Sometimes you have to go outside the box

By Alvin Danenberg, DDS, contributing writer

February 6, 2019 -- We all have personal stories to tell that may prove a point. Sometimes, telling these stories may sound like sour grapes. But sometimes these stories could expose our vulnerability by forcing us to move outside the box.

Moving outside the box is risky, but it may be necessary to get the word out. It's almost like whistleblowers who put ethics and morals above security and the status quo.

So, here are a few personal stories that take me outside the box. As these examples illustrate, patients do not always agree with my treatment recommendations, which is their prerogative.

Food and lifestyle

In a column from April 2017, I described how improving diet and lifestyle might improve the health of the mouth as well as overall health in a very significant way. Again, I got emails from naysayers who stated I should be treating just the obvious problems in the mouth.

“Dentists must be aware of the health of the total body and all that goes into making that body healthy.”

Of course, the obvious and acute infection in the mouth must be treated immediately. However, my point was to investigate potential common causes of disease rather than just treating manifestations of various diseases.

Could there be underlying and treatable factors responsible not only for diseases in the mouth but also diseases in other areas of the body? I think so. Just as importantly, however, as health professionals, dentists must be aware of the health of the total body and all that goes into making that body healthy.

Chronic diseases

I saw a patient who had significant periodontal disease along with various chronic diseases including type 2 diabetes, cardiovascular disease, and oral lesions called lichen planus. I suggested that I could treat his gum disease, but that he may also want to consider some other factors that could be affecting not only his gum disease but also his other medical diseases.

I gave him some information about food, the gut, and chronic inflammation. After he left my office, he called the receptionist to transfer his records to another dental office.

Marathon woman

A prominent businesswoman in my area made an appointment with me. She was an ardent marathon participant and trained almost every day. This patient had severely advanced periodontal disease, along with Hashimoto's thyroiditis, an autoimmune disease.

Alvin Danenberg, DDS
Alvin Danenberg, DDS.

I suggested that her periodontal and autoimmune diseases might have a common cause. I additionally proposed that her marathon training could be causing excessive oxidative stress, possibly contributing to both her thyroiditis and periodontal disease.

I asked her about making some changes in her training program. These suggestions did not go over very well, and when she left the office, she told my receptionist that she would never give up her daily marathon training.

She never scheduled another appointment with me.

Why share?

I am passionate about treating my patients appropriately. I am also passionate about sharing knowledge that will help their mouths and also the rest of their bodies.

It is difficult because there is so much misinformation being promoted, but the science is there.

Fortunately, many colleagues and patients are thirsty for this information. Following my initial periodontal examination, most of my patients say they have never received such a thorough examination and so much useful information from any healthcare professional.

Most chronic diseases have common causes that need to be addressed. Specifically, nutrition (for the most part) starts with the mouth. And the mouth is where dentists are experts. Well-informed dentists are in a perfect position to treat dental diseases while also helping patients put together many of the puzzle pieces of chronic disease.

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 © 2019

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