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How does tooth decay/cavity heal?

diş-çürüğü
diş-çürüğü

“Can it heal?”  Yes, tooth decay in the initial stages can heal if a cavity has not formed. In fact, even if you eventually need a filling, the measures you take to recover the tooth decay will stop the rapid progression of the decay and prevent the decay from reaching the canal and infecting it. Therefore, this topic should not be read only to avoid fillings. We can also try to cure decay to keep our teeth alive.

But how?

I will look at it from two perspectives:

1. What happens on the outer surface of the tooth:

According to the currently accepted theory of caries formation, the food we eat is broken down by the bacteria in our mouths, resulting in acid formation. This acid dissolves the minerals in the tooth enamel. This is called demineralization. Thanks to our saliva, this acid environment becomes neutral again, and the minerals in the saliva return to the tooth surface. This is called remineralization. This demineralization-remineralization cycle is a normal process, but if the minerals are frequently moving away from the tooth surface and cannot come back, that is, if the balance is disturbed, then caries will form in this area over time. So, the building mechanism cannot keep up with the rate of destruction.

dentin-ve-mikrotübüller
2. What happens inside the tooth:

There is another repair mechanism that we dentists often encounter while filling, but for some reason, we do not emphasize stopping decay much. The repair that takes place inside the tooth, in the part we call “dentin.” Dentin is not just a mineral tissue. It contains canals and extensions of very special cells called odontoblasts. These sense threats from the outside and condense the dentin tissue to protect the tooth from the inside. There are also thousands of tiny canaliculi in the dentin, through which fluid flows from the inside of the tooth to the outside, which helps to keep bacteria out. Defence elements are also present here and actively protect the tooth.

In this case, we need to support our teeth externally and internally to protect them against cavities and heal incipient cavities. We can do the following.

Improve the quality of our saliva: There is a lot to say, but in short, saliva’s flow rate, pH, minerals, and immune system elements are important for healing caries. It is also important that our nutrition is not deficient, that we do not mouth breathe, and that we drink enough water. Vitamins A, D, and K2, minerals such as calcium and phosphorus, vitamin C, and adequate protein intake are important.

Oral flora: Acid-producing bacteria love sugar very much. When we consume it, it takes over in the mouth. As I wrote above, we need a diet that is free from packaged, processed foods and provides macro and micronutrients well.

Frequent snacking should be avoided because it doesn’t give the teeth time to remineralize. Especially if you eat junk food!

Avoid foods that stick to the teeth. These are usually processed foods. If you have to eat them, you can take measures such as rinsing your mouth or stimulating saliva flow by chewing gum after a meal.

Although there are different opinions about brushing your teeth immediately after a meal, it is not recommended. Brushing with paste can cause more mineral loss. You can wait half an hour.

To nourish the teeth from the inside: There are theories that vitamin K2 controls the flow of dentin fluid inside the teeth. Sugar reverses the direction of this flow, making the tooth unable to protect itself. Vitamin C can balance this. It is also necessary to provide the tooth with building blocks for repair. Calcium and fat-soluble vitamins come to mind again.

In Biological Dentistry, Uncategorized

How to Avoid Root Canal Treatment, What Can Be Done Instead of Root Canal Treatment?

Kanal tedavisi
Kanal tedavisi

Root canal treatment is a treatment in which the infected and dead tissues inside the teeth are cleaned and then the cavity is filled with root canal filling materials in cases where the teeth are severely decayed and infected. In fact, we can say that it is a kind of tooth embalming method. In this way, it aims to keep the tooth that is no longer alive in the mouth.

Root canal treated teeth do not contain blood circulation and defense mechanisms. In addition, the dentin fluid flow from the center of the tooth to the outside of the tooth, which is found in living teeth, is unfortunately no longer present. Therefore, they cannot be equated with living teeth. There is no defense and feedback mechanism against infections that may develop inside. In addition to the root canal system, the hard part of the tooth consists of thousands of tiny tubes (tubules). Unfortunately, it is not possible to clean and fill these parts 100% with root canal treatment. Therefore, in biological dentistry, it is considered that leaving root canal treated teeth in the body may have negative systemic effects (the recommendation of biological dentistry is not to leave the tooth without root canal treatment, but to extract the tooth). In classical dentistry, this idea is not accepted and root canal treatment is considered as saving the tooth. Because when a good root canal treatment is performed, the inflamed areas at the tip of the roots can shrink and patients can use this tooth for years without symptoms. Treatments such as tooth extraction and implants are avoided. As an additional information, I should also mention that even without symptoms, there may still be bacteria in these teeth. Special laboratories that have examined the bacteria in extracted root canal treated teeth have found pathogenic bacteria even in well-executed root canal treated teeth that do not show inflammation even on tomography. Unfortunately, there are not many studies on whether these bacteria harm the body.

In this video, you can see how the tooth decays and goes to root canal treatment, causing inflammation at the root tip and how root canal treatment is performed.

Since I have already discussed the debate on this subject in other articles, I do not want to extend it further here. If you want to read more in detail, you can take a look at my articles “The Root Canal Treatment Discussion” and “Tooth Root Inflammation and Heart Diseases”. Because of these doubts I mentioned about canals, I believe that we should do everything we can to prevent a tooth that is alive and has the potential to heal from going to the canal. It should not be so easy to force a tooth to undergo root canal treatment. Therefore, in this article, I will try to answer the question of whether we can avoid root canal treatment.

First of all, if a tooth is really infected or dead enough to require root canal treatment, unfortunately, we cannot keep the tooth in the mouth without root canal treatment. If a root canal is not desired, we have to extract the tooth, otherwise this tooth will quickly cause inflammation in the bone at the end of the root due to the infected and dead tissues inside. With root canal treatment, the areas where bacteria can grow are reduced. In summary, we can say that in cases where the decay is very advanced and the tooth is irreversibly inflamed, root canal treatment must be performed if we do not want to extract the tooth.

However, unfortunately, sometimes root canal treatment can also be performed on teeth that are not dead or severely infected. There are some things we can do to prevent a live and healthy tooth from going to the canal in this way. We can pay attention to these points so that our teeth do not die in vain.

1 – Is Root Canal Treatment Necessary in Tooth Sensitivity?

Except for very severe tooth sensitivity that does not go away when it starts, tooth sensitivity does not require a root canal. Most of the time, there are other underlying causes of sensitivity that can be addressed without root canal treatment. In fact, tooth sensitivity can even be a positive signal that the tooth is alive!

  • The cause of tooth sensitivity may be a problem with the restorations in the tooth. For example, if composite fillings are placed in very large pieces when they are made, in other words, if they are made very quickly, they undergo severe shrinkage and break away from the walls of the tooth and cause micro gaps to form between the filling and the tooth. This could be the source of the sensitivity (that’s why it takes us so long to do fillings:))

  • In another scenario, sensitivity can be caused by tooth decay. If the sensitivity occurs with a stimulus and goes away within a few seconds, the decay has not yet progressed to the canal of the tooth. In this case, it will be useful to see your dentist as soon as possible in order to treat the tooth only with a filling without a root canal, preserving the vitality of the tooth.
  • There may be a crack in the tooth. In this case, different restorations can be made depending on where the crack is and how far it extends, but again, root canal treatment is not required.
  • There may be a gum disease. As a result of inflammation or recession of the gums, the root surface may be exposed and sensitivity may develop. Gum treatment is performed, not root canal treatment.
  • Tooth surfaces may be worn. Bruxism, bite disorders, hard brushing, bulimia, etc. There may be abrasions on the tooth surfaces for many reasons, and if these have developed rapidly, sensitivity may also be seen.
  • There may be mineral loss in the teeth. The minerals normally found in saliva constantly repair the teeth from the outside. Teeth are also nourished from the inside, and the flow of dentin fluid inside them protects the tooth against external factors. These mechanisms can be disrupted and teeth weakened by poor diet or gut health, mouth breathing, medication, systemic diseases. In this case, various applications can be made on the tooth surfaces to relieve sensitivity, but of course, it is also important to question the causes and try to correct them in order to prevent further loss in the long term.

When the cause of tooth sensitivity cannot be found or no relief can be achieved, canal treatment is sometimes recommended to end the complaints of patients. I do not find this approach correct because in this case, root canal treatment means actually killing a living tooth with our own hands! Here, of course, it is useful for our patients to be conscious and cooperate with their doctors (such as not pressuring their doctors to resolve a complaint that requires a healing process as soon as possible:)).

2 – Not every deep filling requires a root canal!

Unfortunately, another situation I encounter very often is that dentists tell patients that the tooth will go to the canal based on the depth of the filling without evaluating the symptoms. In fact, such information may be given here in order to prepare patients for the worst possible situation. Nevertheless, in deep fillings, if the work is not precise and unnecessary material is lost from the tooth, unfortunately, the tooth may actually go to root canal treatment. There are some methods we apply to prevent this situation (you can use this term when looking for your dentist, as these are the field of interest of biomimetic dentistry).

  • Biomimetic approach – In this approach, the biomechanical properties of the natural tooth are mimicked as much as possible and unnecessary tooth cutting is avoided by opting for restorations that bond to the teeth by adhesion rather than mechanically. In addition, how much decay is removed is based on certain rules determined by scientific studies, so that a living tooth, no matter how deep the decay, does not go into the canal. Another aim of biomimetic dentistry is to prevent irreversible damage to the tooth in the future (for example, fractures due to excessive loss of material or weak tissues and extraction of the tooth).
  • The use of a caries detector – Actually, this is another substance that is routinely used in biomimetic dentistry. It allows us to see the different layers of decay and prevents us from unnecessarily removing parts that normally appear dark but are actually healthy. Thus, we are less likely to take the tooth to the canal because we are cleaning the decay.
  • Pulp Capping Treatment – Sometimes, when the decay is very deep, the canal may be exposed. Even in this case, if clinical findings allow, it may be possible to preserve the vitality of the tooth without root canal treatment with the treatment we call pulp capping. In this treatment, after stopping the bleeding from where the canal is opened, the cavity is closed with biocompatible agents that will stimulate dentin regeneration and then the tooth is restored. In this treatment, sodium hypochlorite is generally used to stop bleeding and clean the area. We use ozone at this stage. Whichever is used, we do not take the tooth to the canal immediately. And most of the time it is successful.
  • Using a loupe – Working with a dental loupe gives us a much larger and more detailed view of the area we are working on. In this way, we can work much more carefully and gently in places where we are very close to the canal and we do not injure the teeth unnecessarily. I think I can best explain this with the photo below:
In the first picture, we can see only the general image without any magnification, while in the last picture, we can see that we can master the details of the tooth with 8x magnification. (I work with 10x in the clinic).

3 – Dental veneers made for aesthetic concerns or to eliminate misalignment

Another sad situation that we often encounter that leads to the need for a root canal is the cutting and veneering of teeth, which are often very healthy and beautiful, for aesthetic reasons or to correct crowding. Unfortunately, you can see that teeth made with this approach are called “Turkey teeth” on social media. It is quite sad to be labeled with this label even though we have very good dentists in general and we are a country with very high quality dentistry services, but unfortunately, it cannot be denied that there are clinics working in this way in our country. In this approach, teeth are cut and veneers are placed on them in order to provide a beautiful smile(!). I don’t think patients are informed that the enamel will never come back, that the more sensitive layer called dentin will be exposed as a result of cutting the teeth, that some teeth may require root canal treatment and that teeth with root canal treatment are teeth that have lost their vitality. Moreover, if these restorations are not made with great care, after a while the remaining tooth tissues will decay and gum problems will develop. Restorations will need to be renewed. Perhaps some teeth will be lost in the process.

To return to our topic, if the aesthetics of your teeth make you unhappy, you can avoid root canal treatments by first considering more minimally invasive solutions. For example, orthodontic treatment can be considered for crowding. If the size or shape of your teeth bothers you, porcelain or composite laminates can be considered. If you want your teeth to be lighter in color, you can consider teeth whitening. Of course, all these treatments can have side effects, but they are still much safer than cutting and capping teeth.

 

4 – Protective Dentistry Medicine

Last but not least, I would like to add the most obvious point: Let’s not cause tooth decay so that we don’t need a root canal! For this, you may first think of brushing, flossing, mouthwash, etc., but it is not. In fact, the most important measure we can take is to pay attention to our diet. This will protect our teeth from both inside and outside and prevent the formation and rapid progression of caries.

In addition, routine dental check-ups allow you to take the necessary precautions by detecting problems at the initial stage. In other words, you should not wait until your tooth hurts to go to the dentist, because when it reaches this stage, unfortunately, the tooth is in such a bad condition that it can no longer repair itself and root canal treatment (or tooth extraction for those who do not want root canal) is often inevitable.

In Uncategorized

How microimmunotherapy makes use of homeopathy?

I was first introduced to homeopathy many years ago when I was watching an internet summit on paediatric health. The talk was about how homeopathy can be used, especially in emergencies, and the speaker was talking about how homeopathic remedies provide healing without suppressing symptoms. For example, if you gave an antipyretic to a child with a fever, you were suppressing the body’s response and therefore preventing the body from developing the ability to cope with illness. It was explained that this is not the case with homeopathy.

This speech and the stories of those who told that they were cured by homeopathic methods made me curious about homeopathy, but at that time, perhaps like many of us, I thought that homeopathy was a kind of herbal treatment and I had not investigated the way it worked. By the way, homeopathic “remedies”(this expression is used instead of medicine in homeopathy) that evoke toxins such as “mercurius”, “arsenicum” also sounded a little suspicious…

Then, in a training I attended on a different subject, I met one of our well-known homeopaths and he told me that the substances used to prepare homeopathic remedies are diluted many times and when analysed, that substance can no longer be detected in the remedy. In fact, he said that it was not the substances themselves in the remedies, but their “spirit”.

Unfortunately, after this short talk, I said “hmmmmmmmm” to myself and moved away from homeopathy and did not feel the need to research homeopathy further with many other topics in my focus. No matter how open-minded I think I am, as a person who has been raised with modern medicine and a scientific perspective, I may have difficulty accepting some ideas and I expect more concrete explanations.

After a while, I became interested in homeopathy again. A few of my patients, who came one after the other by coincidence, told me about the results they obtained with homeopathy.

As I mentioned above, the remedies used in homeopathy are obtained by repeatedly diluting a substance that is deemed suitable for a particular condition. The principle of “like cures like” is the basis of homeopathy. For those who do not know homeopathy, this may not make much sense. When we look at the origin story of homeopathy, we can better understand what is meant. The father of homeopathic ingredients, Dr. Samuel Hahnemann (1755-1843) develops homeopathic treatment, which causes the same diseases caused by malaria and the diseases caused by consuming the bark of the cinchona plant (containing quinine), which has been used against malaria for many years. Initially he diluted the remedies to make them less toxic and easier to tolerate, but over time he came to believe that more dilution gave better results and he used more and more diluted remedies (ref). The remedies currently used in homeopathy are obtained by repeatedly diluting the substances to very large numbers, such as 10⁶⁰⁰ or 10⁴⁰⁰ (ref). Shaking these diluted solutions is also part of the remediation process.

In short, we are talking about quantities that are not in the doses we are accustomed to from medicines and supplements, even if they are nano-sized in the remedy (ref), they will disappear like a drop in the ocean when they enter the body.

From Homeopathy to “Microimmunotherapy”

I met the field of microimmunotherapy at a conference I attended in 2019. When Beatrice Lejeune, a researcher named Beatrice Lejeune, who explained the immunological response seen in gingivitis step by step, explained how they developed a drug by diluting interleukins and TNFs, which play a role in inflammation, and how they stopped inflammation with this drug, I thought, “Wait a minute! Isn’t this homeopathy?” When you dilute the inflammatory substances themselves, you stop the inflammation! After a few minutes, he started to talk about diluting the drugs so many times as “homeopathic doses”. He even started to joke: “Can you believe it, we got EU funding for a study involving homeopathy!”

Microimmunotherapy aims to regulate the response of the immune system and fight diseases by using substances belonging to the immune system. It uses “cytokines” produced by the body itself. And in doing so, it dilutes these substances many times over, as in homeopathy (ref). And just like the “like cures like” principle of homeopathy, when the cytokine that plays a role in the course of the disease is diluted in homeopathic doses and applied, the destruction order normally given by that cytokine stops!

In microimmunotherapy, different actors (RANTES, Il6, Il1b, TNFa, etc.) that play a role in each stage of inflammation are taken into account and these agents are administered to the patient in a specific order in different dilution doses. The course of inflammatory events is modified. For example, the development of fatty degenerative osteonecrosis of the jawbone is thought to be caused by too much RANTES in the environment after tooth extraction, which stimulates the formation of fatty tissue instead of bone formation. In microimmunotherapy, the administration of too much diluted RANTES promotes bone formation by inhibiting RANTES activity (this can be found in the research of Beatrice Lejeune and J. Lechner) (ref). Studies on microimmunotherapy, both in the lab and in humans and animals, can be found here.

But how does this work? This question was rightly asked during the talk… How is it that the substance itself is in the body, but when given externally in very low doses, it gives such a result? Speaker Lejeune said that we don’t know and that whoever finds the answer will either get a Nobel Prize or be labelled a buffoon!

In Uncategorized

Holistic Oral Examination

Holistic Oral Examination

We cannot treat oral and dental problems as if they are problems specific to the mouth, independent of general health. Problems in the mouth can both point to other problems in the body and can be the cause of these problems!

Holistic Oral Examination
In Featured, Nutrition, Uncategorized

How Much Calcium Can We Absorb from Different Foods?

When removing a food group from our diet, we sometimes cannot calculate what we should include instead. For example, think that your breakfast consists of cheese, olives, tomatoes, cucumbers and eggs (typical Turkish breakfast). One day you realize that you are intolerant to dairy. When you only take out the cheese and continue with the rest, you are saved from a food that is harming you, but on the other hand, there is a possibility that some of the nutrients you get with that food will diminish. Therefore, when removing a food group, it is necessary to take a look at which micronutrients come with it. In this article, I will share how much calcium we can get from which alternative calcium sources, especially for those who exclude dairy products from their diet for various reasons.

Normally, you can easily find information about the calcium content of food. However, to find out how much calcium you actually get from a food, we need to take into account how much of the calcium in that food can be absorbed by the body. For example, the absorbable part of 300mg calcium contained in a glass of milk is 32%. This means that we get 96mg of calcium from 1 glass of milk (240g). The same amount of calcium-rich spinach (240g) contains 322mg of calcium, more than 1 glass of milk; However, since only 5% of it can be absorbed, we only get 16mg of it. That’s why I prepared the list below so that we can make our calculation according to this absorbable calcium. Don’t worry, spinach is a bit of an extreme example… You can see that many vegetables on the list have a lot of absorbable calcium.

Of course, before we can use the list, we need to know how much calcium we need. You can find the recommended daily intake of calcium according to age in the table below (1).

Age Male Female
0–6 months* 200 mg 200 mg
7–12 months* 260 mg 260 mg
1–3 years 700 mg 700 mg
4–8 years 1,000 mg 1,000 mg
9–13 years 1,300 mg 1,300 mg
14–18 years 1,300 mg 1,300 mg
19–50 years 1,000 mg 1,000 mg
51–70 years 1,000 mg 1,200 mg
71+ years 1,200 mg 1,200 mg

* adequate intake (this warning in the original source may mean that the ideal intake for these age groups may be higher.)

In this table, the recommended daily intake of 1000mg for an adult, actually refers to dietary calcium, not the absorbable amount. How do we understand this? It is recommended that we consume 3-4 portions of dairy products to meet our daily calcium needs. If all 1000mg were to be absorbed daily, it would be recommended to consume 10 portions of dairy products since we would get 96mg absorbable calcium from 1 serving of dairy products. Based on this, we can say that the recommended amount of calcium to be absorbed daily is 300-400mg (5).

Let’s also briefly mention that there are different opinions about whether this is the amount of calcium we really need. Different factors such as physical activity, estrogen hormone and vitamin D level can also change the amount of calcium we need. Asian and African societies with fewer bone fractures with less calcium intake, raise questions about the recommended amounts of calcium. Of course, there are so many variables in diet and lifestyle that it is difficult to explain this difference with calcium intake alone.

After this detail, we can move on to the table showing the absorbable calcium amounts in foods. Hope this helps you to regulate your diet …

 

 

FOOD PORTION SIZE CALCIUM ABSORBED
Bone (eg. softened bones in chicken bone broth) 3 g 270mg
Collard greens 1 cup cooked(≅ 190g) 173mg
Turnip greens 1 cup cooked(≅ 190g) 102mg
Feta Cheese 30g 96.3mg
Yoghurt 240g 96.3mg
Milk 1 bardak 96.3mg
Sardines (with bones) 106g 95mg
Canned Salmon (with bones) 106g 71mg
Chinese cabbage 1 cup cooked(≅ 170g) 69-85mg
Broccoli 1 cup cooked(≅ 156g) 57mg
Kale 1 cup cooked(≅ 125g) 46mg
Mineral water

(San Pellegrino, one of the highest Ca containing)

 500ml 41-45mg
Mustard Greens 1 cup cooked(≅ 190g) 42mg
White Beans 110g 24.7mg
Rutabaga 85g 22mg
Almond 28g 17mg
Red Beans 110g 15.3mg
Spinach 1 cup cooked(≅ 180g) 12mg
Radish 50g 10.4mg
Sesame (hulled) 28g 7.7mg
Sweet potato 164g 9.8mg
In Biological Dentistry, Uncategorized

Root Canal Treatment Discussion

The documentary Root Cause, which claims that root canal treated teeth may be one of the underlying causes of chronic diseases, has created a heated debate on root canal treatments. These claims are actually not new, but are based on experiments conducted by Weston Price in the early 1900s. When W. Price extracted root canal treated teeth and placed them under the skin of rabbits, he observed that the rabbits developed the same problems as the person from whom the tooth was extracted. Price’s studies were criticized as not being done in a sterile environment because they were very old, but the controversy did not end.

Why can root canals be problematic?

Firstly, because the canal structure can vary so much, it is very difficult to clean them perfectly. For example, molars are “mostly” considered to have three canals, maybe 4 canals, and treated. However, there may be other canals connecting and branching with each other. In the photo below, these mixed morphologies of the canals are shown in color.

Complex morphologies of dental canals depicted in color

  • The second and main problem is the thousands of microtubules that make up the structure of the tooth. Even if we clean the main and side canals perfectly, the tooth itself consists of thousands of tiny canals. In a living tooth, there is a fluid flow in these canals. In a dead tooth with root canal treatment, this disappears. This area becomes an ideal environment where microorganisms can settle. I have shared a drawing below so that you can visualize the microtubules.

microtubules present in the tooth structure

The photo below shows electron microscope images of the microtubules and the microorganisms inside them. microtubules and microorganisms inside them

  • These microorganisms in both main and side ducts and microtubules can produce gases such as methylmercaptan and thioether. These gases are thought to stimulate the immune system and cause the response to be systemic (1). 

Some studies suggest that root canal treated teeth can cause diseases in the body. For example, clots taken from 101 patients who suffered a heart attack were analysed and 78.2% were found to contain bacteria found in root canal treated teeth. (2). In addition, the bacterial DNA in these thrombi was 16 times higher than in the blood of the patients.

Dental canal anatomy illustration showcasing intricate structures and connections

However, before making a direct decision about root canal treatment, it is necessary to consider some other points.

Root Canal Treatment and Failed Root Canal Treatment

In most of the studies on root canal treatment and systemic diseases, root canal treated teeth with chronic inflammatory areas at the end of the roots were used. Not root canal-treated teeth that looked “successful” on X-rays… The study I gave an example of above was one of them.

Even if the fact that microtubules cannot be cleaned and filled is also valid for looked successful root canal treatments, there are not many published studies on these.

Are the Channels Considered Successful Really Successful?

In conventional dentistry, X-rays are used to interpret the condition of the root canal treated tooth. In recent years, it has become clear that X-rays are very inadequate in detecting these pathologies compared to tomography images. Therefore, a “successful” appearance on the X-ray does not necessarily mean that the root canal treatment is problem-free.

Comparison of 2d opg and 3d dvt techniques:The x-ray image on the left may suggest that the tooth is unproblematic. However, in the tomography on the right, we can easily see the inflamed area at the tip of the root.

The following study(3) compared root canal treatment in patients with and without systemic disease. It states: “In the group of 98 people with systemic disease, chronic lesions were also detected in 95% of all root canal treatments counted (tomography was used).

root canal treatment in patients with and without systemic disease.

In the same study, root canal treatments in a control group with no health problems were also less favourable: 444 of the 656 root canal-treated teeth detected on 631 CT scans had chronic inflammation at the root tip. The high rate of “unsuccessful” root canal treatments is probably due to the use of tomography in the diagnosis.

In other words, root canal treatments associated with systemic diseases may be unsuccessful root canal treatments, but their rate may be higher than we think.

Which of them started it?

There are many more studies showing that chronic inflammatory root canal treatment is more common in patients with systemic diseases (4, 5, 6, 7). But based on this relationship, can we say that root canal treatment has caused these problems? Or is there a basis for the failure of root canal treatment in people with these diseases? Whatever the condition that causes systemic diseases, does it also cause root canal treatment to fail?

There are studies suggesting that the formation of such a lesion at the tip of the roots may be related to genetic predisposition(8, 9). In the study in the photo, a genetic change of the type that increases inflammatory responses was observed in people with clinically unsuccessful root canal treatments.

genetic change of the type that increases inflammatory responses

Conclusion

For now, I would like to end by briefly writing my comment in order not to extend the article further. When we look closely at the root canal treated teeth, we can see that they are not the kind of environment that we want to harbour in the body. On the other hand, we cannot say “Root canal treatments cause diseases in everyone” with the data we have. You know how some people smoke, do not sleep properly, eat poorly, and while you approach all of these issues meticulously, you feel unhealthier than that person… There may be a similar situation with root canal treatments. The person may have an advantageous structure that manages to keep the problems that the canal may cause under control. Or everything has not come together yet! The glass has not overflowed… We do not know. Some biological dentists are definitely in favour of extracting all root canal treated teeth. Not only among dentists but also among oncologists, cardiologists and doctors from other specialities. On the other hand, there are also physicians who believe that we have not yet reached the point and that further research is needed. The IAOMT (International Academy of Oral Health and Toxicology), which has a very clear stance on amalgam fillings and fluorine, does not make a clear recommendation on root canal treatments.

Therefore, I think that many factors such as the patient’s general health status, expectations, replacement procedures, not only X-ray but also tomography images of the tooth, etc. should be evaluated in order to decide whether or not to perform root canal treatment, whether or not to extract the canaled teeth. I also believe that the patient should be informed about this issue and his/her consent should be obtained before the procedure is performed.

For this purpose, measures such as raising awareness of the society especially about nutrition, making regular check-ups a habit in the society, educating patients about the symptoms that can provide early diagnosis and giving regenerative treatments more chance can be taken. Root canal treatment can be avoided as much as possible where it is not necessary (For example, a crowded tooth to be crowned for aesthetic purposes can be treated with orthodontics if it is foreseen that it will go to root canal).

I will try to share more detailed information about all these measures in the following days…

References
  1. https://www.ncbi.nlm.nih.gov/pubmed/25864743
  2. https://www.ncbi.nlm.nih.gov/pubmed/23418311
  3. https://www.omicsonline.org/open-access/impact-of-endodontically-treated-teeth-on-systemic-diseases-2161-1122-1000476.pdf
  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3448330/
  5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6164509/
  6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4856634/
  7. https://www.ncbi.nlm.nih.gov/pubmed/26174809
  8. https://www.ncbi.nlm.nih.gov/pubmed/21419289
  9. https://www.ncbi.nlm.nih.gov/pubmed/29306532 
In Biological Dentistry, Safe Amalgam Removal, Uncategorized

Genetic Predisposition To Mercury Toxicity

While some people observe that their health problems begin after amalgam fillings are made or removed without taking the necessary precautions, others can feel healthy even though they have had amalgam fillings for years.

Of course, everyone’s criteria for being healthy can be different. Someone whose body gives serious alarms is so accustomed to living with these symptoms that they consider themselves healthy.

However, it would not be wrong to say that not everyone exposed to mercury has the same problems. Some people seem to cope with mercury or other toxins more easily, while in others these types of toxins can cause many health problems.

Why are some people more affected by mercury than others?

There may be many reasons for this: the amount of toxins that are exposed, whether this amount accumulates over time or is exposed at once, exposure to more than one toxin at the same time and increasing the effects of each other, such as pathogenic bacterial toxins present in the body.

Another reason that is getting more and more attention is that certain aberrations (polymorphisms or SNPs) in a person’s genetic sequence make that person more susceptible to the effects of toxins.

The introductory part of the article describing a study conducted on members of the American Dental Association in 2015 included the following comment:

“One of the major challenges in performing the risk assessment of mercury is that, despite exposure to similar mercury levels, […] there are huge differences between members of communities in terms of mercury measured in hair (Canuel et al., 2005).” In other words, although people seem to be exposed to the same amount of mercury, the amount of mercury they can throw out can be different. Let’s continue… “Although the source and dose of mercury may explain to some extent the difference in mercury content between individuals, differences in the absorption, distribution and elimination processes (in other words, toxicokinetics) of mercury may also play an important role in the formation of this distinction. Mercury toxicokinetics can be affected, for example, by changes in functional enzymes and proteins that transport, oxidize or reduce mercury (Gundacker et al., 2010).” (1)

As a result of her study of 500 children in 2013, Woods said:

  • Abnormalities in genes (SNPs) that enable the body to produce metallothionein increase the susceptibility of children to mercury neurotoxicity.
  • The relationship between mercury and neurobehavioral performance was observed mostly in boys.
  • In children with 2 metallothionein SNPs, the adverse effect of mercury on performance was measured at the highest level. (2)

Now let’s look at what metallotionein does in the body:

Metallothioneins are small proteins containing sulfhydryl groups that bind to zinc, copper, iron, cadmium, mercury, and other metals (3). With these properties, they not only regulate zinc metabolism, but also act as a natural chelator in the body and play a role in removing toxic metals from the body (4).

In an experiment to better understand the role of metallothioneins, the researchers silenced the mice’s MT-I and MT-II genes. While this appeared to have no developmental effects in the mice, they became more susceptible to cadmium poisoning. On the other hand, increasing MT genes increased their resistance to cadmium (5).

In short, even a difference in a gene that produces only one protein can adversely affect the excretion of metals and therefore mercury, leading to the accumulation of too many toxins for the body to cope with.

You can find other genetic variations that come to the fore in mercury research in my previous article titled “Facts About Amalgam Fillings“.

If we’re genetically unlucky…

We now know that our genes are not destiny. Epigenetics has shown that environmental factors can play a huge role in how genes are expressed. The environment you create for your body can control your genes’ on-off switches. Many factors such as what you eat, sleep, getting sunlight, spending time in nature, having good social relationships, and breathing properly can make this environment better. You may think these are irrelevant, but each one of them makes it easier for the biochemical events in the body to run smoothly.

Of course, while trying to increase the body’s ability to cope with toxins, let’s also remember that we should reduce the toxins we are exposed to from the outside as much as we can and lighten the burden of the body…

Resources:

  1. https://www.ncbi.nlm.nih.gov/pubmed/26673400
  2.  https://www.sciencedirect.com/science/article/pii/S0892036213001669
  3. N.V. BHAGAVAN, in Medical Biochemistry (Fourth Edition), 2002
  4. Susan L.-A. Samson, Lashitew Gedamu, in Progress in Nucleic Acid Research and Molecular Biology, 1997
  5. https://www.sciencedirect.com/science/article/abs/pii/S007966030861034X
In Biological Dentistry, Safe Amalgam Removal, Uncategorized

Is It Possible to Remove Heavy Metals by Sweating?

Sweating is known as a good way to remove toxins and is considered among the general recommendations for detox. So how effective is sweating when it comes to heavy metals? When he hears round words like me, “Do we accept it as true because it is repeated thousands of times, or is it really like that?” If you are one of those who think, this article, which I will talk about research on sweating, may be of interest to you. I recently wrote this article on greenmedinfo.com, on an article by its founder Sayer Ji. However, in his article, he emphasized that sweating does not only help to regulate body temperature, but is also important in removing toxins, while I shared the points that caught my attention from a study that I reached from the bibliography of the article and compiled many studies.

In a nutshell

The amount of heavy metals excreted by perspiration in individuals in the studies was generally higher than the amount of heavy metals detected in their urine and blood. In some individuals, while heavy metals were detected in sweat, it could not be detected in blood or urine. Exercise, sauna or sweat-stimulating drugs were used to make the participants sweat.

Meanwhile, Sayer Ji, in his article, included studies showing that bisphenol-A (BPA) and phthalates, which are found in plastics and are associated with many health problems, are also higher in sweat than their amounts in urine and blood serum. Even here, while these substances could not be detected in the urine or blood of some participants, they were detected in the sweat. So sweat can also be a good excretion method for these substances.

Now back to heavy metals. The results of the studies that caught my attention from an analysis of more than 20 studies that measured mercury, lead, cadmium, and arsenic are as follows (2):

Mercury:

  • In a study conducted in Canada, in which 10 healthy individuals and 10 individuals with chronic problems were examined, we can say that the average blood, urine and sweat mercury levels were close to each other even though they were slightly higher in sweat (0.61, 0.65, 0.86 mcg/L, respectively). However, while the number of people who detected mercury in all three samples was 16, only mercury was found in sweat in the remaining 4 people. In other words, if these people had blood and urine mercury tests for diagnostic purposes, the result would be negative, and it would be thought that they did not have mercury in their bodies.
  • In a case shared in 1978, the treatment of a worker who was exposed to mercury vapor for an hour a day while working at a place that produced thermometers for 13 years. The patient, who became incapacitated in the last 6 months, was first given various chelation agents for two months. Then, sweating and physiotherapy sessions were applied every day for a few months. During the treatment, it was observed that mercury was removed from the sweat by measurements. At the end of the treatment, the amount of mercury measured in the blood, urine and sweat decreased to normal levels without any side effects in the patient (3).

Lead:

  • In the Canadian study I mentioned above, the average amounts of lead in sweat, blood and urine were found to be 31, 0.12, 1.8 mcg/L. Here, we see that the amount of sweat excreted is quite high. Lead was detected in all three samples in all participants. Lead is everywhere!
  • In 1991, a very interesting study was conducted in England. Two volunteers drank lead chloride once or twice, for a total of 20mg! What kind of science is this? Or were they two researchers willing to even drink poison to complete their doctorate? We do not know these… But as a result, this lead compound, which was measured in the acute period, was not excreted much in sweat this time. It reached its highest level in the blood 4 hours after ingesting lead. It maintained this high level in the first 24 hours and gradually decreased over the next few weeks. Similar amounts were also detected in the urine. I was so intrigued by this work that I opened it and read it and realized that this was not actually the first time! There are many other works. In one of these, a researcher had 16 -initially- healthy subjects drink nickel! And after that, he could not see a significant breakthrough in sweat. Although there is an increase in nickel in the blood and urine… Our researchers who drink lead have drawn the following conclusion, taking into account other previous studies: These types of heavy metals are more common in blood and urine, since they have not yet penetrated into the tissues in the acute stage. When it is exposed chronically, accumulation in the tissues increases, and therefore it’s excretion with sweat also increases (4).
  • In a study conducted in Germany in 1986, the amount of lead thrown by aerobic endurance training (rowing) was found to be higher than the amount of lead thrown by shorter but more intense training (cycling) (values ​​measured in blood). So, according to this study, sweating for a longer period of time may be more advantageous than sweating at the same (or more?) rate over a shorter period of time.

Cadmium:

  • In Canada, in the study I mentioned above, cadmium could be detected in all samples, including blood, urine and sweat, in only three of the participants, while cadmium was detected in the sweat of 17. So sweat can be a good method for detecting cadmium. Considering the average amounts detected, it is seen that cadmium is excreted better with sweat than other ways. Average amounts in blood, urine and sweat, respectively: 0.03, 0.28, 5.7 mcg/L.
  • In the study in which 28 lecturers volunteered in the USA, the amount of cadmium detected in sweat ranged from 11-200mcg/L, while it was between 0-67mcg/L in urine. There is no such thing as too much cadmium in the urine of those who have too much cadmium in their sweat. From this, we can conclude that a urine test performed alone does not always reflect the situation in the body.

Arsenic:

  • They compared a group in Bangladesh who had arsenic poisoning and showed skin symptoms, another group exposed to arsenic in drinking water, and a third group who had never been exposed to arsenic. As expected, the sweat arsenic content of those exposed to arsenic was several times higher than those that were not exposed. There was no difference between the arsenic poisoning group and those who received arsenic from drinking water. I wondered if there is a maximum amount of arsenic that can be excreted in sweat, or if the arsenic taken with drinking water is too high, perhaps because it spreads for a long time, although it does not cause skin symptoms… seen to be thrown. This shows that, as with other heavy metals, our need for these vitamins and minerals increases with arsenic toxicity.
  • Again, in the Canadian study, arsenic was detected in 17 of the 20 participants. This time, the most arsenic was measured in the urine. (Average amounts are 37mcg/L, 3.1mcg/L, 2.5mcg/L in urine, sweat and blood, respectively)

I think we can draw two important conclusions from these findings:

First; Routinely practicing sweating through exercise, sauna or other means can reduce the body’s heavy metal load more than we think over time. As I said at the beginning of the article, we say “Sweating removes toxins,” but when we suspect heavy metals, the first detox method that comes to mind is usually taking chelation agents or supplements. I can’t compare the amount of metal excreted with these agents with the amount excreted through sweat, but even the mildest and the most herbal ones can have side effects. Therefore, sweating seems like a safer method to me compared to trying to get rid of the heavy metal accumulated in the tissue into the blood. As I said, I can’t compare their effectiveness, but I think that at least applying it in addition to other methods can speed things up.

The second conclusion we can draw is that sweat tests may be a new alternative to blood and urine tests, which generally do not work very well in measuring body accumulation. There are other tests such as hair, erythrocyte, intracellular spectrophotometer analyzes (oligoscan, zell-check) used to measure this load. Although hair tests are found to be more reliable than urine and blood, sometimes they may not reflect the situation directly and it may be necessary to interpret the mineral ratios. Zell-check, on the other hand, although it is a very practical test, is criticized by some researchers as inaccurate (5) (6). In short, a method that everyone considers valid has not yet been found to fully understand the heavy metal load in the body. Therefore, measuring the amount in sweat can be another method we can apply.

If you can’t sweat…

Unless you have an inherited or acquired disorder that damages the sweat glands, skin or nerves, the inability to sweat may improve over time. It has been stated that sweating may become more difficult, especially in people who are exposed to toxins, since the autonomic nervous system’s ability to balance body temperature may decrease(2). In order to regulate this, correction of biochemical processes with the help of nutrition and food supplements, as well as methods to stimulate lymph drainage and exercise before sauna were recommended (2) . Examples of methods that stimulate lymph drainage are massage, dry brushing, trombone jumping, and all sorts of other exercises. Unless you’ve been a regular exerciser, don’t expect great results on your first workout. It has been observed that those who exercise regularly for a longer period of time sweat better. Therefore, it is necessary to give the body some time to adapt… And of course, drinking plenty of water is another trick for sweating. When you drink plenty of water and insist on exercising, you will gradually find that you can sweat more easily. Let me write as a small reminder that you should also pay attention to your diet in order to compensate for the increased mineral excretion when you sweat.