Breathing and Orthodontics: Not doing one gets you the other

Recently I attended the North American Association of Facial Orthotropics ( NAAFO) meeting in Chicago, IL. Though a meeting of fellow “BlocHeads”, those practitioners using the Bio-Bloc® technique, this meeting featured a multi-discipline lineup of presenters; dentists, orthodontists, neuro-surgeons, ENT specialists, pediatricians, and others.

The focus was airways. Though seemingly boring, it’s actually pretty important. Though it seems obvious, you need to breathe, what’s not obvious is the quality of the airway space.
Humans were designed to be nasal breathers, using their diaphragms to move the air. However, a large number don’t. Many can’t breathe through their noses easily, despite what they say, and others don’t breathe properly for proper gas exchange in the lungs. This is where a lot of problems start.
Carbon dioxide levels in the lung will trigger chemical receptors in the lung which then go to the brainstem which sends out signals to make you breathe. So, carbon dioxide levels, not oxygen levels, are the primary trigger in breathing. There is a lot of chemistry surrounding this, but if you maintain too high a level you will develop a condition called respiratory acidosis, which can become metabolic acidosis as well. Basically, your lungs become too acid (low pH), and eventually your body as well. The common blood screening to measure CRP levels can show this. Usually you are told that you have inflammation when CRP (c-reactive protein) levels are elevated. Inflammation in a neutral pH (around 7.1) environment is difficult to maintain, BUT, in a lower pH (acidic) environment inflammation it is far more frequent. Your enzyme systems are also very pH sensitive, so a slight shift in either direction, acid or alkaline (higher pH), and you have diminished enzyme function (affects things like heart, liver, kidney,etc.). I am not saying that all inflammation problems are associated with increased carbon dioxide levels, but I heard from a few physicians who presented arguments that it is far more prevalent than their profession believes.

As a dentist we deal with people with issues such as obstructive sleep apnea. Due to compromised airways, a lot of these people do not sleep well. What we find is that most of these people have other medical issues, which could be considered a consequence of the sleep apnea. In adults, the treatment options are limited. The gold standard to date is a CPAP machine, but almost half of all patients can’t tolerate them, so dentists are able to make an oral appliance that moves the jaw forward. Since the tongue is attached to the lower jaw, it comes forward as well, and that opens the airway. Orthodontic enlargement of the shape of the jaws can also improve the airway. Surgical advancement of the upper and lower jaws in almost all cases eliminates sleep apnea, but the surgery rarely is covered by insurance plans.

At the NAAFO meeting an emphasis was placed on ways to make corrections in children, utilizing growth, to guide the proper development of the face. In children, by using orthodontic appliances you can get the effect of the adult surgical techniques without the surgery. The result is a better looking face and a significantly better airway. More information can be found at www.biobloc.org, or contact us at 703 820-0809.

I am currently writing a series of articles for a local newspaper, some of which will be about the relationship between breathing and orthodontics. They will be found here after publication. There will be more pictures and diagrams in the articles.

For more information about the Orthotropic philosophy of treatment contact us or go to www.Orthotropics.com . This site is the most followed dental site on the internet.


Dentist Alexandria VA
Bradlee Dental Care  
3690 King Street, Suite KL
Alexandria, VA 22302
(703) 820-0809 

Dental Amalgams (silver fillings) and the Kidney

Dental amalgams, more commonly known as “silver fillings”, a mixture of the organo-metallic toxin mercury and several metals, have been used in dentistry for about 150 years.  A cheaper alternative to the more commonly used gold-based fillings used at that time, they became widely embraced by the dental profession because of it’s cheap cost as a filling material after decay had been removed from a tooth.  There is no question that it’s implementation has been successful.

 However, there has been controversy in its use since its beginning. Many have warned of the potential side effects over the years.  Many of the earlier studies were anecdotal or used disputed scientific methods.  However, the body of evidence was growing, both for the use of amalgam and against it’s use.  Though there was no overwhelming evidence one way or the other, panels testifying in front of the Food and Drug Administration were able to make their arguments be heard.  Several years ago the FDA downgraded its classification from universal to general use, with restrictions (Class one to Class two). It is no longer regarded as safe for young children and pregnant women.

In recent years the level of scientific research has improved dramatically as we are now able to do detailed studies at the cellular and molecular levels.  The amalgam issues have not gone away and now they are looking at the controversy  with “new eyes”.  Last year a peer-reviewed paper was published that stated that inflammatory markers were found in the immune-systems of people with dental amalgams that was significantly higher than in those without. 

This month, in the journal of Human and Experimental Toxicology, a peer-reviewed paper was published that states that kidney damage is found in people with dental amalgams that is significant compared to those people without dental amalgams. 

Inside your kidney is a series of tubes lined by cells that help to filter wastes out of the blood to be eliminated by the urine.  Damage was found in the part of the tube called the proximal tubule.  The damage was dose-dependent, meaning the more dental amalgams that a person had, the more damage was found.

This author is  not jumping on the band wagon stating that “ if you don’t get your silver fillings replaced you’re going to die”.  What we are doing is giving you the information, that’s readily available, for you to make a decision about your health.

There is always some risk in replacing dental amalgams since mercury release is highest at placement and removal, and tooth damage during removal is always a possibility. No man-made material is as safe as that you were born with.  However, the chronic issues may be of far more importance to your well-being.

The use of dental amalgams will remain controversial for some time.  Insurance companies tie their benefits to the use of dental amalgam and will be slow to raise the benefits to the more expensive options available today.

If you have more questions that you can contact our office.  We have not placed dental amalgams since 1987.

Daniel F. Babiec, DMD,MAGD

Dentist Alexandria VA
Bradlee Dental Care  
3690 King Street, Suite KL
Alexandria, VA 22302
(703) 820-0809

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Geier et al, 2013- mercury exposure from dental amaglams and kidney integrity biomarkers

A significant dose-dependent relationship between mercury exposure from dental amalgams and kidney integrity biomarkers: A further assessment of the Casa Pia children’s dental amalgam trial

DA Geier, T Carmody, JK Kern, PG King and MR Geier
Human and Experimental Toxicology 32(4) 434-440. 2013.

Abstract
Dental amalgams are a commonly used dental restorative material. Amalgams are about 50% mercury (Hg), and Hg is known to significantly accumulate in the kidney. It was hypothesized that because Hg accumulates in the proximal tubules (PTs), glutathione-S-transferases (GST)-a (suggestive of kidney damage at the level of PT) would be expected to be more related to Hg exposure than GST-p (suggestive of kidney damage at the level of the distal tubules). Urinary biomarkers of kidney integrity were examined in children of 8-18 years old, with and without dental amalgam fillings, from a completed clinical trial (parent study).

Our study determined whether there was a significant dose-dependent correlation between increasing Hg exposure from dental amalgams and GST-a and GST-p as biomarkers of kidney integrity. Overall, the present study, using a different and more sensitive statistical model than the parent study, revealed a statistically significant dose-dependent correlation between cumulative exposure to Hg from dental amalgams and urinary levels of GST-a, after covariate adjustment; where as, a nonsignificant relationship was observed with urinary levels of GST-p. Furthermore, it was observed that urinary GST-a levels increased by about 10% over the 8-year course of the study among individuals with an average exposure to amalgams among the study subjects from the amalgam group, in comparison with study subjects with no exposure to dental amalgams.

The results of our study suggest that dental amalgams contribute to ongoing kidney damage at the level of the PTs in a dose-dependent fashion.

 

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Alexandria, VA 22302
(703) 820-0809

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Alexandria, VA 22302
(703) 820-0809

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Dentist Alexandria VA
Bradlee Dental Care  
3690 King Street, Suite KL
Alexandria, VA 22302
(703) 820-0809