Dentistry is getting it wrong

By Alvin Danenberg, DDS, contributing writer

September 7, 2016 -- Dentistry (as a profession) and dentists (as professionals) are placing the wrong emphasis in the wrong place. I'm putting my two cents in here as I've been a practicing periodontist now for 42 years.

Here is how I see it:

Oral health is a result of balance in the mouth and balance in the body. Tooth decay and gum diseases are problems of imbalance -- that is an imbalance between good and bad bacteria, an imbalance between efficient and inefficient immune system responses, and an imbalance between healthy and unhealthy food choices and lifestyles.

Alvin Danenberg, DDS
Alvin Danenberg, DDS.

I see dentists telling patients to brush harder and floss more frequently. I see dental practitioners placing fluoride on teeth, for both children and adults, to make their teeth harder and stronger. I see filling materials being placed into grooves on the chewing surfaces of teeth to prevent tooth decay. I see so many procedures and recommendations to apparently prevent tooth decay and gum disease. What I don't see is an emphasis to teach patients the real causes of tooth decay and gum disease. In my opinion, it's elementary -- eliminate the causes of disease and you will prevent the disease.

As an aside, I know a few dentists who have their pediatric patients grab a candy bar from a "Halloween treasure chest" following their dental appointment. Can you believe that? I also know of many dental conventions where free sodas are provided to dentists as they walk around the exhibit halls deciding what new gizmos they need to buy for their dental offices.

Here are my recommendations to my patients to prevent tooth decay and gum disease:

“What I don't see is an emphasis to teach patients the real causes of tooth decay and gum disease.”
  • Eat nutrient-dense foods to give the body the building elements to support a healthy mouth and balanced bacteria.
  • Avoid all processed grains, sugars, and sodas, because they feed unhealthy bacteria, increase acid levels in the mouth, and compromise the immune system.
  • Clean teeth and gums efficiently to remove unhealthy clumps of plaque by using a toothbrush angled into the gum margins and using dental floss and a tiny brush that can clean between the teeth.
  • Brush your tongue to remove decaying food remnants and harmful bacteria that thrive on the top surface in the back of your tongue and are a major source of bad breath.

I believe the entire medical profession should place a greater emphasis on educating patients about the causes, prevention, and elimination of their disease. Today, in my experience, the medical profession emphasizes the treatment of the manifestations of disease. I get it. It is important to repair the damage that has been created by disease. But ultimately, prevention might avoid the damage.

I challenge my colleagues and profession to learn the real biological causes of dental disease and to implement biological prevention education for every patient who enters their offices.

A version of this column first ran on Dr. Danenberg's blog. appreciates the opportunity to reprint it. Future columns will address how dentists can serve their patients and their profession.

Alvin Danenberg, DDS, practices at the Bluffton Center for Dentistry in Bluffton, SC. He is also on the faculty of the College of Integrative Medicine and created its integrative periodontal teaching module. He also spent two years as chief of periodontics at Charleston Air Force Base earlier in his career. His website is

The comments and observations expressed herein do not necessarily reflect the opinions of, nor should they be construed as an endorsement or admonishment of any particular idea, vendor, or organization.

Copyright © 2016

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