Causes in the mouth
Factors in the oral cavity
Even something as simple as a displaced wisdom tooth, a previously undetected chronic gum disease (periodontitis), one or more root-dead teeth with previously undetected inflammation at the root tips or a filling, crown, bridge, denture or implant material that is immunologically unsuitable for the patient can be the cause of chronic inflammation with effects on the whole organism.
Below you will find more detailed background information on:
The "dead" tooth - root canal treatment
If a tooth nerve is dead due to deep caries or an injury, the remaining canal is sealed with a root canal filling. The aim here is to prevent bacteria from entering the surrounding bone through the root canal.
Unfortunately, this root canal treatment of dead teeth must be seen as a compromise and can only ever be an attempt to keep the tooth usable. The root canal system is often so heavily branched that it is not possible to keep this canal system germ-free in the long term. In most cases, however, the body can cope with this, which is why the treatment of dead teeth has been an integral part of dentistry for many decades. Not every root-treated tooth is immediately a problem that needs to be removed. But sometimes it is...
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This is because germs and dead tissue can remain in such a tooth or new germs can migrate through leaking fillings. This produces hydrogen sulphide (methyl mercaptan, thioether), which causes an inflammatory stimulus and to which the body can react both immunologically and toxicologically.
From a biological point of view, the best treatment result that can be achieved is one that is so small that the dead tooth continues to be tolerated by the organism.
The dentist and patient must therefore agree on whether root canal treatment should be carried out and how high the associated biological risks should be assessed. However, it is difficult to make a prognosis due to many unpredictable factors.
For chronically and severely ill patients, the mere possibility of a root canal-treated tooth influencing the disease should be reason enough to part with it.
Diagnostics
- immunological systemic detection:
Effector cell diagnost. Mercaptan/thioether - Toxicological local detection:
Orotox test
Amalgam
Amalgam is a long-term stable and cost-effective filling material. For some patients, the gray color and poor aesthetics may play a role in its removal. For many patients, it has been problem-free at first glance for years ... but not for everyone!
For this reason, its use was banned by the EU Commission in 2024. Much more important, however, are the toxicological and immunological effects of amalgam. Amalgam is not a solid alloy but merely a mixture of up to mercury, silver, tin and copper.
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Especially people who have several different metals in their mouth (e.g. gold, amalgam, silver) have increased mercury levels in their body, as mercury ions can be released from the amalgam due to electrochemical corrosion (battery effect) in the mouth (see photo: "Gold plating" of an amalgam filling).
The heavy metals copper and tin also enter the body through abrasion (abrasion of the teeth under function). Mercury is mainly absorbed in the form of mercury vapor. When mercury is absorbed, there is increased excretion in the urine and mercury is stored in the body, especially in fatty tissue. This enables the neurotoxic effect of the heavy metal, as nerve tissue is surrounded by fat, among other things.
For this reason, fillings are removed in our practice using highly protective measures such as a cofferdam, slowly rotating instruments, double suction and respiratory protection.
Due to its toxicological and immunological effects, amalgam or mercury can trigger many secondary diseases, which can break out sooner or later depending on the physical condition or degree of exposure.
A further danger to the tooth itself is that amalgam does not remain stable at the edges under the masticatory load in the long term. Over the years, exposure to oxygen increases the volume of the filling, the edges crumble, become leaky, break off or crevice corrosion occurs. In the worst case, the tooth is literally blown apart, like rocks in winter due to the formation of ice in crevices
We are an amalgam-free practice and, in cooperation with our medical partners, we offer a check of the heavy metal load in the mouth and body, as well as heavy metal removal after amalgam removal.
Diagnostics
- Detection in the mouth: MEA TOX Saliva
- Detection in the body: MEA TOX Urine
- Sensitization: LTT-Dental
Metals
The problem of patients' exposure to metals is becoming increasingly important, especially in the more developed industrialized nations, and is being discussed in connection with the increase in chronic inflammatory diseases. In addition to the intake of metals through food and the respiratory tract, metals introduced into the body medically are among the most significant sources of heavy metals for the human organism.
In addition to surgery, dentistry is also of particular importance. Implants, dentures, fillings, crowns, bridges and braces are metallic irritants that are permanently inserted into the body. This is because they remain in the body 24/7 and year after year...
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Corrosion stability is an important quality criterion for metal dental restorations. A high corrosion rate due to processing errors causes a greater release of the metals and is therefore a prerequisite for absorption into the body. The problem is often exacerbated by the fact that a dentist inserts such a prosthesis into a mouth that already contains other metallic constructions such as fillings, crowns or implants. This starts a galvanic process (battery principle), i.e. more and more metal ions dissolve due to corrosion and are permanently absorbed into the body via the mucous membranes of the mouth and digestive tract. Over the years, the load in the organism accumulates.
The consequences of metal release in the oral cavity caused by corrosion or abrasion can be: demineralization of the teeth, redness, swelling, burning and discoloration of the mucous membranes, chronic periodontitis, metallic taste, bad breath and even cell degeneration.
The systemic effects of metals depend strongly on the individual sensitivity of the person concerned.
In our practice, we avoid metal-containing dentures wherever possible and offer metal-free dentures made of modern high-performance plastics and ceramics.
Diagnostics
- Detection in the mouth: MEA TOX saliva
- Detection in the body: MEA TOX urine
- Sensitization: LTT-Dental
Plastics
Filling resins, also known as composites, are tooth-colored plastic filling materials for dental treatment, but they are also used for luting ceramic restorations, crowns and root canal posts.
They consist of a large number of organic plastic matrices (poly- and monomers), which are mixed with inorganic fillers (ceramic particles). A plastic filling can therefore contain up to 200 different ingredients, some of which are toxic, to which individual sensitization or allergies can occur.
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Harmful substances in the composite include, among others:
- Triethylene glycol dimethacrylate (TEGDMA)
- Hydroxyethyl methacrylate (HEMA)
- Urethane dimethacrylate (UDMA)
- Bisphenol glycidyl (di)methacrylate (Bis-GMA)
These substances, which are considered particularly reactive substances, are toxic to living cells and have a highly permeable capacity. This means that they increase the permeability of the mucous membranes for toxins and can therefore easily enter internal organs - especially the liver and kidneys, where they are deposited and accumulate over time, even in higher doses. HEMA and TEGDMA should be mentioned here in particular.
A special feature is BisGMA, which contains bisphenol A. This is banned in baby bottles due to its estrogen-like effect...but is contained in almost every plastic filling - as are phthalates as plasticizers.
Possible effects of resin fillings are always very individual. After appropriate diagnostics, our practice uses suitable resins for each individual case.
Diagnostics
- Detection in the mouth: MEA TOX Saliva
- Type IV sensitization: LTT-Dental
- Type I sensitization: BAT
Titanium implants - special case of titanium incompatibility
First of all: the often-mentioned "titanium allergy" does not exist! It is physiologically impossible as titanium is highly reactive. Possible titanium ions are oxidized with oxygen in fractions of a nanosecond and therefore cannot be recognized by the immune system as an allergy.
Other immunological mechanisms play a role in relation to titanium. One speaks of a "Titanium incompatibility". Titanium intolerance follows the same rules of non-specific inflammation by macrophages.
If titanium intolerance is detected, this is an indication for a ceramic implant
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If a titanium implant is placed, the screwing in of the implant, micro-movement or biocorrosion leads to the release of titanium particles into the surrounding tissue with a local, non-specific inflammatory reaction, as the macrophages attempt to break down these titanium particles. This usually occurs without any problems.
However, there are genetic deviations (polymorphisms) in some people that lead to a higher release of cytokines and therefore represent a significantly greater risk of peri-implant inflammation (approx. 6-12 times higher). The inflammation processes are similar to those of periodontitis.
A possible titanium intolerance should therefore always be checked using a titanium stimulation test prior to implantation. However, a classic allergy to titanium is not relevant in practice due to the rapid reaction of titanium with oxygen to form titanium oxide and the associated isolation from the body.
Diagnostics
- Proof of titanium incompatibility: Titanium stimulation test
- Evidence of increased inflammatory tendency: Inflammation genetics
The FDOK - "NICO"
FDOK stands for a fatty degenerative osteolysis in the jawbone. This is a chronic degeneration of the jawbone, which is mainly caused by a lack of blood circulation.
This also used to be called NICO (Neuralgia Inducing Cavitational Osteonecrosis), often occurs where teeth have previously been removed and wounds have not been able to heal optimally. However, germination of supernumerary teeth can also be a cause.
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The resulting lack of blood circulation leads to the death of bone and fat cells in the bone marrow. These "atopic" fat cells produce an immune messenger - the chemokine "Rantes". Rantes is an essential component of our immune system and is associated with many diseases. However, Rantes was found to be elevated in such FDOK areas. An elevated level of RAntes in the blood serves as an indication of an FDOK event.
However, the FDOK areas cannot be detected on a conventional X-ray. If the Rantes value is elevated, a 3-dimensional X-ray image (DVT) is therefore taken in our practice after taking a corresponding medical history in order to detect corresponding "hollows" by means of comparative density measurement.
To prevent FDOJ, we insert blood concentrates (PRF) into the resulting wounds after tooth extraction.
In the case of an existing FDOJ, we make a precise diagnosis and then surgically clean the bone. This involves removing the damaged bone tissue and removing the degenerative area.
Diagnostics
- Laboratory diagnostics: Rantes
- X-ray diagnostics: 3D X-ray DVT
Environmental dentistry gets to the bottom of such causes with diagnostics that go beyond the normal findings of conventional dentistry, sometimes with a detective-like approach.
Dr. Jens Tartsch
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