General Family Practice With a Holistic Approach To Dental Care...

Homeopathic Treatment of The Acute Dental Patient

By Dr. Gary Fortinsky

 

Homeopathy has much to offer in the treatment of oral conditions as is illustrated with the various examples discussed below.

Medicine has created a separate field for the treatment of the oral condi­tion (dentistry). Currently, medical education gives minimal training to its students on the art of oral diagno­sis and homeopathic education is no different. There is so much to learn about health that the oral states of disease are not studied in detail. To allow for a competent oral diagnosis, the use of instruments such as an explorer, mirror, excellent lighting, and a radiograph (an X-ray is required to show the hard tissue changes e.g. cavities, abscesses, wis­dom teeth) are required. Without the above tools and the information they provide, the work of a homeopath in treating a dental problem is much more difficult.  

Complexities of dental treatment  

If an assumption is made regarding a patient's tooth problem, certain reme­dy choices may be eliminated and the case missed altogether. More impor­tantly, there is the concern that if a "correct" remedy is given with an associated alleviation of symptoms ­such as pain - then the patient may not pursue dental treatment. For instance, if a homeopath thought the pain experienced was connected to the eruption of a wisdom tooth when, in fact, it was due to a cavity, if the cavity was left untreated, then the decay process would continue. A moderate cavity in time turns into a large cavity that encroaches on the dental pulp and creates the risk of endodontic (root canal) involvement, its associated discomforts and costs of treatment. As well, even if root canal treatment is unnecessary, a larg­er cavity, with time, means a larger filling and a weaker tooth structure. This in the future can lead to break­age and subsequent loss of the tooth.  

That is why a working relationship between different disciplines is essen­tial; we all have expertise to bring to the table and sometimes another's knowledge about the pathology makes our homeopathic prescribing more accurate.

Advantages of homeopathy in dentistry  

Homeopathy can still be beneficial to the patient before, during, and after dental treatment. Certain remedies are indicated for specific tissue types or specific pathological processes. For example, in the case of an abscess, Hepar sulph or Silica should be con­sidered whereas, if there is an inflammatory process, Hypericum or Belladona would be indicated. Many dental complaints are self-limiting, meaning that the problem passes on its own. The goal of homeopathic dentistry is to allow the process to pass quickly and more comfortably; the main concern is the morbidity of a condition and its influence on the patient's daily life. 

To return to the above example of wis­dom teeth, there are not many dental options for treatment other than antibiotics and/or painkillers, to allow the discomfort to resolve, followed by extraction. Alternatively, a well chosen homeopathic remedy will, in a short time, allow full recovery from discom­fort, and provide time for the tooth to erupt further into the mouth, follow­ing which a decision can be made as to whether extraction is required, (which it often is). Even if the tooth still does require removal, the further it has erupted into the mouth, the less inva­sive or traumatic the extraction will be. There is also the possibility, albeit uncommon, that the tooth may erupt fully into the mouth and not require extraction.

Homeopathy for extractions and tissue traumas  

After an extraction, there are a num­ber of remedies that are possibly indi­cated to stimulate healing. Non­homeopathic choices for the patient are to either take painkillers, or to grin and bear the pain. The beauty of homeopathy is that, with the correct remedy, not only is healing stimulated but also pain control is part and par­cel of the healing process.

There are a number of tissue traumas that can lead to discomfort after a fill­ing. The gums may be traumatized by the procedure, either by use of the drill if the cavity was below the gum line, or the rubber dam clamp (a ring that goes around a tooth) which can pinch the gums. The pulp of the tooth also can become irritated by the process of drilling because whenever a tooth is drilled, inflammation is caused. As a general rule, this process settles on its own for most patients within a day and in other patients between two to three days. In rarer circumstances, the area remains irritated or inflamed for longer and in this case homeopathy proves very effective. (Homeopathy is also useful insofar as a remedy can always be tried prophylactically, before treatment, to prevent the prob­lem from occurring in the first place). In patients where the inflammation persists, the nerve tissue just does not want to heal and the body needs assis­tance to direct the healing process. (Note that this example assumes the patient's bite will first be examined to ascertain whether the filling is high, perhaps by a only fraction of a mil­limetre, which also can cause inflam­mation but can be alleviated by the dentist making an adjustment.)  

Another example is the discomfort experienced by certain individuals after receiving a needle for freezing. In this case, a homeopathic remedy can be given prophylactically or given post-injection if discomfort arises. Remedies can also playa role in help­ing the anxious patient. When a rem­edy is to be used in a prophylactic manner, it is always best to take the remedy a few hours before the sched­uled dental appointment and to repeat the remedy once in the office or dental chair as it takes time for a remedy's influence to stimulate the change in the body.

Use of homeopathy in more severe oral conditions 

All of the above oral discomforts tend to be self-limiting. However, infec­tions due to a dying tooth and its abscess, or a gum abscess, can be much more debilitating, accompanied by severe pain and/or swelling and will not settle so readily without some intervention. Prescribing for this sce­nario requires much more precision and expertise with respect to history taking, materia medica, and follow­up. We are all familiar with the phrase "it's like pulling teeth". Taking an acute homeopathic history on a toothache is much more difficult and challenging, as a rule, than pulling a tooth. Most patients have no awareness about their experience or may have had the discomfort for only a few hours so they have not had the opportunity to experience the dis­ease process. Many people take pain killers during a toothache and as such have not experienced much more than a nondescript discomfort. As homeopaths, we are always searching for the strange, rare, and peculiar symptoms within a disease and, in the toothache situation, it may be elusive at first. When a remedy is first prescribed, it is helpful if the patient stops taking the painkillers so that more symptoms can manifest and thereby a determination can be made upon follow-up whether the healing process is occurring or if a different remedy is indicated. If the correct remedy is prescribed, the patient often may still experience discomfort as the problem starts to resolve but the intensity or frequency of the dis­comfort lessens. Thus it is important to ask the patient to rate the discom­fort from one to ten at the initial interview and also on follow-up. Some people will report that they were able to sleep after taking the remedy whereas, before treatment, they were awoken by the pain. For serious infections it can take two to seven days for resolution.  

In the case of abscesses even after the correct homeopathic prescription, the patient usually still needs dental treat­ment to address the cause of the prob­lem, for example, cavities. Full recov­ery or comfort may not be possible with a homeopathic remedy alone until the mechanical or physical issues are dealt with dentally. The purpose of the remedy is to stimulate the healing process, and to encourage the body to start dealing effectively with the infec­tion so that when dental treatment is initiated, it is a less traumatic experi­ence, both during and after. The array of remedies that are possibly indicated in infection is much larger due to the varied possible personal experiences the patient can encounter, and there­fore an accurate description of the experience by the patient is paramount in finding the simillimum.  

Dr. Gary Fortinsky, DDS, practises dentistry in North York, ON and can be reached at 416-225-1352. 

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Suggested dental remedies

The following is from an information sheet I give patients describing how to take a remedy in an acute situation with examples of some commonly used remedies.

All remedies can be taken in the 30C or 200C potency. If the symptoms are strong, then the remedy may be repeated every half hour up to two to four hours. If symptoms do not improve or worsen, a more appropriate remedy needs to be chosen and you should consult with a health care practitioner who can further evaluate the oral complaint. In terms of application of ice, it may make one feel better but does not indicate a remedy because it anaesthetizes the nerve.

Aconite - one of the main remedies for apprehension and fear before an event e.g. dental appointment, acting, presentation. Associated with this nervousness is restlessness. Also may be useful if gag reflex is strong.

Arnica Montana - used in cases of trauma to tissues which leads to bruising e.g. tooth pain after filling, extraction.

Calendula - for abrasions in the mouth, can use tincture in glycerin e.g. gum treatments, ulcers, burns rinse 60 seconds ]-5 times per day.

Chamomilla - for severe toothache that feels better with cold, wisdom tooth eruption, fussy baby cutting teeth. In all cases you would expect to find irritability.

Gelsemium - another remedy for apprehension but here you find heaviness or lethargy of the body and stomachache often with diarrhea.

Hypericum - another trauma remedy but here it is indicated in tissues rich in nerves such as teeth or fingers. Consider after injury and Arnica does not seem to be helping.

Ledum - indicated after injuries by sharp pointed instruments or punctures e.g. after injection for freezing.