in a position in which they're concerned that if they just say, yeah, we're gonna go along with the court's finding on that lawsuit, let's get the fluoride outta the water, that all of a sudden there's gonna be an overload of lawsuits. There's a particular legislation, the TSCA bill. It has to do with these toxic substances that could be in the water. And then if there's all of a sudden all these lawsuits against EPA to do a better job of regulating and removing these things from what— that it's gonna create absolute chaos. It's hard to say what the EPA's endgame is, but they did decide to appeal the lawsuit. So you get within the same overall Trump administration. You've got the heads of two different agencies that are in a bit of conflict here.

I see.

And not been able to sort this out. And that's why I'm extremely frustrated with the situation because it appeared that we were gonna be in a good position to get rid of fluoridation, but now we're kind of stuck, stuck in limbo.

And through the—

there are efforts—

government.

Yeah, there are efforts behind the scenes to try to work through this somehow, and we'll see what comes up.

Yeah.

So stay tuned.

Stay tuned for the fluoride issue as it continues here. Now, let's talk about mercury. I know, you know, Europe banned all mercury fillings starting January of this year. What's the status for United States?

Yeah, we were very excited. You know, the— and pretty much the thing that opened the door for the ban in Europe was more from the environmental perspective. You know, the United Nations has a division called UNEP, United Nations Environmental Program. And gosh, back in 2009, there started to be global meetings about, you know, getting rid of the use of mercury in a lot of different products, not just mercury fillings. Of course, there's a lot of resistance from the typical proponents of mercury fillings that claim that they're safe, But long story short, yeah, Europe finally banned them. In the United States, the closest we've got is, you know, I mentioned that, that hearing earlier in 2019, Metals in Dentistry. And, and so after that hearing, a year later, the FDA did release basically some warnings and guidance. The unfortunate thing is nobody was following them or paying attention to them. They're not well publicized. I mean, yeah, there's a website. I'd talk to dental students, they never heard about it. I'd talk to faculty members of dental schools that like, what? What are you talking about? You know? So it's like there's some warnings there. And basically the warnings are not to place new amalgams in any individuals that have neurological disease, kidney disease, pregnant, well, children, women of childbearing years, basically when you add up all those groups in our population, you're over 50%, uh, yeah. And it's a lot of people, but they're not getting the message. So just recently in the IOMT, who have been very, uh, strong in advocating for amalgam to be banned, we have submitted a, a new revised and updated position to the FDA to reconsider this issue and hopefully ban it. And again, with the new administration, there is some sense that we, um, might get a different result than we did when we sued the FDA back in 2010.

And I hope so.

It took 9 years to get some kind of warnings put in place.

Yeah.

There was actually a paper published this Monday I don't know if you know who David Geier is. He is, he and his dad, his late father, uh, had published a lot about mercury relative to the mercury fillings, relative to the mercury that had been used in vaccines. His paper just again confirms from a lot of government data and statistics that people with amalgams will have higher blood levels of mercury. So there's, there's continually been more research coming forth. Fortunately, and you've probably seen this in your, your experience as a dentist, the patients coming into us today compared to 20 years ago, uh, do not have as many amalgam fillings. And fortunately, a lot of our younger patients, at most, they might only have one or two, if that. Some of it's socioeconomics. Unfortunately, there are some states in which their Medicaid program will only pay for a mercury filling. They won't even pay for the other type. That's getting to be less and less.

Mm-hmm.

So there's, there's still work to be done in, in the USA relative to diminishing its use. Of course, the flip side of this is, okay, even if it's banned, we unfortunately have what some of us call a legacy product in which the fillings are still in people's mouth, putting off the, the mercury toxin and exposing our patients to levels that could be a problem. And then if the patient decides to have them removed, that there's a whole protocol to safely remove them. Uh, we actually call it SMART, which stands for Safe Mercury Amalgam Removal Technique. And the Academy has been educating dentists, physicians, all healthcare practitioners as well as the public as best we can. We're, we're a nonprofit organization without a lot of funding. And so we, we do some on social media and just try to get the word out. We've made a lot of progress, but, but we need more dentists who take this seriously, who will go through, go through the training, get certified. Um, you know, we have a directory on the iomt.org website where patients can look up search on their zip code, state, however they want to look, and find a dentist who's SMART certified, who will take the issue seriously. You know, I see patients sometimes that come in and they've got composites, the tooth-colored composite fillings. You look at their x-rays and there's still mercury that wasn't removed when the dentist did their treatment, which is always unfortunate.

It's unfortunate. So what do you do with those patients? That's a good question.

Well, the, the sliver of good news with that is that the exposure to the mercury is a lot less as opposed to if you can look in the mouth and see that mercury filling on the surface where every time you chew on it, you know, brush and create friction, or you consume hot foods and beverages, all those activities will increase the release of mercury. So at least if it's somewhat covered up, even though it can still penetrate and get into the tooth and into the body that way, it's a lot smaller amount. So we just have that conversation with the patient, inform them of what the situation is, and, you know, you either take your chances, leave it alone. Hopefully the person is, is a good detoxer and not that sensitive to the, to the mercury. And maybe just leave them alone. That's just a personal choice that has to be decided of having this kind of a conversation.

Well, let's go back to the, the SMART certification. Yeah. I know we have some dentists that are listening to this. What does that look like at IAOMT? And by the way, IAOMT stands for International Association of Oral Medicine and Toxicology.

Well, actually Academy. Close. International Academy of Oral Medicine. It's a mouthful. Now everybody knows why we call it the IAOMT. Um, so we, we have this, so basically a dentist would need to join the academy and we take this issue very seriously, even though the majority of the certification is accomplished through an online module in which the dentist would read the information. There's some testing and it's pretty straightforward. There is part of this protocol, the dentist would have to have certain pieces of equipment, specialized suction devices, and use of, of a dental dam. Non-latex is preferred. It does a better job of, of keeping the mercury out of the mouth. And, uh, but anyway, it goes through all the details, how to protect your patient, but also how to protect yourself and your staff. Because we're the ones that are drilling these things out with regularity. There's All the details of that, the type of face shield, respiratory protection, covering up. You don't want skin exposed, whether it be the patient or the staff. It also is a requirement to attend one of our conferences so that you can be more familiar with the concepts of biological dentistry and attend our, our fundamentals class in which there's some more lectures about mercury as well as other problems with, with dentistry.

Yeah. I, I, I, for people listening that have never been to a conference at IOMT, it's a great way, a great introduction. I know you have a course for dentists who want to start on the biological path, the fundamental course you mentioned. It's a one day to start to understand the principles.

Exactly. And we, you know, we have a video that shows the application of the whole SMART protocol, start to finish, and But it's important to understand the reasons why you're doing things, because the other part of this is a lot of the patients who come in, they've already read a lot about this, or they've talked to their friends, and they have very high expectations. And if you're not prepared to meet those expectations, you're gonna have a disappointed patient and a frustrated dental staff. And we want to avoid that. We want to provide the optimal care and experience for our patients in receiving the protection that they deserve.

Definitely. I agree. This has been so enlightening, Dr. Jack. Impressive. Like, you know, I love talking to you because you really put things in perspective. You've been there from the beginning, so we can really understand where we were and how far we've come. I mean, we've made significant progress. In the last few years. And I feel, I hope in the near future biological dentistry is going to be mainstream and practiced by most dentists.

Well, it's interesting because like I gave that example that Dr. Miguel Stanley over in Portugal, so he's well known by a lot of the, our traditional dental organizations and well sought out as a very very good speaker, and he has a nice way. In fact, sometimes he won't even bring up the term biological dentistry or whatever. It's like, this is how dentistry should be. And, and he, he does it in a way to normalize the, the, the way we biological dentists practice. And I agree with you that in, in the near, not too distant future, I think I think we will just be identified as dentists that have changed the way that we practice, and it's gonna be a way that's healthier for all of us, the practitioners as well as the patients on the receiving end.

Yeah. Yes, I hope so. Well, thank you so much for joining us today, or those of you listening Send us questions and comments and let us know what other topic in biological dentistry you'd like to hear. Until next time, keep smiling. Thank you so much for joining me this week. Please make sure you check out the show notes for any links mentioned in the show. If you'd like today's show, please invite your friends to listen as well. That would mean a lot to me. Do you have a question you'd like me to answer? Message me on Instagram @DrSandaMoldovan. This is Dr. Sanda Moldovan, and remember, your mouth is the gateway to your health, so take care of it in the most natural and best way possible.