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Integrative Dentistry for a Natural Smile

A new style of dentistry focuses on making patients —and the planet —feel better.

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Not long ago, I lived in Asia for three years —and managed to see a dentist just once, thanks to a less-than-pleasant experience. I returned home with an aptitude for conversational Japanese, an ominous plaque buildup, and irritated gums that bled when I flossed. I dreaded finding a new dentist, but I was in desperate need of care.

Luckily, things had changed since I’d been away. There was a new breed of dentist in town —practitioners who call themselves “integrative.” Instead of focusing only on your plaque or toothache or gums, an integrative dentist pays attention to the big picture: What other health issues might relate to the state of your mouth? What chemicals are you absorbing while your teeth are being repaired? How’s your mental state while you’re sitting in the dental chair?

To ease patients’ pain and fear, these dentists use complementary techniques such as meditation and massage. And they prefer using materials and procedures that do as little harm as possible to the earth and their patients: by substituting digital imaging for x-rays (no toxic processing chemicals required), for example, or using composite fillings instead of mercury amalgam (no hazardous waste to dispose of).

My yogi friends raved about one practitioner in particular, who calls his business the Transcendentist. When I phoned his Berkeley, California, office, the receptionist told me that every visit included a foot massage. Sold!

On the day of my appointment, I was pleasantly surprised to walk into a warm, inviting living-room-like atmosphere. The bamboo shades, peaceful-looking Ganesha statue, and teak furnishings immediately put me at ease. I sipped organic chamomile tea from a ceramic mug while I finished my paperwork.

When I was called in, I settled into the dental chair with a pair of noise-canceling headphones that transmitted a progression of ethereal-sounding, slow-moving instrumental chords. Then the hygienist handed me a pair of rose-colored glasses (color therapy glasses, she said) to bring “stability” and help ground me.

Once she started the cleaning, it was indeed painful —no surprise, given my three years of neglect —but the pain was entirely manageable thanks to the music, which the hygienist had called a “brain-balancing meditation.” I began to forgive myself for avoiding the dentist for so long. The foot massage wasn’t bad, either.

A meditator, yogi, and tai chi teacher, Transcendentist founder Fred Pockrass, D.D.S., lived in the Indian Himalayas for 11 years, serving as the personal dentist to his teacher and guru, Swami Shyam. Pockrass considers his dental work to be his sadhana, or spiritual practice. His challenge? To transform an experience that many people find scary.

“I invite my clients to use the chair as a meditation cushion —I call it a samadhi chair,” he says. “You’re lying there for an hour —you might as well have a deep, restful meditation experience.”

Was this really a dentist talking?

Fresh Beginnings

Integrative dentistry is a new phenomenon; so new, in fact, that professional and regulatory agencies governing the field have yet to be established. Lynne Martz-Marshall, an integrative family dentist in Walnut Creek, California, estimates that fewer than 9 percent of all U.S. dentists use integrative techniques.

The field got its start when some dentists began to connect the dots between dental health and overall well-being. And some were uneasy about the potential hazards of certain dental materials, particularly the mercury-based amalgam used to fill cavities.

Mercury amalgam fillings contain up to 50 percent mercury, along with other metals. Concern about the safety of these fillings has risen over the past 30 years, sparking a controversy in the dental community and leading some patients to request that the metal be removed and replaced. Although the American Dental Association, citing extensive research, says amalgam fillings are safe (except in rare cases in which patients are allergic to the metals), most dentists —conventional and integrative —will replace amalgam when requested to do so.

And according to the California Environmental Protection Agency, mercury in wastewater from dental offices accounts for a significant amount of mercury pollution in the environment. Integrative dentists like Pockrass and Marshall have been at the forefront of a trend toward using amalgam separator filters to capture the metal and dispose of it safely, and to have patients breathe through an oxygen mask to prevent the inhalation of mercury vapors during treatment.

Integrative dentists also offer alternative remedies like arnica for pain and inflammation of the mouth. By replacing x-rays with more costly digital imaging, they expose the patient to 75-90 percent less radiation, get clearer views of the tooth, and eliminate the need for the chemicals used to process x-rays, says Ina Pockrass, Fred Pockrass’s wife and Transcendentist cofounder.

Going Green

When the Pockrasses opened Transcendentist four years ago, they became pioneers not only in the field of integrative dentistry but also in eco-dentistry, an even newer alternative to conventional dental practice. Their simple idea for creating an integrative practice soon blossomed into an eco-friendly “dental wellness spa.”

From the nontoxic paint on the walls to the chemical-free wool carpet, more than 75 percent of the materials used to furnish the office are sustainable: Headrests and bibs are made from reusable surgical-grade cloth, rather than disposable paper. Instruments are cleaned with steam rather than chemicals, and most are housed in cloth rather than disposable wrappers. Patients “swish” and rinse with porcelain cups, not paper.

“The more we looked at the implications of our choices, the more eco-friendly our business became,” Ina says.

The practice, in fact, is certified by the Bay Area Green Business Program, a government and private-sector partnership that vets eco-friendly companies. “The earth has limited resources, and businesses like this are a necessity,” says Pamela Evans, Alameda County Coordinator for the program. “Transcendentist really stands out —they’re an innovative model for sustainable dentistry.”

Open Up and Say Om

If you wait awhile, integrative dentistry is likely to come to you.

“It may take 5 years, it may take 20 years,” says Joel Kreisberg, a chiropractor who directs the Teleosis Institute, a Berkeley nonprofit that teaches health professionals how to create greener practices, “but general dentistry will look more like ecologically sustainable dentistry.”

It could happen sooner. The Pockrasses plan to license the Transcendentist business model in two years. Until then, Fred recommends that patients take dental health into their own hands by cultivating self-awareness: “You need to approach your mouth with the same consciousness as your yoga practice. Floss regularly, use a soft toothbrush, and be attentive to your diet— avoid sticky, chewy, carb-rich foods.”

If you do find an integrative dentist, be prepared: While you’ll be reducing the impact on your body and the environment, your wallet may take a hit, at least temporarily. Pockrass requires patients to pay upfront for services. Depending on your policy, you should receive your share back from insurance, but you may need to be patient. I was reimbursed for most of my initial $250 visit —which included consultation, digital imaging, and teeth cleaning —in about six weeks.

Even if my reimbursement check had taken six months, though, I’d still make a repeat visit. It’s been years since I’ve been able to brush without pain. I actually look forward to flossing every night. And plaque-free, my smile is brighter. I’m reducing my impact on the environment and can count on a twice-yearly foot massage. What’s not to smile about?

Andrea Kowalski was the Web content editor at Yoga Journal.