What is holistic dentistry?

Holistic dentistry — also called biological dentistry — is an approach built on the view that the body should be treated as a whole, and that a change in one part can affect the rest. In practice it emphasises prevention, nutrition, material choice, and the relationship between oral and general health. The service page is holistic dentistry, and the companion article the benefits of holistic dentistry describes how it is actually practised here.

Some of what it advocates is uncontroversial and is simply good dentistry. Some of it rests on claims the evidence does not support. This article sets out both, because a page that describes the philosophy without distinguishing between them would not be much use to anyone deciding.

One point of definition first: neither term is a protected title. There is no AHPRA specialty called holistic or biological dentistry, so nobody’s registration will confirm it — see why would I need to see a dental specialist? for what the protected titles actually are, and finding a dentist online in Australia for how to check the rest.

The stated principles

According to the Holistic Dental Network, the basic principles of holistic dental health practice are:

  1. Proper nutrition for prevention and reversal of degenerative dental disease
  2. Avoidance and elimination of toxins from dental materials, including amalgam fillings
  3. Prevention and treatment of dental malocclusion — bite problems understood as physical imbalances
  4. Prevention and treatment of gum disease at its biological basis

The contrast usually drawn is that conventional dentistry deals mainly with the head and neck, focused on the oral cavity, while holistic dentistry emphasises the impact of oral health on the whole person. The described procedure typically involves a thorough examination followed by an educational review of the findings, a discussion of proactive treatment choices, and encouragement to choose materials the patient is comfortable with — which is what understanding your treatment describes as ordinary practice.

What holds up

Several of these are mainstream contemporary dentistry rather than an alternative to it.

A preventive rather than reactive approach. Treating causes rather than only symptoms is standard good practice. A dentist who restores a decayed tooth without also discussing diet, hygiene and risk has done half the job — that is not a holistic insight, it is a competent examination. See how do I prevent dental decay?, caring for your teeth: 8 steps to dental health and the ideal daily routine for oral hygiene.

Nutrition and dietary counselling. Diet assessment is a routine and evidence-based part of managing decay and erosion. The frequency of sugar and acid exposure is one of the main determinants of dental disease — how does your diet affect your teeth?, how does sugar affect your dental health?, how does acidic food affect your teeth? and what is acid wear and how can I avoid it?

Early decay can be reversed. Demineralised enamel that has not yet cavitated can re-mineralise with fluoride, better plaque control and reduced sugar frequency. This is well established — see can you reverse tooth decay? and the stages of dental decay. If you would rather avoid fluoride, read selecting a toothpaste — fluoride or non-fluoride? and the two opposing pieces on water fluoridation, is it good for you? and why I worry.

Occlusion matters. Bite problems genuinely do have effects beyond the teeth — on the jaw joints and chewing muscles, tooth wear, and in some cases the airway. See treatment of malocclusion, TMD vs TMJ vs bruxism, and on the airway, mouth breathing and snoring and sleep apnoea.

The oral–systemic relationship is real. The links between periodontal disease and diabetes in particular are well documented and bidirectional — diabetes and dental health: the two-way street and diabetes and oral health. The wider list is in health problems linked to poor oral hygiene and dental health and general wellbeing, and the practice frames its own version of it as wellness and longevity.

Tooth-coloured materials. Composite resin and porcelain restorations are used routinely, and preferring them is entirely reasonable. They bond to tooth structure, often require less removal of healthy tooth than amalgam preparations, and look better. The comparison is set out in porcelain, amalgam or composite resin and porcelain fillings and composite fillings: differences and costs; the single-visit ceramic option is same-day CEREC restorations.

Where the evidence does not support the claims

Amalgam and mercury

Holistic practice frequently advocates against amalgam on the basis of mercury toxicity. The evidence position needs stating accurately.

Major health authorities — including the World Health Organization, the Therapeutic Goods Administration and the Australian Dental Association — have found no reliable evidence that amalgam fillings cause systemic illness in the general population at the exposures involved. Amalgam has been used for well over a century and is among the most studied materials in dentistry.

There is a genuine, separate reason for the global move away from it: the Minamata Convention phase-down, driven by environmental mercury concerns rather than patient health. Australia is a party to that convention.

The part that matters clinically: removing sound amalgam fillings for health reasons is not supported by the evidence, and it is not risk-free. Drilling out an intact amalgam removes additional healthy tooth structure, transiently increases mercury vapour exposure, and can bring the restoration closer to the nerve — and a restoration that reaches the nerve becomes a root canal. How long do dental fillings last? explains the replacement cycle a tooth enters once it has been restored, and why each cycle costs tooth structure.

If you want amalgams replaced for appearance, or because a filling is failing, those are legitimate reasons — why do I need a filling? covers the clinical triggers. “Mercury detoxification” is not. Dental myths exposed deals with several claims of the same family.

If you have a documented allergy to a dental material — which is uncommon but real — that is a proper clinical reason for choosing an alternative, and it should be recorded in your file.

Homeopathy, aromatherapy and herbology

Holistic practice sometimes incorporates homeopathy, aromatherapy, herbal medicine and hypnosis.

On homeopathy, the position is settled in Australia: the National Health and Medical Research Council concluded after a systematic review that there are no health conditions for which there is reliable evidence that homeopathy is effective. It should not be relied on in place of treatment that works.

Aromatherapy and herbal preparations have limited evidence for dental applications. Some herbal products interact with medications, and “natural” is not a synonym for safe or inert — tell your dentist and doctor what you take. Can oil pulling make my mouth healthier and my teeth whiter? and home whitening and charcoal whitening — does it work? Is it safe? apply the same test to two popular examples.

Hypnosis is the exception in that group. There is reasonable evidence for hypnosis and other psychological techniques in managing dental anxiety, and it is used in mainstream practice for that purpose — see how can I ease my anxiety about visiting the dentist? and, where that is not enough, sleep dentistry.

How to think about it

The useful question is not “holistic or conventional?” but a set of specific ones:

A thorough examination, a proper explanation, attention to diet and prevention, and a choice of materials you are comfortable with are all reasonable expectations of any dentist — see general dentistry and what makes a truly great dentist?. Where an approach goes beyond that to claim health effects the evidence does not support, that is worth questioning regardless of what it is called, and a second opinion is the ordinary way to do it.

And for anything concerning your general health, your doctor is the appropriate practitioner. Dentists should not be diagnosing or treating systemic illness. The one genuine exception is screening: the soft-tissue check at each visit looks for early signs of oral cancer, and findings are referred on.

Common questions

Is ‘holistic dentist' a qualification? How would I check?

It is a description of an approach, not a registration category, and the distinction is worth understanding before you use it as a filter.

Australia recognises 13 dental specialties, approved by the Australian Health Workforce Ministerial Council and listed by the Dental Board of Australia: dento-maxillofacial radiology, endodontics, forensic odontology, oral and maxillofacial surgery, oral medicine, oral and maxillofacial pathology, oral surgery, orthodontics, paediatric dentistry, periodontics, prosthodontics, public health dentistry (community dentistry), and special needs dentistry. Holistic and biological dentistry are not among them. Nor is ‘orofacial pain', which is a recognised specialty in the United States but not here.

What you can check, for anyone, is registration. The Dental Board states that ‘Ahpra publishes an online register of all dental practitioners that provides the profession and the public with up-to-date information about a dental practitioner's registration status', including ‘details of the specialty or specialties for dentists who hold specialist registration'. A search takes a minute and shows current status and any conditions.

So the useful question is not whether someone calls themselves holistic. It is whether they are registered, what specialty (if any) the register records, and — for any specific claim they make — what the evidence for it is. The next answer covers how the law says that should be judged.

How am I supposed to judge the claims on a dental website, including this one?

There is a published standard, and you are entitled to hold any Australian practice to it. AHPRA's advertising guidelines, made under section 133 of the National Law, state that advertising must not ‘be false, misleading or deceptive'. The guidelines then list what that looks like in practice. Advertising may be misleading when it:

On what counts as proof, the guidelines are specific: ‘Advertisers of a regulated health service must be able to substantiate claims made in advertising… Acceptable evidence mostly includes empirical data from formal research or systematic studies in the form of peer-reviewed publications.'

Two practical uses for that list. A page that names a long list of general health conditions a dental approach can ‘help with' is describing the exact pattern the guidelines identify. And a page that cites a study without naming the journal is doing what the third bullet describes. Apply the test to this page too — where we quote a figure, we name the publisher.

If I want to avoid fluoride, what am I actually turning down?

A measured effect with a specific size, so you can weigh it rather than guess.

The National Health and Medical Research Council reviewed the evidence and ‘found that water fluoridation reduces tooth decay by 26 to 44% in children and adolescents, and by about 27% in adults'. Its conclusion is that ‘the existing body of evidence consistently shows that water fluoridation safely and effectively reduces tooth decay across the population at the current Australian levels', and it ‘strongly recommends community water fluoridation as a safe, effective and ethical way to help reduce tooth decay'. The range it supports is ‘0.6 to 1.1 milligrams of fluoride per litre'.

On the safety questions people most often raise, the NHMRC states there is ‘no reliable evidence of an association between community water fluoridation as practised in Australia and other human health conditions such as chronic kidney disease, kidney stones, hardening of the arteries (atherosclerosis), high blood pressure, low birth weight' and others. It also defines the term it is using: ‘no reliable evidence' is used ‘when there is a lack of confidence that the evidence reviewed is relevant to Australia or valid to accept any association'.

It is still your decision, and nobody has to justify it. But it is a decision with a quantity attached, and if you make it, the practical consequence is that the other levers — sugar frequency, cleaning between the teeth, and the recall interval — have to do more work. Say so at your appointment so your risk assessment reflects it. The benefits of fluoride

Do aromatherapy, music or virtual reality actually help with dental fear?

This is the clearest example on the page of a popular idea meeting a large, recent, unwelcome dataset. A 2024 systematic review and meta-analysis in the Journal of Anxiety Disorders pooled randomised trials of adult dental anxiety and concluded, in the authors' own words, that ‘with moderate certainty… virtual reality exposure therapy, virtual reality distraction, background music, acupuncture, or preoperative video information provision did not alleviate state anxiety', and, ‘with low certainty, that aromatherapy did not reduce state anxiety'.

The numbers behind those sentences are not close calls. Background music, with an outlier excluded, came out at a standardised mean difference of −0.10 (95% CI −0.23 to 0.03) across 12 trials and 883 participants. Acupuncture against sham was −0.04 (−0.32 to 0.24). Lavender aromatherapy was −0.39 (−0.86 to 0.08), a confidence interval that crosses zero.

Two things did hold up. Hypnosis showed a moderate-certainty benefit for acute anxiety in extraction patients (−0.31; −0.56 to −0.05), which is why hypnosis is treated differently from the rest of that group further up this page. And for long-standing dental anxiety rather than anxiety in the moment, the review found that ‘evidence with moderate certainty supports employing CBT'.

The review is also candid that not everyone agrees — it notes its results ‘contradict a recent network meta-analysis' that found music and VR distraction did help, while arguing that the heterogeneity in that analysis ‘casts doubts on the reliability of the evidence'. If a practice offers you headphones and a diffuser, none of that is harmful and you may well like it. It is just not treatment, and it should not be presented as a substitute for an approach that is. Dental anxiety

What about ‘detox', ozone, and the other things that turn up under this heading?

Here we have to be straight about the limits of our own checking. Our reference set is a curated collection of Australian regulator and professional-body documents and peer-reviewed literature. It contains no independent source at all on amalgam removal protocols, mercury detoxification, ozone therapy, oil pulling, or homeopathy in dentistry. That is not evidence they work, and it is not evidence they do not; it means we cannot tell you either way from material we can show you.

What we can offer is the test the regulator applies, from the answer above: a claim about the effectiveness of a treatment needs ‘acceptable evidence', which ‘mostly includes empirical data from formal research or systematic studies in the form of peer-reviewed publications'. So the question to ask anyone proposing one of these is simply: which published study, in which journal? A practitioner who can answer that has given you something to check. A practitioner who answers with an anecdote has not.

One caution that does not depend on the evidence either way: be wary of any proposal that involves removing healthy tooth structure — drilling out sound restorations, or preparing intact teeth — on the strength of a systemic health claim. That part is irreversible whatever the theory behind it turns out to be. A second opinion before irreversible work is always reasonable, and no reasonable clinician takes offence at it.

Related reading

Practical details

All practitioners providing dental care in Australia must be registered with the Dental Board of Australia and are bound by the same codes of conduct and advertising requirements, whatever approach they describe themselves as taking. Registration can be verified on the AHPRA register, or by calling 1300 419 495 — the practice’s own clinicians are named on our team and dentists and registered specialists.

Smile Solutions, Level 1, 220 Collins Street, Manchester Unity Building, Melbourne VIC 3000 — see how to find us. Phone 13 13 96, or theteam@smilesolutions.com.au; full details on the contact page. Monday–Friday 8.00am–6.00pm, Saturday 8.30am–1.30pm, Sunday by appointment.

Published 6 February 2017, by Dr Kia Pajouhesh; updated to state the current evidence position on dental amalgam and on complementary therapies. General information only; it does not replace advice from your treating practitioner or your doctor.

Smile Solutions trades under ABN 28 193 514 103.

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