Can a dentist help your arthritis?

Mounting evidence is connecting oral hygiene with chronic disease. Holistic Dentist Ron Ehrlich helps us to understand this relationship which includes a fascinating turnaround in his patient with rheumatoid arthritis. 

Transcript

Copy Transcript Copied

Daniel Baden: 0:06

Most people, including many health professionals, don't think about oral health when considering the cause and treatment of chronic disease. However, there is mounting evidence that this connection exists. And to help us understand it better, is Dr. Ron Ehrlich. Ron is a holistic dentist. And I'd like to introduce him. Hello, Ron.

Ron Ehrlich: 1:04

Thank you, Daniel. Thank you. Thanks for having me on

Daniel Baden: 1:08

how long have you been a dentist? How long have you called yourself a holistic dentist? And why did you become a holistic dentist?

Ron Ehrlich: 1:16

Oh my god, I've been a holistic dentist for almost my entire career, to be honest, very inept, that it's over 40 years now. And it started very early on, because I somehow found myself treating somebody with a headache that I didn't expect to pay that person came in, I would just graduated six months earlier and took a history and they said, Oh, this tooth has been a bit tender

Daniel Baden: 2:06

Well, you're the best kind of practitioner because you're a curious practitioner. And that is so important. It is what is a holistic dentist? What is the definition? What do you do that's different from normal dentistry?

Ron Ehrlich: 2:21

Look, at the end of the day, if you came in and spent a day in my surgery, you would see me doing dentistry and restorative dentistry is was is a big part of that. But I think what defines a holistic dentist is really it's a dentist with attitude. And, and that attitude is and it is an attitude. Because it colors everything you do. It's it's so easy as a dentist, because we deal sleep disordered breathing, snoring, obstructive sleep apnea. So there's a lot going on there in the mouth, in holistic dentistry, and I think, to be fair, many dentists are now practicing holistic Lee, even if they themselves don't refer to themselves as holistic. I think that's a fair statement.

Daniel Baden: 4:57

I know from holistic dentists I've been involved with over my career, they were often at loggerheads with general, non holistic dentists for one of a better word. And there was discussion or heated discussion around types of materials used, the actual effect of advice, and really how important that was, you know how that affects the vagus nerve and what that really means to

Ron Ehrlich: 5:41

Yeah, look, it's an interesting one. And look, it's easy when you discover that, for example, the bite affects muscle throughout the body to think that that's, that's the secret, that's the key. Or if you've removed a tooth and infection is cleared up, then you think, wow, that's the key to, but I learned very early on probably I've been in this for over 40 years, probably 35 years ADEA does a wonderful, wonderful job in advocacy and all of that. But the whole story about mercury in fillings is just a very sad reflection on a profession that just needs to change its game a little bit. Because, for example, that as an example, I've got lots of dentist who have said to me over the years, I'll come on, give me a break. You know, Mercury effects, everything does it. And I

Daniel Baden: 8:55

into an active system that's going to have behaviors.

Ron Ehrlich: 8:59

And then we'll get the story then another story goes, well, it's in it will get in it's in the inorganic inert form. It's in a safe form. And I go i Yes, that is true, until it comes into contact with microbes, and then goes through what's called a methylation process, and then makes it bioavailable to a person. So you know, are there any bacteria in the human body? Yes, yes, there are

Daniel Baden: 9:38

But back to my question, do you feel that that's changing?

Ron Ehrlich: 9:42

Yes, it is. It is. It is definitely. And the reason it's changing is because so much research around gum disease has been linked to every health condition you can think of, and the common denominator there is chronic inflammation, so it's kind of dragged the profession into a more wholeness. Take view. And also the connection between the mouth and sleep disordered breathing also has as

Daniel Baden: 10:13

When we met recently, you said you had a case to discuss, which put an understanding around this other gentleman you saw, who came into it with rheumatoid arthritis. Would you mind starting to discuss that case, he was in his early 60s. And yeah,

Ron Ehrlich: 10:28

he was a guy in his 60s who over the last two years had developed rheumatoid arthritis. And he'd seen doctors and it was getting worse. And he had seen an integrative doctor who had been treating him with all sorts of supplementation and support, and then felt that just perhaps the mouth may be a contributing factor. So he came in, and he could barely walk from his bedroom to his

Daniel Baden: 12:38

you when you when you mentioned that case, to me a little while ago, I looked up, did a little bit of research. And there's actually some article supporting the connection between rheumatoid arthritis and dental hygiene, particularly periodontal disease. One was quoted in journal arthritis research and therapy in 2019. And they talked about a much higher incidence of worse,

Ron Ehrlich: 13:15

Well, how's this for a statistic? I mean, 92% of people have a more superficial presentation of gum disease into what's called gingivitis. So when you look in your mouth, you see the pink surrounding a tooth, that's called gingiva. And when it's inflamed, you get gingivitis. So if people are wondering, do they have gingivitis? I asked a simple question. Do your gums ever bleed when you

Daniel Baden: 14:27

when someone comes in and they open their mouth and you can see the obvious issues. But when you step back and you look at things holistically, like do you also take concern over the patient's weight, their diet, their lifestyle, habits, smoking, do you discuss that with a patient and they comfortable discussing those issues with you as a holistic dentist?

Ron Ehrlich: 14:48

Yeah, our initial appointment in the practice is for an hour. Right and it's a it's a comprehensive oral exam and it goes into a whole medical history a whole dental history, a whole lot. We asked about sleep, is it easy for you to fall asleep? Do you wake up through the night? Do you need to go to the bathroom? Do you wake up feeling refreshed? Do you wake up with headaches, neck

Daniel Baden: 16:35

Is the profession moving more towards the 3d X rays?

Ron Ehrlich: 16:40

Yeah. Yeah, it's, it's, I mean, for example, if a person came in to see us with no fillings, or hardly any fillings in their mouth, and all the nerves in the teeth looked like we're responding, so they weren't dying, you wouldn't go and do a 3d x ray. But if you were concerned about a heavily restored mouth, with a lot of complex Dental, a lot of heavy fillings in the mouth, a

Daniel Baden: 17:22

And is that something that's done within the surgery?

Ron Ehrlich: 17:26

if it's if it's only one or two teeth that we're concerned about, we have the facility to do that in the practice. But if we're wanting to do a whole mouth, which would include sinuses, in that, then we would we send we work with laboratory and Macquarie Street, where the report gets we not only do we look at it, but we also get a very comprehensive report from us, a specialist, a

Daniel Baden: 18:00

Okay, going back to the patient with rheumatoid arthritis, you cleaned up their teeth, you took out the ones that were necessary, deal with the infection as best you could. And you also mentioned that you helped to restore his bite. Yes. And and what does that mean? And what is the relevance of that to him? And is there a relevance to the condition?

Ron Ehrlich: 18:24

Interesting that I think the relevance to the condition revolve more around getting the infections under control. Right, you know, so that was definitely the key to that. But then if we're talking about health, establishing resilience and good health beyond the diagnoseable condition, then establishing a bite, and ability to chew your food, because this is the first step in the

Daniel Baden: 19:56

Yeah, yeah. Well, as time goes on, we're discovering the The net effect of chronic inflammation in every modality of medicine, whether it's regular medicine, natural medicine, holistic dentistry, is just coming up absolutely everywhere. And that relationship between chronic inflammation and the bacteria that live throughout our body is getting more and more comprehensive, as you

Ron Ehrlich: 20:53

Well, there are three things really on board with a few things, there's quite a few things you can, the most obvious one, of course, is diet, because it's interesting, but they did a study a few years back where they put it, they put people on a stone age diet Paleolithic diet for a month and told them not to brush or floss their teeth. And what they found was that they got a not good for you either. So drinks is one. So food and drink are the main things given that we live in the real world and we do eat a real diet, then that then comes to your oral hygiene. And and this is why brushing and flossing is important. And I think it's a wonderful opportunity. I like to multitask, Daniel so when I brush or floss my teeth, I practice mindful brushing and flossing. So I use and to maximize your chances of not getting it. So based

Daniel Baden: 25:22

on the patient that we've just discussed, also, with rheumatoid arthritis, and we obviously many other patients with many other chronic inflammatory and metabolic type of diseases will also benefit from good oral hygiene. Should every patient with every chronic disease get a full dental assessment?

Ron Ehrlich: 25:45

Absolutely. I mean, there's just no question about that at all. And what frustrates me and actually, often we will see health practitioners. And I must say, sometimes we'll even see integrative health practitioners do an assessment of a patient's oral health by saying, Have you been to the dentist lately? And they'll go, yes. Was anything done? No. He said, everything was fine.

Daniel Baden: 26:45

So interestingly, there was also a study that came out in the last couple of years that strongly associated depression with oral disease. So it's not just physical evidence, but depression is also very strongly associated with bad oral hygiene. That doesn't surprise, look, you

Ron Ehrlich: 27:03

know, I think, all diseases, this is we're coming back to all diseases, the common denominator is chronic inflammation. And that is true of, of mental health, as well as physical health. In fact, I'm just reading a fabulous book called brain energy, which talks about mental health is written by a psychiatrist, talking about mental health as a metabolic disease.

Daniel Baden: 27:26

Absolutely. The old paradigm of treating mental health with anxiolytics antidepressants is being challenged strongly even by the medical profession. So you've got to step back and say, what's going on with the whole person? Absolutely. Yeah. What how do people find the right dentist? Or how do they this is a tricky question. I don't want to throw get you throw any colleagues under a

Ron Ehrlich: 27:53

think there's an increasing number of dentists that are doing that. I mean, obviously, our practice, which is the Sydney Holistic Dental Center, there's the free plug in the city of Sydney. You know, I mean, we get patients coming from war, literally all over Australia. But there are other holistic dentists all over the place. And, and I think that's worth looking out for and

Daniel Baden: 29:15

Yeah. I'll look there is tons of information out there about dental or dental health increasing cytokines, which increase inflammation and every disease. People should get looked at every six months, 12 months.

Ron Ehrlich: 29:28

Look, I think at some stage in a person's life, a comprehensive oral exam is important. And then once they've established if there are problems and what those problems are and how to deal with them. Then it varies from look I had, I had a patient that came in. This was literally a one in a 1000s who had all 32 of their teeth through an imperfect alignment. Not a filling in their mouth,

Daniel Baden: 30:10

the rest of my life, what were they eating?

Ron Ehrlich: 30:13

Well, that's such an interesting one, you know, I think they really were, they were grown up in the country. And they were had been on a nutrient dense diet, when they were when you know, when they were in utero and, and through their lives, and they they just looked after their health, they were just really healthy. But I'm telling you, the vast majority, I mean, we're talking about

Daniel Baden: 30:55

So just going finishing off looking back at your patient. Did you see him again? And were you in any position to take any Bloods and look at rheumatoid factor to see if there's any changes or anything like that there?

Ron Ehrlich: 31:06

I wasn't because I love working with other practitioners. You know, I mean, I have knowledge of nutritional Environmental Medicine, lifestyle medicine, I've got fellowships and those, but I much prefer to stick with what I do well, but as the so we love working with integrative doctors, naturopaths homeopaths nutritionists, and I would rather hand them back to that, that practitioner

Daniel Baden: 31:48

Wrong. It's just wonderful to know what's possible. Thank you so much for your time. And just finally, how to people get in touch with your surgery.

Ron Ehrlich: 31:56

Our surgery is, as I said, the Sydney Holistic Dental Center in the centre of Sydney, opposite Hyde Park, just go on SH dc.com.au Sh dc.com.au. And you can get a lot more information there.

Daniel Baden: 32:11

Fantastic. My thank you so much for your time. It's I've learned a lot and I hope everyone else who listens does as well. T