What is Functional Dentistry

Functional Medicine Dentistry is a whole-body approach to dental care that emphasizes understanding potential underlying factors of issues, educating on maintaining oral health, and its connections to overall wellness. It also focuses on using materials that are considered biocompatible. Those practicing functional dentistry attended a conventional dental school and then further specialize in functional dentistry through various continuing education endeavors.

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Functional Dentistry vs. Conventional Dentistry

The most significant difference between functional and conventional dentistry is its focus on oral health and its relationship to whole-body health.

Conventional dentistry focuses on brushing, flossing, mouthwash, fluoride applications, and visiting a dentist two to four times a year for cleanings. It generally addresses dental disease and may not always make connections to how oral health can influence overall wellness. The focus tends to be primarily on the teeth and the mouth.

Functional dentists consider how oral health may impact systemic health and vice versa. The approach involves understanding potential underlying factors, with an emphasis on the oral microbiome, gut health, inflammation, genetics, and lifestyle habits. Functional dentists examine their patients' eating, sleeping, breathing, and lifestyle habits to understand oral health better and focus much of their practices on airway health.

Oral Health Issues That Can Be Affecting Your Wellness

Issues like inflamed gums, root canals, crowns, fillings, and retainers can potentially influence your oral microbiome and overall health. Each tooth is a living organ, with nerve, blood, and lymph supplies, communicating with the rest of your body. The mouth is an environment where certain pathogens can thrive if not properly managed. What happens in the mouth may influence the entire system.

The Oral Microbiome

A significant emphasis in Functional Dentistry is maintaining a balanced oral microbiome. Like other microbiomes of the body, the oral microbiome is a collection of bacteria, viruses, fungi, and parasites that can influence health. The mouth is the start of the alimentary canal, and we are constantly introducing microbes to our GI tract through swallowing, so the oral microbiome is important for systemic wellness. Many Functional Dentists may offer oral microbiome testing to help understand your microbial health and diversity.

Root Canals

There is ongoing discussion about whether root canals can affect health. The idea is that microbes can become trapped if not properly managed during treatment. Functional dentists may use ozone gas and water, biomimetic materials, and lasers during procedures and provide alternative options while educating on proper dental care to potentially avoid future root canals.

They may also recommend regular CBCT or 3D images of root canaled teeth to ensure they are functioning properly and not contributing to inflammation or microbial issues.

Metal in Your Mouth

A common concern with metal dental devices and amalgam fillings is the potential for metal sensitivities. Saliva can interact with these metals. Research has shown that materials in teeth can release small amounts of metals like mercury, nickel, chromium, and iron in silver fillings, dental crowns, and permanent metal retainers.

Airway and Sleep Health

Functional Dentists often emphasize the importance of nasal breathing and quality sleep for overall health. They may have additional training in airway and sleep screening and can help explore potential underlying factors of mouth breathing, snoring, restless sleep, and other airway issues.

Functional Dentistry Labs

Some Functional Dentists may use specialty labs to test for heavy metals, metal sensitivities, and inflammatory markers as an add-on service to explore potential reactions to materials or inflammation that may not be visible. These tests are often out-of-pocket costs but can provide valuable information.

Other tests Functional Dentists may offer include:

Vitamin D

A deficiency in vitamin D3 can affect tooth development and make teeth more susceptible to issues. Knowing a patient's Vitamin D levels can be important, especially if they are prone to cavities or demineralization, to help maintain optimal levels.

Micronutrient testing

Micronutrient deficiencies can influence oral health and may worsen oral conditions. Deficiencies can affect dental development, gum health, and bone strength. Your Functional Dentist may suggest testing your micronutrient levels as part of your oral healthcare plan if they suspect underlying issues.

Oral Microbiome Testing

Our mouths are the gateway to our bodies, and what happens in the mouth can influence overall health. Understanding your oral microbiome's relationship to conditions like diabetes, cardiovascular disease, and more is important. Functional Dentists may test your oral microbiome as part of their baseline exams to create a personalized treatment plan.

HbA1C Testing

Diabetes is a chronic condition that can influence the inflammatory response to dental plaque, contributing to gum issues. Periodontitis and diabetes can affect each other, and your Functional Dentist may test your HbA1c to understand your status.

Gut Microbiome Testing

The oral and gut microbiomes have a relationship where microbes can influence each other. Functional Dentists believe that oral and gut health are interconnected. If oral health is not improving, exploring gut health may be indicated.

If your dentist doesn't offer these tests, you can ask your Integrative Medical Practitioner to order them. Functional Dentists often work collaboratively with medical providers to ensure comprehensive care.

It's important to inform your provider of any changes to your dental health, like new materials in the mouth or gum inflammation, as these can impact overall health.

How To Find a Functional Dentist

You can find a Functional Dentist in your area using different search terms online. If Functional Dentistry doesn't give you the results you are looking for, try similar search terms, including "biologic dentistry" or "holistic dentistry."

Another option is to look at the following organizations and databases, as they will have lists of dentists with additional training who may take more functional approaches to their care:

• ‍International Academy of Oral Medicine & Toxicology (IAOMT)
• ‍American Academy of Dental Sleep Medicine (AADSM)
• American Academy of Oral Systemic Health (AAOSH)
• ‍International Academy for Biologic Dentistry and Medicine (IABDM)
• ‍Holistic Dentistry
• Ask the Dentist's Functional Dentist-Finder

Before making an appointment with a new dentist, consider preparing a list of questions to ensure they are the right fit for you. Never feel pressured to stay at an office that doesn't meet your goals or preferences.

Some important questions you could ask before or during an appointment include:

• Do you use mercury-free fillings in your dental office?
• Are your composites BPA-free? Ceramic-based?
• What are your dental procedures for removing mercury fillings? Are you SMART (Safe Mercury Amalgam Removal Technique) Certified?
• What alternatives to root canals do you offer?
• Do you use digital x-rays instead of film?
• Do you offer alternatives to metal implants?
• Do you offer ozone treatments?
• Does your office offer alternative antibiotics or nontoxic alternatives to pain medication if indicated?
• Does your office offer alternatives to drill-based oral cavity treatment, such as laser dentistry or remineralization and arrest protocols?
• Does your office offer oral microbiome testing or other routine functional tests?
• Do you support a patient's wish to avoid fluoride-containing products and materials?
• Do you go over Functional Nutrition relating to oral health, along with any personalized dietary strategies?
• Besides cleanings, how do you manage gum and periodontal diseases in your office?

Summary

In summary, Functional Dentistry is an approach to oral and dental health that focuses on understanding potential underlying factors rather than only addressing symptoms. Functional Dentists can be considered more "physicians of the mouth," whereas conventional dentists may focus more on technical aspects of dental care.

There are several ways to tell if you're dealing with a functional dentist (or at least someone more open to holistic concepts) versus a conventional one, including their recommendations on what causes and how to address cavities, their perspectives on certain procedures, and their insights on how your oral health issues may be impacting your whole body health and vice versa.

Several organizations manage databases of functional dentists (also called biologic dentists, integrative, or holistic dentists), but you can also call a dental office or check out their website to determine whether that dentist is someone whose practice philosophy resonates with you.

The mouth matters, and its connection to systemic wellness is important. Finding a Functional Dental provider that mirrors this sentiment can help you support your health from where it begins…in the mouth!