Episode #51: Biological Dentistry with Dr. Stuart Nunnally, DDS

Welcome to Better Health Guy Blogcasts Empowering your better health. And now here's Scott, your Better Health Guy. The content of this show is for informational purposes only and is not intended to diagnose, treat or cure any illness or medical condition. Nothing in today's discussion is meant to serve as medical advice or or his information to facilitate self treatment. As always, please discuss any potential health related decisions with your own personal medical authority. Hello everyone and welcome to episode number 51 of the Better Health Guy Blogcast series. Today's guest is Dr. Stuart Nunley and the topic of the show is biological dentistry. Dr. Stuart Nunneley is a graduate of the University of Texas Health Science Center Dental School in San Antonio. He maintains an integrative biological dental practice in Marble Falls, Texas where he and his partners have treated patients from all 50 states and 24 countries. Dr. Nunley is chairman of the Jawbone Osteonecrosis Committee of the International Academy of Oral Medicine and Toxicology. He holds fellowships in the Academy of General Dentistry and in the International Academy of Oral medicine and toxicology. Dr. Nunneley is board certified in Naturopathic Medicine and is board certified in integrative biologic dental Medicine. He is licensed in intravenous conscious Sedation and is a member of the American Dental Society of Anesthesiologists. He serves on the teaching faculty of the Academy of Comprehensive Integrative Medicine and the American College of Integrative Medicine and Dentistry and he frequently teaches on all aspects of biological dentistry. He is married to his high school sweetheart Rebecca, and they have three grown children. And now my interview with Dr. Stuart Nunley. So in my own journey with chronic Lyme disease and mold illness, dental cavitations played a role. And I think the importance of exploring dental health when someone has a systemic chronic illness is something that really cannot be understated in my opinion. So it's an honor to have one of the leaders in the field of of biological dentistry with us today. Thank you, Dr. Bentley.

Oh, it's great to be with you, Scott.

Yeah, great to have you as well. So how did you get drawn into the field of biological dentistry? And have you had your own health challenges that drew you to working with people with more chronic systemic illnesses?

I did, Scott. I was a holistic dentist. I thought for all of my, really most of my career. And all of a sudden, actually 15 years ago, I became ill. I started having neuromuscular issues and I had really been. I really thought I'd been pretty much bulletproof up to then, never having Missed a single day of practice in the first 22 years of my life of dental practice. But at any rate, all of a sudden, I began to have these neuromuscular issues. We thought at the time that I had als. I was referred to the Lou Gehrig Center, Houston. As it turned out, it was a mercury toxicity issue. And so as a result of that whole experience, I completely switched the mode of my practice into a holistic dental practice. And actually I went to Montreal to be treated. And at the time thinking that I had als, and I was exposed there to sort of the grandfather of holistic dentistry, and that was Hal Huggins. And he had quite an impact on my life because, number one, he shifted my paradigm. I was a. I was. I have a master's in nutrition, and I'd been teaching on nutrition for years. And I was a bit of a fat phobic, if you can imagine that, 15 years ago, real lean guy. And at any rate, first question out of his mouth was, do you mind if I have you eat two eggs a day and a stick of butter? At any rate, that was one of my first introductions to Hal Huggins. But he had a huge impact on my recovery. He taught me to go slowly in terms of detoxifying and gave me many, many helps along the way. And then, of course, he began to send many, many of his patients to us. And so that's. That's what happened. As it turned out, didn't. I did not have als. And after about a three and a half year period, I recovered. But, interesting, Scott, during that time, I began to see and become more and more experienced with this disease called Lyme. And so that's what happened. I be. I. That disease and many, many other degenerative diseases began to show up on my doorstep. And so that led to a real evolution of my practice.

It's interesting because I knew that you had been impacted by mercury. I did not know that you had motor neuron type symptoms, and that it was suggested that ALS was potentially an issue. So that's new information to me. And I know that you're doing well today. So I think that's also a message of hope for people that are dealing with symptoms that may resemble ALS and that maybe metal toxicity is something to explore in those cases as well. I also had the honor of meeting Hal Huggins a couple of times before he passed away a few years ago, and he certainly was a pioneer in the field and an amazing human being. I'd like to start a little bit with just getting your thoughts on the microbiome of the mouth, we know that there are dental pathogens that more and more research is showing that these can have a chronic health implication. Some of the research on Alzheimer's showing that dental pathogens can be found in the brain. I think that many people think of using substances to kill the bad bacteria in the mouth and that that potentially leads to better oral health. And I'm wondering, is that a reasonable approach, or do we need to think about the potential negative effects of also reducing the good bacteria in the mouth with doing something like that?

No, we have to think about the total microbiome. It's not a great idea to nuke the mouth, just like it's not a good idea to nuke the microbiome of the GI tract, which the mouth certainly is part of the GI tract. There are many bacteria in the mouth that would not be considered part of a normal, healthy microbiome. But in my opinion, some of those help to make our microbiome more vigilant. And it's not a good idea, just like it's not a good idea in an organic garden to pull all the weeds, have basically a sterile carton. Neither do you want to do that in the gut or in the mouth. Microbiome. There are, you know, in this world of degenerative diseases, and of course, especially in Lyme, we recognize that spirochetes can be an issue. But typically, of course, there are many, many different species of spirochetes. And the ones that we see most often in the mouth, we don't associate with Lyme, but we do associate them with other systemic issues, especially with coronary artery disease, heart attacks, and also with cerebral artery disease, strokes. So, that being said, if we see a microbiome that is out of order, where the predominant microorganisms are pathogenic and anaerobic, then we do want to do things to help correct that. In our office, we would typically use ozone under the gum tissue. That will eliminate most of the anaerobes immediately. And then we coach the patients to use a water bath, a water pick in which they put hydrogen peroxide into the water bath, usually about an ounce of hydrogen peroxide mixed in with the rest of the water bath, about a 1 to 7 or 8 ratio. Hydrogen peroxide, water. And then they take the water pick and they. They turn it up about as high as they can stand it, and literally flush the area between the gum and the tooth with the jet of water. And of course, the anaerobes are very much opposed to oxygen. The hydrogen peroxide brings extra oxygen to the area and so that helps eliminate the, the anaerobes. So you're exactly right in that. And now your question was, though, would we want to use mouth rinses that were, for example, high in alcohol, the traditional mouth rinses that you would find over the counter? And I say absolutely not. Absolutely not. I like the idea of just using this technique where you use the jet of hydrogen peroxide and water, flushing it under the gum line to correct a microbiome that's out of balance. And interestingly enough, we do know today that it's absolutely critical to have bacteria in the mouth. For example, if you do not have bacteria, an adequate supply of bacteria in the mouth, you don't convert the nitric oxide that you need to have in your body for the other beautiful systemic health effects. So all that being said, let's don't nuke the microbiome of the oral cavity just like we don't want to do that in the gut.

Excellent. So you talked about hydrogen peroxide with the waterpik. What are some other things that you suggest people do for at home care in terms of toothpaste or other types of things that they can do just to kind of day to day routine maintenance of their oral health?

Well, a wonderful, a wonderful little mixture that you can do at home in making your own toothpaste is to take about an 80% mixture of baking soda with that of salt. And I like for people to, I like for people to use salts that are not sea salt because oftentimes sea salt contains more mercury than we want to see. So we'll typically have them either use pickling salt, which is nothing more than sodium chloride, or maybe the Himalayan pink sea salt, which has other minerals in it, but maybe not so much mercury. And then we'll have them use about 20% salt and 80% baking soda. And then you take that wonderful mixture and mix it up real well, keep it in a glass dish, put a little hydrogen peroxide on your toothbrush, and sprinkle that mixture of salt and soda over your toothbrush. Brush your teeth well, that's a fabulous way to make your own very inexpensive toothpaste without all the other ingredients that we're not so fond of fluoride to be one, of course. And then most toothpaste have in them a material called sodium lauryl sulfate, which makes the toothpaste suds. It makes it nice and sudsy, and that's what we're used to. But it's not, it's really not an Ingredient that you want to have in your toothpaste. Yeah.

And if I remember correctly, Dr. Lee Cowden's talked about many toothpaste having something called bauxite, which contains aluminum. And then I've also heard of people that have had titanium dioxide in toothpaste that had systemic health consequences just from the exposure to some of those things as well.

Sure. There's no need to have all those extraneous substances in your toothpaste especially. You know, the issue here, Scott, is this is something most of us do two or three times a day, brushing our teeth. Who wants to put those sorts of materials in day in and day out? Let's just eliminate the extraneous materials and go with those that we know that work.

Beautiful. So another question that I hear people ask is how important is it to floss? How regularly should people floss? What are your thoughts on flossing?

Well, if someone's a regular water pick, you can toss the floss.

Ah, toss the floss.

A water picker will outperform floss any day. But if you're not going to water pick, then I think floss is fine. It does help certainly get between the teeth, but where we want to really get is below the gum line, and that's where you're going to find the water pick most helpful.

Beautiful. There are many discussions that I've read and I've certainly talked about oil pulling as well. So I'm interested in your thoughts on using oil like coconut oil or other oils and swishing it around in the mouth. Does that potentially help improve the oral health as well?

Well, I'm fond of that. I think oil pulling can be very beneficial. It does help. The oil attracts the bacterial cell walls of the bacteria. It helps lower the bacterial load, no question. And interestingly enough, I'd say the healthiest mouths we see are in people who are oil pulling. So I'm a big fan of. You know, the problem is usually when my wife and I do this, we're going out on a walk and we both put a tablespoon of nice organic oil into our mouth and off we go. And. And about five minutes into the walk, one of our best friends appears and wonders why we're always spitting just about the time they arrive.

Or why you have nothing to say because you can't speak at the time. Right?

Yeah, exactly.

Yeah, very interesting. Okay, fantastic. Let's talk a little bit about the connection between the teeth, the meridians and the organ systems. And so I'm interested in your thoughts on things like can an issue with the tooth also then have an effect elsewhere in the body. And can the reverse also occur? Can we have an issue with an organ or a meridian system that somehow affects us in terms of dental health?

Absolutely. It works both ways. You can have a gallbladder issue and have a toothache in your canine, or you can have a bad canine and it can definitely cause a pain in the gallbladder. They work both ways. And that was just an example of two of the organs. But of course, the ones I think that we see, Scott, that maybe are of biggest concern. And I have to say that this would be anecdotal. I've not seen good solid data on this, but for years, people have noticed that when you have an infected tooth on the meridian of the breast on that side, you're more prone to breast disease, even breast cancer. And the other area that we associate oftentimes with a tooth problem and an organ is the wisdom teeth sites are on the same meridian as the heart. And so we have to at least suspect from time to time that issues in those areas, which are very, very common, the jawbones issues in the wisdom tooth sites can be a cause for issues with the heart. And, you know, it's interesting we don't acknowledge that very much still in Western medicine. It's very sad, though, because these have been acknowledged for centuries in Eastern medicine, and we need to really honestly catch up to what we've been learning from Chinese medicine doctors for years, and that is teeth can play an incredibly vital role in the way other organs function.

What are some of the complex chronic illnesses that you see in your practice where a dental factor plays a role in helping that person to recover their health?

I see. It's very interesting, but so often autoimmune issues like lupus and rheumatoid appear to me to appear to me to either be exacerbated by a dental condition or even caused by a dental condition. One of the most poignant ones for me was my dental hygienist. My dental hygienist got hit in the mouth with a softball at her daughter's softball game. And one of her front teeth, one of her upper front teeth, abscessed almost immediately after that blow. And this was back in the day, Scott, when I was doing root canal treatment. It was probably close to 20 years ago. And I did the root canal on my hygienist front tooth. And interestingly enough, the next year, the tooth right next to it died also from that same blow. I did the root canal. And within A few weeks of doing that second root canal, my hygienist began to develop rheumatoid like symptoms. And to the point of after six months, literally she could not get out of bed. This was a very healthy 33 year old woman, active jogger, mother, and all of a sudden she could barely, barely function. So as it turns out in her case, because there was such a correlation between the trauma to her teeth and, and the demise and her systemic health, we removed her front teeth and within three weeks she was virtually pain free. 95% of her symptoms had gone away. She was already, of course by this time seen a rheumatologist. Her blood work returned to virtually normal within that three week span of time. And I'll have to say this was the very first case where we removed her root canal, treated teeth and saw these incredible changes in her systemic health. So that was one of those cases that really propelled me into the arena of integrative dentistry. I saw the impact, I saw the impact of what teeth could do toward our systemic health.

Yeah, it's definitely a powerful area that people need to explore if they have a chronic health condition. Let's talk a little bit about just traditional cavities. So when someone has a cavity, is the approach still in biological dentistry to fill that cavity with some outside material or are there ways that are emerging that can kind of help to reverse cavities that maybe don't require a filling material?

Yeah, I think there are ways that are emerging for sure, just keeping the tooth real clean. And if you have a good flow of saliva, the saliva itself can remineralize a very small area of decay. Obviously nutrition is of critical importance here because interestingly enough, when we have good healthy nutrition and we're keeping our systemic health or the rest of our body in a nice state of, or an alkaline state, then we are not nearly so prone to decay. And interestingly enough, years ago, research was done that showed if you were in an alkaline state, and one of the things that helps to measure this is, this is if your, if your phosphorus in your serum is at or above 3.4, then the fluid flow through the tooth goes from the, from the tooth and out into the saliva. In other words, it's sort of self cleansing. If the, if the phosphorus level in our serum drops below 3.5, the fluid flow goes the other way, it goes into the tooth and you're much more prone to decay. Well, serum phosphorus levels come up when we live a healthy lifestyle. Very, very interesting. And so one of the. And when our body is in more of an alkaline state. So the things that we want to encourage, encourage our patients to do is do all those things that we associate with health, that is lots of leafy green vegetables, lots of exercise, plenty of sunshine. All of those things tend to help our get our serum phosphorus levels at that 3.5 or above, then we're much less prone to decay. The other thing I would say is that when we're brushing our teeth, this mixture that I'm talking about of using hydrogen peroxide, baking soda, and salt is a wonderful technique for helping to neutralize the acids on our teeth, because baking soda is by definition a base, and it helps neutralize acids. So it's a wonderful way to help. I will say that most times when decay has reached into the dentin of the tooth, in other words, it's gone past the enamel, it's into the dentin of the tooth. Most times I find that that is not very easily reversed. And in those cases, we would want to use a biocompatible bonded material. There are many, many. Now, materials that are contain no mercury. They bond to the tooth, they last for years. And that would be our choice in the case where we didn't feel like we could reverse the decay.

And you mentioned the word biocompatible, and I was going to ask this question later in our discussion, but is there some type of biocompatibility testing for dental materials that you do with your patients to see what their system might be reactive to before those materials then are placed?

We do. We test all of our patients, if they're having restorative dentistry done, so that we can determine what materials they are compatible with. There are two laboratories in the world that can test your blood, your serum, for general materials. It's a wonderful test. And if a patient, for example, comes to our office, we can test them right there. We would draw the blood, send it off, and in a week or so, we have the blood test back. If most of our patients come from long distance, though. And so we can either send that test to them and they can go to a local laboratory, have the blood drawn, and then the test, of course, is sent to us or to another by another dentist who practices holistic dentistry.

And I'm guessing one of those is probably the Clifford test.

The Clifford test is one of those. And that's the test that we use most often.

Yeah. Excellent. So it seems that amalgams, root canals, and then cavitations are some of the main issues that I see commonly discussed. In those with chronic health challenges. So I want to just touch on each of those and kind of get your thoughts. So when we look at amalgams, it seems pretty clear that maybe there isn't consensus in the conventional dental community, but it seems like in the integrative health community that there is some consensus that mercury is not health supportive and that removing amalgam or mercury containing fillings is often something to consider. And so I'm interested in your thoughts on is there a right time and a wrong time for removing amalgams? And then what are some of the things that people should consider in terms of precautions to make sure that they do it correctly? And the reason that I'm asking that question is I've seen people that have done it an incorrect fashion and actually made their health worse.

Well, and you're right, I think if the mercury filling is removed in a way where the patient is not totally protected from exposure, they're best just to leave them in. And the way a patient can determine, I think today whether or not a dentist is going to observe the. The protocol that I think needs to be observed in order to do this safely is they would go to a website. It's I a o m t.org and that stands for the International Academy of Oral Medicine and Toxicology. This organization of which I belong is a fabulous organization. And this organization has adopted a protocol called smart, and the acronym SMART stands for SAFE Mercury Amalgam Removal Technique. So a patient can go and look at the SMART protocol on the IAOMT website and they can look to see whether or not they know that their dentist is using that protocol. Better yet, they can call their dentist and say, hey, are you a smart certified dentist? And literally, literally many, many dentists now in this country have become SMART certified. Not as many as we'd wish. We should have thousands and thousands over time. I think we will because we know this is a tried and true SAFE technique for remove moving mercury fillings, not only safe for the patient, but safe for the dentist and his staff. So all that being said, that's the way to find out. The protocol is very well spelled out for the lay public on the IAOMT website. So I would encourage your listeners to go there.

It's interesting because you mentioned your own health challenges that were related to mercury. And so I would guess that some of that mercury exposure was probably from doing dental work on patients before you were more holistic. Is that, is that reasonable?

Oh, that's absolutely correct.

Yeah.

I, you know, when I got sick, Scott I hadn't placed a Mercury filling in 20 years, but I had been removing them. There were a number of physicians who referred their patients to me to remove them. Unfortunately, my protocol for those patients was still not great. It was not what it was nowhere close to what it is today, of course, but I was taking no precaution for myself or my staff whatsoever. So finally I just became overwhelmed from sitting in that little mercury vapor fog four or five days a week. And that's what happened.

And would you say that it's fairly common for people to notice some improvements in their health after they have their mercury containing amalgams remaining?

Absolutely. Almost all will report, over time, a greater stamina. Many times patients will feel like the brain fog that they have has been lifted or much improved. Many times patients will report a lessening and depression. Because one of the ways to depress a laboratory animal is through using mercury compounds. That's how it's oftentimes done in the laboratory. That's oftentimes how you induce autoimmune diseases into laboratory animals. So whenever you can lift the mercury load from your body, you ought to do it. You really want to do it. You want to. I will say this. I think it's important to be careful about removing mercury too quickly because mercury gets bound up in our tissues and if we shake too much of it loose too quickly, and oftentimes that's done with various chelating agents, patients can report feeling badly and even returning back to even a worse state than what they were before they started treatment. So I think it's important that people detox slower rather than faster. But by the same token, getting mercury out, you can never go wrong by getting the mercury burden out of your body. Mercury was never intended to be one of the elements in our body.

And it's interesting because I think that in some cases where people have systemic heavy metal burdens, getting the amalgams out then can open the door to other tools that could potentially be used where some of those chelation agents and complexing agents and other things can't really be used when you still have metals in the mouth.

Oh, no question. Absolutely. You don't want to be dragging the metals right out of the mercury and through the body with an aggressive chelating agent. So I think you're exactly right.

So let's talk then a little bit about root canals. And I have heard it said, and I think this actually came from Hal Huggins work with the dental DNA that is now DNA connections that root canals can harbor dozens of different pathogens and that a root canal is essentially, and you already referred to this term, but a dead tooth or a dead body part that's really left in the body. So what are some of your thoughts? Are there safe root canals? Are almost all root canals infected? What are your thoughts on root canals?

All root canals that I know of are infected. There may be a way occasionally to sterilize a root canal system. I think the jury's still out. But there are. There are some wonderful biological dentists who still believe in root canals. I'm not one who would encourage anyone to have a root canal, but there are some biological dentists who, as part of the protocol for doing the root canal treatment, will inject the tooth with ozone gas. I think that has about as good a chance as any of eliminating the pathogens. The problem is, even if you eliminate the pathogens at the time of the procedure, how long does it take the tooth to become repopulated again with bacteria? Here you still have a dead entity. And you don't think of teeth as being porous, but teeth are porous. If you look at them under an electron microscope, they look like honeycomb. And a little. All of those little honeycomb areas can be re. Infiltrated with bacteria. It's not that big a deal for the bacteria to go from the mouth into the tooth and into those honeycomb areas and then to repopulate the tooth. Even if the tooth is rendered sterile at the time of the procedure of the root canal. In traditional root canal therapy, you cannot get a root canal sterile. And that is even in the mainstream dental literature, it is acknowledged that you cannot get a root canal system sterile. The large canals can be cleaned out nicely, and oftentimes the tooth can be made where it's comfortable. But the problem is, is that in a tooth, there are miles and miles of little microscopic tubes, these little honeycomb areas that I'm speaking of, that still harbor bacteria. So once the tooth has had a root canal treatment, it has been severed from your own blood supply. So now you have no way to deliver your own immune system to the tooth. And the tooth sits there. It's dead, full of bacteria. And what happens then? They just have this marvelous opportunity to grow colonies and to produce toxins. And that's why back. That's why root canal teeth can be very troublesome to our systemic health.

And then tying that back into the points that we talked about earlier, if you have a root canal that's infected and essentially a dead tooth, whatever meridian and organ is associated to the tooth that has the root canal. Those can then be affecting other parts of the body as well.

Well, they can. And they could be directly affecting that organ that's on that meridian. Because when you have a dead tooth on a line in the meridian, what happens is it becomes a block to that flow of energy. And so any of the organs along, or even, interestingly enough, even emotional states can be impacted by these blocked meridians. And so that's an issue. But I think even equally as big of an issue, Scott, is the fact that the toxins associated with root canal treated teeth don't just affect organs located along those meridians. Those toxins are potent and they can go anywhere they wish. So we're, we're dealing with a very, very, interestingly enough, we're dealing with an incredibly toxic, toxic entity when we have a root canal treated tooth. I'll never forget, Scott, the first time I ever met Boyd Haley. I went to, I went to Boyd's lab in Lexington, Kentucky. Boyd's a fabulous biochemist. At that time, he had examined hundreds and hundreds of root canal treated teeth. And I said, Dr. Haley, how many of these show up as non toxic? He said, not one. Not one. And then he went on to say, I've never seen anything, I've never seen anything in a human, in a human model that comes close to the toxicity associated with the root canal treated too. Then he went on to say, except for this, he said, except for a cavitated area in the jaw. So there we are.

Well, that's a good segue into the next topic, which is cavitations.

Well, that was perfect.

Cavitations seem to be a very common issue, particularly in people with Lyme disease, which is a lot of the people that I interact with. And I had Lyme disease myself for many years. Dr. Klinghardt has been one of my mentors. He suggested that Lyme associated co infections like Bartonella, for example, maybe even Babesia to some extent can be a factor in cavitations. And so I'm wondering if you can just share with us, what is a cavitation? What impact does it have on the body? Does someone generally have localized symptoms when they have a cavitation, or can it be asymptomatic and still be causing a systemic health burden?

It can be definitely asymptomatic. It typically is. And it certainly can cause a systemic effect. So this is a very interesting disease process. I guess we shouldn't be that over overwhelmed or impressed by it because there are many, many disease processes that seem to be asymptomatic I mean, actually, to tell you the truth, most cancers are not symptomatic for months or years. Periodontal disease, for example, is not symptomatic for months or many years oftentimes. So. But we still marvel at the fact that somebody can have what's called a cavitation, which is a basically a cesspool of bacteria typically located in the area where a tooth has been removed. And it's in the jawbone. It remains in the jawbone. It remains typically totally asymptomatic. Patients are not aware of these. They don't hurt, they don't throb. Patients typically don't have fever, no pus leaks from these. And yet they're little brewing areas of anaerobes that are having a heyday in your jawbone. And so the treatment for this, by the way, is simply making a small incision over it, cleaning it out. We of course, use ozone in combination with this because it's such a wonderful antibacterial and antifungal and antiviral agent. And then we clean those out and then we actually put the patient's own platelets and stem cells back into those areas. They heal beautifully. One of the things that your listeners will see is if they do much research regarding cavitations, they'll see that the research typically reports that these reoccur very often after they're treated. And I think that was the truth for years. In fact, there have been 12 studies on these to see how often they did reoccur. And in those 12 studies, 40% of them reoccurred. But that was before we started using this protocol that we use, where we use the patient's own platelets to pack into these surgical sites where they have high dose vitamin C and all sorts of other modalities to help them get over the infection. And I think now today we're getting close to zero percent reoccurrence.

Wow, that's amazing. Yeah. And so I just wanted to underscore. So you said typically in areas where it a tooth was previously extracted, but is it true that one can have a cavitation or a jawbone infection in a tooth area that is still present?

You can, you can positively have a cavitated area and other areas of the mandible or maxilla, but they're much more common in areas where you've had a tooth removed.

Okay, and how is the potential for a cavitation evaluated? Is this something that you can see well on a patient panoramic X ray, or does it take an ICAT or a 3D cone beam or something like.

That to really see those well, again, that's a great question. The longer you've treated these, the easier they are to see. Of course, initially I didn't start treating these until 15 years ago. When I first started, it was very difficult for me to see them on a two dimensional X ray. And even on a real good panoramic X ray, I wasn't sure what I was looking at years ago. More and more, I feel like I can see them frequently, even on two dimensional X rays. But I think the gold standard now is to use a cone beam to give us a nice 3D image of the area. Even then, I would say, Scott, they're not always, I don't think they're 100% diagnosable with 3D cone beam. And oftentimes what we'll do is if we suspect an area, but we're still not sure. By using the cone beam, we'll make a very small incision over the area and use a small instrument that's designed just to go to this area area, much like a little Roto Rooter. We can go through that outer cortical plate of the jawbone without the patient really even know knowing we've been there the next day. And we can go through that area and if there's a, if there is an area of infection, we'll drop right into it and then we can clean that out and again fill it up with our own platelets. And the patients do beautifully.

How common would you say cavitations are in the general healthy population as compared to the population of people with a systemic chronic illness like Lyme disease or something similar?

I think they're quite common, honestly, Scott, in both. And it's one of those disease states, quite frankly, that again, once we've reached a tipping point in our health, I think the issue of having cavitations can be a greater issue than obviously than someone who is in robust health and has an intact immune system. But once that's been challenged, those anaerobic bacteria in these and these lesions that get in our jawbone then have the opportunity to, to really do their thing. And their thing is to produce toxins. Those toxins leak out of these sites in minuscule amounts, but they're so potent that they can be a real troublemaker. I think, you know, the issue is when we're in our 20s and 30s, it seems as though we can handle most anything unless we have Lyme or some other degenerative disease that we catch early on, but typically, my patients are those who come to us about middle age, and they've hit some sort of turning point in their health. And much like as what happened in my own case, I'd lived in a mercury vapor fog for the first 22 years of my practice, felt bulletproof. I was a competitive triathlete. And then all of a sudden, things began to fall apart and spiral downward. Well, the beautiful thing is, you know, the body is so magnificently made, we can spiral back the other way once we begin to lift the burdens. And so that's the wonderful, encouraging thing about this, is once we clean these areas out, oftentimes patients begin to feel better, and then they get out and take a walk and they feel better, and they get out and have some good, nutritious food, and they feel better, and all of a sudden, their health spirals back the other way. I don't see a big difference, though, Scott. And whether healthy people or sick people have cavitations, I find them. I find them often in both groups.

Yeah. And it's interesting because I think a lot of people with Lyme disease that eventually learn about their cat cavitations, think of it being Lyme came first and cavitations came second. I know in my personal experience, when I had my wisdom teeth removed in high school, I did get a dry socket, got infected, ultimately got Lyme disease and mold illness, and later learned that I had two cavitations that needed to be addressed. And so my perspective now is that those two cavitations that were brewing for many years probably were part of what set the stage for Lyme and other things to eventually kind of take me down.

Yeah, I would concur with that. Yeah, I would concur.

So Dr. Mary Ackerley is a doctor in Arizona that I've had on the podcast. She talks a lot about how cavitations and root canals can be a reservoir for something called Marcons, which is a multiple. It sounds like you're familiar with it staff, that we find in the sinuses, in Richie Shoemaker's work, in people dealing with biotoxin illness and chronic inflammatory response syndrome. I'm wondering if you've seen Marcons in the materials that are removed from cavitations or in root canals that are removed in your patients.

We suspect it. We suspect it. And of course, we have patients who present to our office who are Marcons patients. But the testing, the DNA testing, tests for 99 different anaerobes and also some viruses and fungus, but we don't typically Know, when we clean these out, whether we're actually removing Marcons or not, we certainly suspect it, especially in a patient who's already been diagnosed, many of whom are doing nasal sprays, as you know. And so we're suspecting that part that they inhabit these lesions, but we're not absolutely sure.

Yeah. And it's interesting because for years people have tried to eradicate Marcons from the sinuses with marginal success. And oftentimes it's very difficult to get rid of it. And I know just in the last year or so, I think it was October of 2016 that Dr. Ackerley first showed shared that she was finding Marcons in people's capitations. And so I think it's very interesting that it underscores again that the dental piece is really significant in a lot of these systemic biotoxin illnesses as well. When someone has a cavitation that they've identified, their dentist has identified, but they can't yet really do the surgical procedure for whatever reason either. They just don't feel like they're healthy enough. Are there certain things they can do to mitigate the systemic effects of those cavitations until they can do the procedure at some later time?

Well, I think so. One would be just doing those things that, you know, are consistent with a healthy lifestyle. Good nutrition, exercise, plenty of sleep, well hydrated, being well hydrated. All of those would be things that you would want to do until you could address the cavitations.

And would you say that if someone is significantly ill that they may not be able to tolerate a cavitation procedure? Or would you say that even in those that really have a significant illness, the cavitation may be a big piece of the puzzle and thus they would still be a candidate potentially for removing it.

I think most times patients tolerate this procedure very, very well. The procedure has improved immensely since I had mine cleaned out 16 years ago. It's done, in my opinion, can be done very adeptly through very small incisions. And so the healing time is cut shorter. And the introduction, I think, of the platelets into the surgical site helps speed the wound healing so much along with high dose vitamin C that typically patients, no matter what sort of shape their, their systemic health is in, typically they tolerate these very, very well. Usually. Honestly, I'll just say this, Scott. Most people are surprised that with how within a couple of days they're back to a normal diet, having very little discomfort. I would say most of our patients, for example, who have cavitations cleaned out don't need Pain medication other than, say, Advil or Tylenol, but that's it.

Yeah, I would agree. That was my experience as well when I had mine done four plus years ago. Now, no pain medication. And the anxiety leading up to the procedure was actually worse than the procedure itself. So I think that's just generally too. Are there things that you recommend a patient does prior to the procedure to kind of maximize their outcome? Should they be on some type of detoxification program, or is that not really a necessity?

I think it's not a necessity. But obviously, when patients come, and the healthier they are when they, for example, present to our office, the better the outcome will be, the quicker the healing, less the pain. All of those things just play into a patient's favor when they come to the office in a healthy state. You know, there are a number of other things because we see. I think we see the sickest of the sick, Scott, in our office. And so we want to support them along the way. And one of the things, of course we do also is that we have an acupressurist on staff to develop to deliver acupressure before the day before treatment, immediately after, and even the following day. All of those things help prime the system to get them through the procedure in a way that they don't have much discomfort. So I think there are ways to support a patient. So even if they're very sick, so that they do well through this procedure. I think this procedure is much simpler than, for example, having a tooth removed.

So when people think about cavitation procedures, you've talked about that there's a small incision made. How is the bone then clean during the procedure? And I've heard some European dentists talk about a piezoelectric device that is supposed to be more effective in kind of cleaning these areas. Is that something that's used in the United States, or what does the general procedure look like?

Yeah, typically a series of round, little round burrs are used to go in and clean this area out, along with a set of instruments. They're made specifically for cleaning out jawbone lesions. So there's a German company that's made a set of instruments that work so beautifully to clean these out. And that's what we use. We use the round burs. We use the. We use the set of instruments. We have the piezo instrument in the office. I don't find it that much more helpful, quite frankly, than using the other two, the hand instruments and the round burs. But I feel confident that we're Able to get the pathogens. You never can get all the pathogens. These are microscopic bugs, of course, that can escape and go anywhere. But if we. If we remove the source of the infection and clean that beautifully, and we use ozone and the other things to support the immune system, patients then can heal.

And would you say that after a surgery? I know Hal Huggins used to talk about not driving very far, not flying, all of those kinds of things. Do you recommend that they stay locally for some period of time so that the healing and the clotting and all that can occur?

Well, we prefer it. But also remember, Hal was not able to do these procedures back in the day. Back in the day when he was coaching dentists on how to do this, platelets were not. The use of platelets had not been developed. And so now that we can pack the patient's own platelets and stem cells into the area, we get this fabulous clot, honestly, within minutes that we used to not feel like we got. And so I, quite frankly, don't have people stay as long as we used to. We used to have people stay for at least 48 hours in our little town of Marble Falls before we would allow them to fly back home. Now we say, you know, probably 24 hours after surgery, you're safe to fly. We've not found issues with that because, again, we feel like the clot is so well integrated.

After a cavitation procedure, do people tend to have detox reactions by removing this area of infection? Does that kind of allow the body then to start detoxifying? Are there occasionally some increases in systemic symptoms after a procedure, or is that not very common?

There are a. Great question, Scott, because occasionally, and I would say maybe once a month, we will see a patient who goes through a detox reaction that may. It may be something where they develop a skin rash. It may be something where they feel like they have flu like symptoms. It may be something where they just feel achy and fatigued. And I would have to say I can hardly remember a case where that didn't finally resolve itself. But it is a possibility that. Because we're opening up a hornet's nest, honestly. And once again, those bugs can go where they wish. We do all kinds of things, and I think most dentists who do this treatment offer all kinds of things to support their patients. But one of the things I love to do is use a high dose of vitamin C, iv, which we think is one of the best detoxifiers for these types of toxins.

Yeah, beautiful. Let's talk A little bit about ozone connected to cavitation. So I've heard some people say, suggest that after a cavitation procedure that it may be good to do a series of ozone injections. It sounds like maybe that's not really required anymore if the recurrence rate is so low. So do you think that ozone injections after a procedure is helpful at all or no?

I think it can be helpful, Scott, especially on someone who's immunocompromised. But for the most part, I don't think it's. I don't think it's essential anymore because once again, if I had to only choose one of the modalities that we use to help get these cavitations healed, it would be the use of platelets through this platelet rich fibrin technique. And so using this technique, I don't feel like we need to use ozone injections around the site anymore after the treatment, because we've done this now for over five years where we've used platelets and stem cells. We just see these areas resolve. Whereas in the past, even though we never, I thought, had a 40% failure rate, as the literature would suggest, I think we did have a failure rate of probably close to 10%. We're not anywhere close to that now. We're close to zero percent.

I have seen some suggest that cavitations can be completely resolved with ozone injections, which never really resonated with me if there's something physically that needs to be removed. But what are your thoughts about, is there a potential for ozone to be the sole therapy to resolve an existing cavitation?

Well, and again, those reports are anecdotal. There's no science in the literature to say definitely you've eliminated these lesions just with ozone. I think it wise to remove them surgically. I really feel like that's the best approach. If, for example, a patient were challenged financially and they had a dentist who is willing to inject ozone into these areas and do it for perhaps just to help them financially, then I think that's, that's an option. It is an option, but the truth of the matter is we don't have great data to know whether the lesions ever completely heal. And if they do heal, how long do they stay healed? Because you're expecting a large area of bone to re heal and regrow to keep anaerobes from repopulating this area. So whereas you might be able to get it sterile for a while, maybe you'll get some healing. My question is, will it stay that way?

Very Good. I put some questions out for people prior to this show to see if they had specific questions. And one of the people that wrote in asked about people that have had prior surgical procedures and they now have insufficient bone in the areas of the jaw that might prevent them from having additional surgeries. And how common is that? And then are there tools to help them regrow bone to the point that they can kind of create the right condition to allow them to be a surgical candidate?

Again, there are tools to help them regrow bone. I personally am opposed to the use of cadaver bone. Cadaver bone has been sort of the gold standard for years in helping to regrow bone. I don't like that. I don't like the idea of using cadaver bone. And so. But there is a product in this country. The developer of it is a brilliant man by the name of Greg Steiner. S T E I N E R and he has a product which I think is a. An innocuous product, and yet it does definitely help to grow bone. That material, coupled with platelets that I've been talking about, can definitely be used. And his product will help form the scaffold for help for directing the growth of the bone. And then I like the use of platelets to help cause an increased blood flow to the area. And then we have the opportunity to regrow bone. It's not an easy process. It's really not an easy process. So I would say, first of all, just like anything, prevention is where we want to be. And we want to try to not have these cavitated areas in the first place. And we certainly want to do our best not to have them surgically retreated and retreated and retreated and retreated. And today, fortunately, if I think many, many, many of the people who are doing this treatment are using platelets, they can clean these areas out, put the platelets in. Hopefully there's no need for retreatment, and they've still preserved the bone. That's what I think is best.

What are your thoughts on titanium versus zirconium implants, and is that something that you do in your office?

Well, we do zirconia implants occasionally. We will not do a zirconium implant on a Lyme patient who's in the throes of their disease. We don't want to challenge their immune system anymore. And we think that anytime you introduce anything into the bone of a patient, you do stimulate their immune system, challenge their immune system, and it's best not to do that. We think that zirconia has a much better biocompatibility track record than does titanium. There are some drawbacks to where you can use zirconia, but in our office we opt not to place any titanium implants. We would only place zirconia and we would only place those in patients whose health is really robust and stable.

So if someone has a root canal or a tooth extracted to avoid a root canal, then do they potentially just need to wait until their overall health would allow them to have an implant, or is there something else that can be done for aesthetic purposes?

For aesthetic purposes, there are all kinds of ways to treat that area until the patient's healthy enough to have zirconia implants. And so typically that's not going to be an issue. Scott, for example, someone who has a tooth removed that's in an aesthetic area and it's obviously going to be problematic for the patient when they smile. There are all kinds of ways to replace that in a very inconspicuous way where hardly anyone would ever know that they'd lost a tooth.

Beautiful. Let's talk a little bit about grinding of the teeth. I've heard people suggest that that can be stress related. I've heard people suggest that grinding the teeth can be an indication of parasites potentially. I've heard it suggested it can be a response to not getting enough air while you're sleeping. So can you give us some insights around reasons that people potentially grind their teeth, the problems that it creates, and then what are some solutions people can explore if they've already kind of worn down the surfaces of their teeth from long term grinding?

Oh, it's most often due to having two or three teenagers in the house. And that pretty much resolves about the time your children hit 25. But I think all of those possibilities exist. I have heard for years that they could be that patients would grind as a result of having microorganisms of having parasites? I'll have to say that we can't be sure because we as dentists over the years have not tested all of our patients for parasites. I certainly have patients who are under parasite therapy and who grind their teeth, but whether one is causing the other, I'm not sure. I do know that people when many times patients will manifest their stress and their sleep and they'll work it out with their teeth. And so we see, and we see people, for example, who have worn very distinct wear patterns into their teeth during stressful periods in their life. Maybe it was through job related, maybe it was family related who have actually quit bruxing their teeth. But they have these amazing wear patterns in their teeth that shows. Well, at some point in your life, you are definitely bruxing or grinding your teeth and primarily in your sleep. So we know stress can be it. And then of course, we don't know all the other reasons why people do it. But more and more we know that this, this issue of having an inadequate airway does cause people to brux their teeth. And what they're doing is subconsciously they're trying to move their mandible forward to create some space to get their tongue out of the way so that they can breathe. So we know that that's also possible. I think you hit on the three primary concerns in terms of bruxine.

So once someone has a notable pattern, is there anything that can be or should be done, or is that not really pathogenic in and of itself?

Well, it can be. I mean, certainly if you're going to, if you're wearing the enamel off your teeth and you're getting into the dentin of your teeth, that's pathogenic and you're going to shorten the life of your teeth and you're probably going to precipitate issues with your teeth like causing teeth to die in the future. You know, teeth can only stand so much, and if you just continue to wear and wear on them, you're going to accelerate the potential for those teeth to have problems in the future. So I would recommend if a patient is bruxy and you can't for sure identify the root cause, or maybe you can, and maybe it is a case of three or four teenagers in the house and you just need a little time to buy, then I would just simply make a night guard, live with it. Know that it's nothing more than a crutch. It's a crutch to get you through the next eight or 10 years and once your life kind of settles down again, hopefully you won't continue to brux in the case. One other thing too, Scott, though, in the case of the patient where they're bruxing because they have an inadequate airway, you know, dental appliances now are becoming, I'm just telling you, they're becoming wonderful appliances in terms of helping patients to stop bruxing and at the same time helping to end their snoring and sleep apnea issues. So I'm a big fan of these dental appliances and I think more and more we'll see dentists using these to help their patients.

Yeah, I think that's fantastic as well. And it seems like a much more logical first step than some of the more significant surgical interventions people have had for sleep apnea. That oftentimes did not resolve the issue, but was a significant surgical experience.

No question.

How important in those with chronic health challenges, how important is the bite, the height of the teeth, the width of the upper palate? Do you find that those are important areas to explore to help someone move their health forward?

No question, no question. Inadequate airways are something that for years we didn't look at in dentistry, but now we have the way the. Not only we, not only are we more aware of it and we can spot it oftentimes during a clinical exam, but also now we have the radiographic tools. When we do cone beam imaging of a patient, we can see how small their airway is. And oftentimes it's so interesting. These patients that have small airways have very narrow palates. They have very narrow, a very narrow occlusion. This is something that was talked about over a hundred years ago. Weston Price addressed this in 1923 when he demonstrated that patients who stayed on an indigenous diet had beautiful healthy skeletons. They had large full arches to accommodate all their teeth. And sleep apnea was absolutely unheard of in those days because patients had big palates, open airways. Of course, typically they weren't obese either. And all of those things gave the patient the ability to not only chew, digest their food well, but also to breathe properly.

Another issue that I've heard many people in the Lyme arena talk about is gum recession due to long term chronic inflammation. And so I'm curious, are there things that can be done to minimize gum recession? And then if someone already has receding of the gums, are there ways to reverse and regrow healthy tissue without the need for tissue grafting?

I don't see it very often where a patient can regrow the tissue. It's very, very unfortunate. You'd think we could regrow the tissue. You can actually now with plate, in the right circumstances, you can take the platelets about which I've been speaking, use those with a very minor surgical procedure to regrow some of the gum tissue. But for the most part, when you lose that tissue, it's going to go away unless you undergo some kind of a surgical procedure to grow it back. The most common cause for loss of gum tissue or gum tissue recession is bruxing your teeth, grinding your teeth. And then once again, the analogy is if you take a fence post and you go out here and you do this long enough, the ground around the fence post will crater. The same thing happens to the gum tissue, you keep even just minute tooth movements. You do that long enough and strong enough, the tissue around it will begin to recede. That's what's happens. And so oftentimes one of the best treatments for this, when it's noticed early on, is simply to make a patient a night guard so that they can't brux the teeth. That improves it. It won't grow it back, but it can help stop it.

But it sounds like with the prf, with the surgical procedure, that you do see some potential for regrowth without the traditional grafts.

Truly we do. Truly we do. We read the words platelets. Platelets can be pressed into a sheet. And so once you press these platelets into a sheet, you prepare the area of the tooth where the gum tissue has receded. You lay the sheet of platelets over that. But you do have to make a small surgical incision to tuck the platelets under the tissue and to give the platelets a blood supply. Those are sutured neatly into place and it provides a beautiful graft without having to go and retrieve the tissue from some other place, which most oftentimes is the palate. So if we, if we can avoid that surgery where. Because usually the gum tissue surgery is not so bad, but the wound where you've had to remove the tissue from the palate is painful. Well, now you can simply do it by drawing the platelets from the bloodstream, pressing them into a nice sheet and surgically positioning them over the area where you've had recession of the gum tissue and grow the tissue back. I made it sound maybe a bit more simple than it is, but that's the technique and it can be done very excessively.

I think you're still really enjoying the work that you're doing. You seem to be smiling a lot and having a lot of passion for what you're doing, which is really awesome.

Well, you know, I'm only 64 and I feel like I'm just getting going.

It's phenomenal. So what are your thoughts on some of the. There's a lot of mineralizing toothpaste that I'm seeing coming online and various people in Japan and other places are talking about these nano minerals in toothpaste. There's charcoal based toothpaste and things. Do you think that those have potential for helping to mineralize the teeth or are they generally just marketing hype?

I think at this point they're generally marketing hype. Time will tell. Maybe we will have a remineralizing toothpaste and listen once again. I like just using this baking soda and salt toothpaste because it neutralizes the acids and then the minerals that come from our saliva remineralize the tooth very naturally. We have plenty of calcium and phosphorus that come from our saliva glands. And for any of the listeners who don't believe it, that's what gets scraped off of our teeth, you know, by the hygienist. That's what deposits onto the backside of our lower teeth and onto the cheek side of our upper molars. It's a calcium and phosphorus mixture. If you can allow those to reintegrate into the tooth, you can truly remineralize it and hopefully heal up small areas the decay.

So that's not always. Then when you have the buildup on the back of the lower teeth, for example, that's not always a plaque type scenario. That is an indication of something bad. Sometimes it's just the minerals themselves that have deposited there.

Oftentimes it's just the minerals themselves. Cool.

Learning lots of new things. It's great. So what things on the horizon in the holistic dentistry arena are excited, exciting to you in the future, do you think there's going to be more of a role for stem cells and things of that nature? Do you think we'll get to a place where cavitations can be addressed with less invasive procedures? What are your thoughts on what's on the horizon?

Yeah, on the horizon, I think the most exciting thing is the potential for regrowing teeth. I thought we would be regrowing teeth five years ago. I am embarrassed that I used to tell people 12, 15 years ago that I thought we'd be regrowing teeth long before now. That whole issue of using stem cells to regrow teeth has just met with one obstacle after another. It's interesting you can regrow the tooth, but it happens that in a true physiological state in our mouth, the tooth is connected to the jawbone with a little ligament called the periodontal ligament. To get the tooth and the periodontal ligament all attached to the jawbone via stem cells is a very, very difficult thing to do. I think we're getting closer and closer to having the protocol for doing that. I can't wait until we have it. I hope. I think we'll be at the forefront of that as soon as it's developed. But predictably, it's not a predictable procedure yet.

So if people are interested in working with you and your team in Marble Falls, Texas, are you taking new patients? How would they go about reaching out to you.

Oh, we do. Of course we do. The majority of our patients come from long distances. And the wonderful thing is, Even though I'm 64 and have been here a long time, I still love doing dentistry. And I have. But the one, the even the better thing is I have three, three fabulous partners. And they are, they're just rock stars, in my opinion. So people can contact us. And that's what happens most times. People call us from, from afar and we work out the process for them to get to Marble Falls, Texas, which is a beautiful little town just outside of Boston. And so we have a website, it's called Healthy Smiles for Life. Healthy Smiles for Life. I think everything a patient would need to know in order to contact us is at that website.

Excellent. So I always like to wrap up with one final question, which is, what are some of the key things that you do on a daily basis in support of your own health?

Well, I'm an avid exerciser, and so my wife and I are always exercising. We may take a long walk. We might do that with heavy hands, with a little weight in our hands, and off we go on a four or five mile walk up and down hills to really get our. We want to get our pulse rate up and then give it an opportunity to relax. And then four mornings a week, I work out at five in the morning diligently at a very intense pace for 45 minutes with a group of friends. And so exercise to me is key because sweating is a fabulous way to detoxify gently. And I, in this world in which we live, we all need to be detoxifying. I love to sweat as a gentle way to do that. And then I eat organically. It's very, very rare that I don't, that I eat something that's not organic, only if I'm eating out inside our home, everything is organic. So. And my wife is a fabulous organic farmer, so. And she has a bunch of very healthy, happy chickens and we have some healthy cows. And so all that being said, we eat what we produce. And so I'm, I hope to continue to. I think those two things, clean food, clean water, and a good glass of red wine from time to time. And exercise is a great recipe for success. And you know what I think more the older I get, I think living in a lighthearted way, enjoying life, strong faith. Strong faith. You know, I was just at this fabulous Truth About Cancer conference in Orlando speaking recently, and it was interesting. I found people there almost ubiquitously. Among the speakers was this, having a strong faith being able to forgive, eating clean food, those three things. I tell you what, you do that and you got a pretty good shot.

Nice. Excellent. Yeah. That's fantastic. Thank you. I want to thank you for spending time with us today. I think of you as a pioneer in this arena as well. Well, I'm very, very happy for all the things that you shared and the things that I learned in this conversation. I think it's great for people to be able to learn a little bit more about things they can do to optimize their dental health. I've heard many good things from people over the years about you and your team in Marble Falls, Texas. So I hope that people listening that need some dental support will consider reaching out to you as well. And I just want to thank you and honor you for the work you do. And thanks so much for taking time to be be here today.

Thank you, Scott. Appreciate it so much.

Thank you. To learn more about Today's guests, visit HealthySmilesForLife.com that's Healthy Smiles4Life.com I appreciate your support of the Better Health Guy blog cast series. If you'd like to follow me, you can find me on Facebook and Twitter as Better Health Guy. The show can be found on YouTube, iTunes, Google Play, and Stitcher. If you'd like to support the show, please visit betterhealthguy.com donate and if you'd like to be added to my newsletter, please visit betterhealthguy.com newsletters I'm looking forward to many more shows ahead and appreciate your interest. Thanks for listening to this Better Health Guy blogcast with Scott, your Better Health Guy. To check out additional shows and learn more about Scott's personal journey to better health, please visit betterhealthguy.com.