Root Canals, Gum Disease and Mercury Safe Dentistry with Dr John Roberts
Functional Medicine Bite Sized is the podcast where Functional Medicine Practitioner Pete chats to experts in the field of functional medicine and health, giving you the listener pearls of wisdom to apply on a daily basis.
In a recent episode Pete chatted with Dentist Dr John Roberts. If you are suffering with gum disease, have previously had a root canal or ever wondered whether your mercury fillings may be problematic, Pete and eminent Biological Dentist Dr John Roberts discuss these subjects in detail. They also talk about dentistry and oral health with particular emphasis on how poor oral health increases chronic disease susceptibility. This episode is full of simple tips and clinical pearls to improve your dental knowledge and your dental health.
Listen to the episode here or find the written transcript below.
Pete Williams: 0:18
So welcome, everyone, welcome. And I'm introducing, as you say, what we do is we go around the world and speak to experts, a lot of them I'm very fortunate that I've been able to know over the years and actually work with and that's very apparant for our expert tonight, Dr. John Roberts. So let me just introduce a little bit about John, because John is well recognised around the world as a sort of leading expert in biological dentistry. But John, you like to use a sort of different term you like biological dentistry, but you also like health orientated dentistry. And I think this is a really nice term because I think it's explaining certainly why we got together because dentistry can no longer be seen as a separate entity to the rest of our health simply because the evidence of what poor oral health has on systemic health is so profound. So John, welcome.
Dr John Roberts: 1:18
Thank you very much. Hey, it's great to do it. And for those of you who don't know, you got two scousers here so you know, you're gonna get an honest podcast at the end of it all.
Pete Williams: 1:24
And I'm just gonna warn, John is that he's desperate to look at the lineup for tonight because Liverpool are playing. And I've told him not to be on his phone, even though we are only praying Preston, aren't we tonight. And even though we got a kid squad out there, we still should win.
Dr John Roberts: 1:37
We still should win. So the bottom line is, you know, I'm next, in December. I'm 40 years qualified. So I started dentistry before most of the dentists even were born. And so I've seen a lot. I've come through a lot. And yet I go into work every day. I have absolutely I have a ball. I love my job still. And there are things that I would change. And there are some good things that have come out. I think there's some poor things that have come out. But you know, I started off as an NHS dentist, I set up my own practice, but very rapidly, I wasn't happy with the way it was being done. And I went on courses not necessarily dentistry, I did nutrition courses, some alternative health courses, osteopathy, kinesiology, herbal medicines, and it became apparent that that was what I was wanting to do. And that's what my patients wanted to do. I don't know a chicken and egg situation what happened, but I very much became an alternative dentist so I used homoeopathy, and back then I used nutrition as well as the conventional drugs, but then it sort of evolved from being alternative because you can be a mainstream dentist doing amalgams and using homoeopathy, and really that wasn't it. And then I became holistic, which is looking at the whole body, and everything I do affects the whole person. So I'm still using my herbs and Homeopathics working with osteopaths, chiropractors. But it sort of evolved and morphed into what we do as dentists should be influencing I hope for good, the health of the patient. And the easiest example is by putting mercury fillings into someone's mouth. And we'll discuss this more. That has an adverse effect on someone's health, some more noticeable than others.
Pete Williams: 3:27
And we look, I think this is one of the one of the big conversations I think, in dentistry, I think, in healthcare. So I know you are and you've done, again, you've been in this for a very long time, and you've done many, many training courses with regards to mercury free dentistry, can you just give us your personal opinion, your experience, and actually where you think the literature lies with this.
Dr John Roberts: 3:50
And one thing is I can share with you, for us now we say mercury free, but we say Mercury safe? Because unfortunately, there are many Dentists saying, Oh yeah, we don't use mercury fillings anymore. But unless they use all the protocols to drill the fillings out properly, then they're not safe. And they're harming the patients who believe they're having the right thing done by having the fillings out, but perhaps they should see a Mercury safe dentist, so they don't get harmed when the fillings are drilled out. So we like to say mercury free Mercury safe. That's what we're looking for.
Pete Williams: 4:24
So John, can you can you give a description of that? Because obviously, what you're saying there is that there's a there's some very specific procedures that are needed to reduce the risk and, and as far as we're aware, is that some of the biggest risk are inappropriate extractions of mercury fillings. So can you just go through that in a little bit more detail for us?
Dr John Roberts: 4:44
And that's it. And so I'm going to say if I can just take one step back Mercury is coming off with fillings all the time. Okay. Anyone who says different, they're wrong because it is and it's coming off by evaporation. So you have a hot cup of tea you brush your teeth you eat a curry which I do lots of Then you're stimulating the top of the filling and mercury is evaporating off, you're also getting Mercury coming off through galvanism, who was stupid enough to get batteries and batteries you can future see in your mouth. So if you've got gold in your mouth, you've got implants in your mouth, you've got crowns in your mouth. The difference in metals between the mercury which has silver mercury fillings, which is silver, mercury, and the metals, you're running electrical currents all the time, so they're just corroding away. And then finally, if you're a person who clenches and grinds, then you're actually a braiding and wearing the fillings, and all these have been measured. And all these are quantifiable, you can argue that small amounts, but small amounts on a 24/7 basis adds up and then a susceptible person, that's enough. So Mercury is coming out all the time, when a dentist drills the filling out you exponentially increase the mercury vapour and the particulates the bits that are drilled. So when I have and I have done for like 25 plus years now, drill out a Mercury filling, there's some simple things I do. One is to use a special tungsten carbide burr, so I don't grind the filling out using a diamond burr like most dentists do, that's the drilly bit and the tungsten carbide cuts and chunks the filling out. So you're getting big chunks of the filling out instead of rubbing it out all to a grinding and grinding it down. We isolate the tooth, usually this is where a dentist puts a rubber dam, which is a clip on the tooth, a sheet of rubber over the tooth. And then it means that none of that slurry gets into the patient's throat and a lot of patients who say Oh, I had a fillling drilled out and my mouth was full of black and I rinsed out. And that's what made me ill. But I would challenge that because if you swallow mercury fillings, you absorb six to 8% of the mercury and they do experiments with animals, they give them mercury in a solution. And they see how much gets absorbed into the body. The Mercury goes into the gut, the bacteria in the gut, change the mercury into a more absorbable form and absorb it, but you absorb six to 8%. If you drill out fillings a new breath the vapour in the mercury that's been released while you're doing the drilling. Then if you breathe in, you absorb 80 to 90%. So for a lot of people it is you've got to stop them breathing it in. And the way you do that is the cutting and chunking, you use copious amounts of water. So when you're drilling, you're not heating the filling, you're not heating the tooth. And always, always, always, in my opinion, you have a separate air supply over the patient's nose. So that breathing in air that is not from the same room, we run it off a compressor we get the patients to breathe medical air. You don't need to breathe oxygen, but it is breathing it in the studies are very clear if you breathe in mercury vapour 80% Plus will get absorbed through your lungs. And it's one pass and it's into the body. Whereas if you swallow it, and you've got the barrier, the blood, the gut barrier. If you take things like activated charcoal activated, clean up to low light, toxic, prevent zeolite clays if you take anything like that, that's going to bind to the mercury that's in your gut and less is going to be absorbed. Ideally, you don't swallow any but you definitely don't breathe any sure you're looking at the dentist. Look at the dentist who has a SMART certification. SMART stands for safe mercury amalgam removal technique. Okay. It's part of an American organisation. And that's what I've taught in this country for about 20 years.
Pete Williams: 8:35
And some of the things that you were talking about John weren't, you were talking about more about thinking of And I think this is probably the difference isn't it is that we're having a group of dentists that are thinking on a systems view, rather than on a local view. It's not just a question of getting rid of the fillings. It's a question of what are the consequences of getting the fillings out? And what are the After Effects hence why you're using substances like the zeolites, the activated charcoal, because what you're trying to do is reduce risk as you go forward with that.
Dr John Roberts: 9:06
And a big push for you guys is very simply, I am a dentist, that's how I make my money and it's expensive to run a dental practice. Patients then say well, what could I be taking to detox? And really, although I've done the courses and you know, I do have another degree in integrative medicine, I really defer to the experts be it functional medicine doctors or functional medicine practitioners like Pete, and really they should do the test to see where your detox is working, and then advise you appropriately because I just want to get the next patient in and do dentistry. I am not licenced, dare I say insured to do a lot of the detox protocols that we'd like to do. We probably know how to do really well defer it to the people whose job it is to do detox properly. What were technicians to remove the mercury fillings, and of course, the next thing is what do we put back in again? because you've got choices, you know, if you've got a hole in the tooth, you've got the hole in the tooth for life. And although there are people out there that say well you can regrow your own tooth, I have yet to see it. And I do find it uncomfortable when people say, Oh, I read the book, and you can do this and you can do that, show me the clinical evidence, show me one picture, and it doesn't happen. So for us, we're either putting sticky white fillings back in now there's glass ionomers. And I'll go to the problems with those in a minute. You're putting composites in which are plastics and have plasticizers in or you're then going to the porcelains, I would really encourage people not have metal put in their mouth, unless there is a good reason to do so equally. We're not dogmatic. We're not saying you should have your amalgams out, you should not have metal you use what's appropriate clinically. And again, that's a more biological approach. I don't want to rob Peter to pay Paul. Yeah. And John,
Pete Williams: 10:56
we've, we've actually been on a project, haven't we for for nearly two years now me and you and your group really trying to get to the bottom of number one, should you have your mercury amalgams removed. And I think in a, in a general sort of ideal world, the answer to that is yes. But we've always known that it's not as simple as that. And, you know, we've always tried to look at, aren't we and we're still looking at it now is that who were the canaries in the mines with regards to adverse risk of systemic toxic effects from mercury. And that's something that just to let everyone know, that's something that we're continuing to look at and continue to develop, because we know there are some susceptible genotypes. And that is something that myself and John are continuing to work on. So that we can give a more rounded view on this isn't it John because it's not just the case. And I think I've been following some of the hate to say it, some of the dental forums on Facebook, and it's frightening, actually, it's frightening to see the general public making, I suppose clinical decisions without any scientific basis, you know, the every single person. So so let me just put this question back to you, John. Every single person who go on those will suggest that you've got to get rid of the mercury fillings, what would be your sort of considered answer to that? or considered reply,
Dr John Roberts: 12:20
okay, if I'm going to consider it. It's not that you shouldn't have your amalgams out. But the appropriateness of when you do it, your condition of your health, is it something that you can spread over a period of time? Is it something you do immediately? Are you working with a team of health practitioners who've checked your detox systems. Long term, that would be my goal with every patient, but I've been treating people for for 30 years, and they're still got amalgams in their mouth. So I'm not dogmatic enough to say you must have your amalgams out. And that is a myth that comes up all the time. It's, it's always the patient's choice. And some patients choose to leave the amalgams in, and they'll say, look, I eat a healthy diet, I take this, there are several places you can use now, because I equally can't take all your fillings out and promise you your health is going to be perfect again,
Pete Williams: 13:08
exactly. And I think this is the major risk. And this is the frightening thing about looking at a lot of these forums, because everything is amd I'm gonna move on to the next subject, because it's very similar again, so everyone thinks that you should have mercury amalgams removed, and again, in a real world with the ideal situation with the ideal support.
Dr John Roberts: 13:27
if it was never used, but we have a population that is going to have mercury in their teeth for the next 50/60 years. So we have to face the fact that if and often with my patients, it is you've got mercury fillings, we'll leave them as they are, as if and when they need to be replaced. We use all the precautions, the smart protocols, and we don't put another Mercury filling back in. And if you have mercury fillings in your mouth, we do not, if at all possible, put metals back in the mouth again.
Pete Williams: 13:55
Sure. John, let's move on to the root cause of dentistry. Because there again is another thing that I suppose in everything we're realising aren't we, that just humans and how they interact in their health, they're just so bloody complicated. It's unbelievable. And of course, this one's very relevant to me, because at the age of I must have been 45/46, i think maybe a bit older, I had my very first root canal. And can we just talk about where we are with the literature and, and the process of having a root canal and whether that is, why don't you expand the conversation because there's, again, if you go on to certain dentistry, and I would say not so much dentist led but certain Facebook pages, it's pretty scary stuff about root canals.
Dr John Roberts: 14:43
It is and the issue is root canals is one of the forefathers of nutrition. A guy called Weston Price actually did research on root canals. 20 years before he wrote the book, nutrition and physical degeneration. He was a dentist, he was one of the leading dentures at the time, did some research and showed with the technology they had at the time. And yes, we've moved on. But with the technology at the time, he showed that there's infections, even in root canal filled teeth that you can bite and chew and everything on, you can take an x ray, it looks fine. But just because you can bite on the tooth doesn't mean it's fine. Just because you can take an x ray and says, look, there's no sign of infection, doesn't mean it's fine. So let me explain you have a normal tooth, and it has a nerve in it has dentine and enamel and fluid bit like a tree, it sucks up water through the root, flows through the dentin and flows out through the enamel in the tooth, that is a normal healthy tooth. But when we put crowns on teeth, or fillings on teeth, we stopped that fluid flowing that is flushing the tooth all the time. And this is out of the 60s and the early 70s. Worse is when you put a crown on it, you stop that fluid flowing, or you get bacteria that get into the tooth, and the bacteria get into the nerve, once the nerve has bacteria in, the nerve dies, and then you've lost that fluid flow through the tooth. And that fluid is flowing through the tooth to flush out bacteria flushing out the tooth all the time. When you cut off the fluid flow, bacteria move into the tooth. Now someone comes in with a painful tooth, because bacteria or I won't say inappropriate dentistry, but Dentistry has caused the nerve to die. So the only way to stop it hurting is to take the nerve out of the tooth. So you do a root canal, which is take out the nerve clean it out and put a material in. And again, we've got questions about the biocompatibility of some of the fillings. But that tooth has now stopped the fluid flow that river and that river, that stream flowing through the tooth and flushing out the bacteria. So the bacteria then find all the little holes that are naturally in the tooth, the holes that cause sensitivity. And bacteria move into the tooth, not the one inch of the root canal that the dentist very cleverly cleans out takes an x ray and says, Look, I've filled up your root canal. They haven't filled up the six miles of tubes that bacteria can live in 10 abreast. And I'm saying this because I know this is what the science is, Yeah, sure. What happens is you take out 99% of the dead tissue, you can bite on the tooth again. And that's deemed a success. But bacteria move into the tooth. And this is acknowledged even by the people who do root canals. And you can get good bacteria move into the tooth, inert bacteria, or you can get bacteria that live in your tooth. And they produce poisons and toxins, their waste products, dare I say their poo. And then when you bite and chew on the teeth, these toxins come out of the tooth and spread around the body. So every root filled tooth by definition is infected because it has bacteria living in them. And it's a matter of luck whether you have good bacteria in there, or whether you have bad bacteria in there. I won't say Good, I'll say perhaps inert bacteria, but the same thing happens with gum disease and I know we're talking about gum disease in a minute. When you have gum disease, you can take out a tooth and you'll find bacteria living in the live tooth because it's lost that fluid flow, that flushing clean that we talked about and how you get the tooth to have that fluid flow, dentine fluid flow is what it's called when. You go back to your nutritionist, you're balancing nutrition, your calcium, your vitamin D levels, and that's what causes the fluid flow that stops decay that then keeps a tooth healthy, but tooth out, and there's plenty of studies where they deliberately root fill a tooth because they're going to take it out for braces, they root fill a tooth take it out three months later and you will find bacteria have moved into this hotel. You have given them an amount. Antibiotics can't get there. Your white blood cells can't get there. homoeopathy can't get there. It is a dead tooth stuck in your body. And then it's Hobson's choice as to is that going to influence your health?
Pete Williams: 19:06
So John, because I'm sure there's gonna be people out there who have had a root canal and maybe are feeling you know what that tooth doesn't feel quite right to me. Again, I think there's a I hate to say it. I think there's a lot of scaremongering on the internet suggesting that infected root canals are the be all and end all of every single chronic disease that they've got. Now, I think, let's just suggest if they do have an infected root canal and they do have , you know, an infection, and there is going to be some systemic consequences of that, certainly increased inflammation. But what would you recommend then, if we've got someone listening to this, they feel as you know, they've had a root canal doesn't feel right, you know, maybe they you know, they're in a maybe consistent one to two out of 10. As far as pain scale, what would you recommend?
Dr John Roberts: 19:55
Well, again, we've got to use the science and if we would When we're talking about gum disease, we know that gum disease, which is an infection around the teeth, influences the rest of the body, we should not be leaving gum disease in the body. And a root canal is an infection in a tooth. So it isn't something different, it's exactly the same, it's an infection. And if someone comes in says, I'm concerned about my root canals, there's a couple of things you can do. You can do a standard 2D X ray, which is what most dentists do, you can go to a dentist, or you can get referred to have a 3D x ray. And it's sometimes only on a 3D x ray, that you can see infections because it's behind the tooth, or between the routes that you can't see clear enough on a 2D. Now that's more radiation. So you've got to build in the risk factor of more radiation. So but you see things on a 3D x ray, that you don't on a 2D X ray. But equally, I'm still going to come from the point, every route filled tooth has bacteria in it. The question is, you have a route filled tooth, it doesn't feel right, you take an x ray, and you say, you know there is an infection. Now you can see it. X rays don't show an infection, all they do is they show bone? And is it dense bone? Or is it clear, it's only Shades of Grey, and the science here is is Shades of Grey, but it is grey. And there is an infection on the tooth, it can show by areas above or around the tooth. So what do you do, and your choices are, leave the tooth as it is, it's always a choice leaving amalgam leave a tooth is always your choice. Another choice would be to go and see someone who does root canals and they're generally known as endodontists. And see if he can take more of the dead nerve out the tooth, clear more of the hotel where the bacteria are living, and seeing whether you see that reduction of infection around the tooth on an x ray a year, two years down the line, or you take the tooth out because realistically, you'll never get that tooth infection free. Now there are other techniques where you can draw a bit of fluid from around the tooth to see whether there's toxins in there. But we're talking in general terms. Now most dentists don't have the technology to have a 3D x ray Never mind having something called it's called an Orotox, O R O T O X test.
Pete Williams: 22:16
So do you want to say John to just explain what that one is John? Because we're just starting to use this in practice. Your advice, an you just explain what that test is?
Dr John Roberts: 22:24
Right? Well, we've just talked about fluid flow. So that's right, that's worked really well, there is fluids in teeth all the time. But it's stagnant fluid, if you don't have that fluid flow. So bacteria living in the tooth, just below the surface, you know, microns below the surface. And if the person doesn't have gum disease on the tooth, you can put a little paper point down the side of the tooth, leave it for 30 seconds, and then test to see whether there's toxins, those toxins are poisons that block your enzyme system. So getting back to the nutrition people, it'll block creatine kinase something to do with the energy of your body. So you can actually pull out toxins from the body and the levels will then indicate how toxic that tooth is, all you're doing is you're measuring one millimetre where the tooth comes out the gum, it's not measuring what's deep down in the root, that's where you need the 3D X ray,
Pete Williams: 23:19
that what you're doing on you with that test is you're getting a sort of entry point to get an understanding of whether there are some toxic metabolites being outgassed, if you like by the bacteria.
Dr John Roberts: 23:32
The toxins in the top of the tooth, the whole tooth, and then when you get the clinical dentist like we do, we take a tooth out and you take pictures of it, you will see strata or layers of different colours in the tooth, some are black. And that's where there are, say, in your home button type of bacteria living in that on the seventh floor, you have different bacteria, which is why the teeth are different colours, because bacteria living in it look at it as a hotel for bacteria that the body can't get at. It's the only part of the body you choose to pickle and leave in the body. You wouldn't leave your appendix in and say, Okay, it's sterile now because it will never be. So why do we? Why do we do it then John? Right, because we can. And because we can do what we believe is a good job. But biologically, it's not a good job. And I will also say there are occasions when I'll get someone to have a root filling for a short period of time because when we start looking at someone's bite and how the teeth fit together and how they're breathing and whether they're clenching or grinding. We learnt and I was doing the courses 20 years ago where you take out wholesale, a whole load of teeth, but then the person can't eat and chew then nutrition goes downhill. And 20 years ago, they were having dentures. Now we're offering them implants, but remember, a root filling might cost you 5 or 600 pounds, implants might cost you five to 6000 pounds. So one's got to look at the motivation of the people who are doing the work. And you've got to be open and honest if you lose that tooth and you're going to have to spend several 1000 pounds having an implant, put back in again, you've got to give people the choice. We don't want to cause them stress by charging them so much money. And that's where it's biological. You're looking at the whole person.
Pete Williams: 25:12
Yeah. And, John, that's a really interesting question. Because as you know, I'm someone with mild periodontal disease. I've got a root canal. And we actually did you, you conducted a 3D x ray, didn't you of my jaw. And we definitely saw that there is a mild infection on the top of that root canal.
Dr John Roberts: 25:31
An between the roots, yeah, you wouldn't have seen on the 2D X ray. Yeah. But very clearly, when we talked through the X ray, it was like, we went on a journey between the roots, and you can see where all the infection is?
Pete Williams: 25:43
Sure. My question for you. And you can use me as a person here. Clearly, the benefits of taking an infected root canal out is that fundamentally, you get rid of the infection. And that is going to have a local and potentially a systemic effect, health wise on an individual. But I suppose what I'm thinking about is that, you know, I don't want a big gap in the in the back of my mouth with my teeth, you know, I would like to have an implant put back in. But of course, there's always a cost implication that goes to that, and they're not cheap. But what would you say are the benefits of putting an implant back in there? Why would you do that? Are there additional benefits for doing that?
Dr John Roberts: 26:23
I'm going to say absolutely, again, make it clear I've put implants in for 10-12 years, I don't do them anymore, I refer them out, you were designed to have 32 teeth, most of us have 28 teeth, because we haven't got our wisdom teeth in. But if you eat and chew with all your teeth, they last longer if all the teeth are lined up properly, they last longer, is when people have teeth out. And they're starting to chew on 20 teeth instead of 28, they lose some molars, so they're chewing more on the front teeth, when now we get our populations who are 60, or 70, or 80, the teeth are literally wearing out I've seen a 74 year old today, her teeth have worn out, there's nothing I can do. Because she's chewing on fewer teeth, and the teeth she's got left are wearing out. So if you were designed to have all these teeth, or be it by the time you're 60, or 70, they're worn out it the more teeth you have, the longer your teeth will last is what I would tend to say I would always say dentures are a replacement for no teeth. But an implant is a replacement for your own teeth. Because it adds some functions like your own tooth. And so there can be complications about putting implants in. Every day we talk to patients about we can do this we can do that you can always put an implant in. But for the stability of your bite for the stability of your chewing in nutrition for the stability of your health, your airway, your breathing, replacing a tooth with a with an implant, I would generally say if it's affordable, it should be doable.
Pete Williams: 27:54
Okay. So I think that leads me on to the next question. And I'm going to use and I know we don't want complications as far as using complicated language here. But can we talk about biocompatibility? And why that's important. So why putting in appropriate materials? And can we also talk about something that we're very keen to explore aren't we and that is implant failures? You know, you're going to spend all that money, you know, maybe five grand, and the implant fails.
Dr John Roberts: 28:26
So when we talk about those two bits and pieces, yeah, so the bottom line is biocompatible in the world go all the way back to Mercury again. There are about 10% of the people I believe, who are allergic to Mercury, that means that like you have a peanut allergy or perhaps peanuts or eggs, or foods you eat that don't make you feel well, there are people who react to Mercury. Yeah. And you can do you can do a test. And the most common one is in the Lysa test. You can see all sorts of energy medicine practitioners, and they can say you're allergic to Mercury, your body has a physical reaction with with its immune system. But Mercury is a toxin for everyone. There is no one who Mercury is safe for what we're now saying is, is this material biocompatible, and we use titanium in so many aspects of medical care, my partner's just had to have her ankle pinned and plated, and it's Titanium they've put in because otherwise she wouldn't be able to walk again. So we're grateful for it. But when we have a choice of putting implants in, it makes sense to see whether someone is actually reacting to the titanium that we're going to put in because again, remember, you're putting titanium implant in, but unless you're having all ceramics put back in, you've got all sorts of metals in the screws for use and in the crowns they use. And then if you've got a variety of other metal crowns or amalgams, you set up galvanic batteries that were that corrode the titanium that corrode the crowns that corrode the fillings. So by compatibility,
Pete Williams: 30:00
John, John, when you mean galvanic forces, what you're sort of suggesting is that, Yeah. So, but they're almost creating like an electrical field, aren't they? That's what Yeah, 100%. And interestingly, you know, 100 years ago, they were talking about the electrical currents running in the mouth between fillings, and then it got dismissed. And I think that's a huge area that no one is really looking at, you know, you're running milli volts and micro amps, that you can run computers off the amount of electricity that's running between lots of metals in people's mouth, is that having a biological effect? Absolutely. What it is, at the moment, no one's looking. But just because we're not looking doesn't mean it isn't there, it's just that we don't know. So going for a metal free man is going to be advantageous going forwards. But coming back to it, I would say 99% of the dentists who are putting implants in and putting titanium in within a variety of metals with the crown that goes on top. So the implant is what screwed into the bone, the ground is what goes on top. And if they're different metals, you're even getting galvanism between the Crown and the implant. But if you screw some titanium into someone's body, and it's being recognised in the surgical field now that people react to the titanium that's being screwed in, it isn't inert, if you do biopsies of glands near where you've had implants put in there'll be titanium in. So titanium doesn't stay in the implant. The simple fact it gets integrated into the bone says that the bone dissolves a bit of the implant away and picks itself into the implant. So metal is coming off your your implants. So biocompatibility is you check someone's immune system to see whether they react to titanium. And then you can take it a step further, because you can then say, well, what about the root filling material? What about Mercury? What about the plastic fillings, and this is where the science gets a bit controversial. You can test someone for anything, including the anaesthetics, and it's sometimes not that you're totally allergic to it. It's a bit like when you meet someone at a dinner party, you don't have a fight with someone, but you just don't like them. And if you screw something into your body, your body just doesn't like it's a source of irritation. It's a source of stress. Yeah, I think this is a difficulty, isn't it? Because what we're looking at is that everyone who gets presented into the dentistry chair is unique. And so for be able to suggest and give indications of what's going to happen to them, is almost impossible to do. Although you can look at the standardised science and say, overall, this is what the science shows us. And it really depends whether you know, you're an outlier or not, depending on the science.
Dr John Roberts: 32:45
And you've got to say, well, what's the motivation? Which is why three people want to leave all the metals in one, I'll take them all out. And one of them I'll say, as and when it's suitable for
Pete Williams: 32:54
you. And I think that's the conversation that you've got to have a dentist, isn't it? Because the reality is, you know, I think about this, and I think about my situation on this is that cost is always I mean, you would want to put the most biocompatible and best materials into your mouth, based on what we understand from the science and based on what you understand from from maybe some of the testing that's been done before you have the implant in. But of course, it's there's, there's always a cost implication to that there's a cost. And,
Dr John Roberts: 33:23
you know, let's just be clear, you can do Titanium implants, and you can do ceramic implants, but ceramic implants cost more, and they're not quite as versatile yet, because we don't have as much experience. They're not as versatile yet as the titanium. I think in time, all the titanium producing implant companies are now starting to buy up the ceramic producing companies because they realise there's a percentage of the market that can't have titanium. So we offer the patients both, we give them the costings for both, we give them the option to have the biocompatibility testing the Lysa testing, and then it's up to them, because let's just say they're paying 10,000 pounds for a couple of implants, you know three or four or maybe more implants. What's a 200 pound blood test? And that's the key now. It's obviously the patient's choice, whether they spend the money or not. And all I'm coming all I'm trying to do here with this podcast is give people choices. Yeah, if a dentist says ceramic implants don't work. I'm going to say the guy doesn't know what he's talking about. Because I show you a lady I saw yesterday then in 10 and a half years, good as the day they went in, because they're biocompatible, and the body loves them. If he says Mercury doesn't come off your fillings, don't see him or her because they don't know what they're talking about. They should be giving you the choices when they root fill a tooth. They said they should say there is always a risk that the tooth may never settle down. The tooth will always have a low grade infection, but you'll be able to eat chew smile, and we're saving you from you know, several 1000 pounds more of implants.
Pete Williams: 34:59
Yeah, well, I think that's exactly the situation I'm in at the moment, isn't it? I've had that root canal in for a couple of years. We know there's a small infection on the top of it, I feel it on a daily basis, it's sort of one out of two pain, but I'm pretty fit and robust guy. So, you know, we can probably hang on for a while whilst we decide what we're gonna do with it. I can do a bit more work to pay for the implant. John, can we talk about because obviously, this is something that we're we're actually, me and you trying to explore about why implants fail, because that is a consideration, isn't it that that the implant may fail, and you've paid all that money for it?
Dr John Roberts: 35:38
Yeah. And it's interesting, it's nice to be part of a team where they're always learning. So my two hygiene therapists who are predominantly ladies, but there's quite a few good men who work for me in the past as well. They're the people involved in cleaning teeth. And really, that's their job. That's what they do well, and we're now seeing research that saying one in five implants placed will within five years get some degree of infection around. Now, it could be due to the fact that person is reacting to the implant, which is your biocompatibility issue. But implants get gum disease the same as teeth get gum disease. And if you have an implant in your mouth, the recommended protocol is to see a dentist or a hygiene therapist every three months. And if we see any signs of infection, we should be treating it straightaway. Because otherwise, you lose the bone that's holding the implant in. Lo and behold, 10-15 years down the line, you've lost the implants, as well as some people think that's a fair deal. But other people want implants put in and they want it to be a lifetime, I believe your teeth should last a lifetime. And if you're going to have an implant, I believe an implant should last a lifetime. But it's our laziness as a human being maybe our eye off the ball as practitioners, that means that the work doesn't last as long as we would like it to. So gum disease is known as Peri implant Titus is going to be an increasing problem. As we go as more and more people have implants per 10 As we get an ageing population. And in the same ways we don't want infections around teeth. We don't want infections around implants, and we should sit on it hard. Because once an infection gets onto an implant, you're on a slippery slope downwards, to lose any implant, as we stand it with the techniques we have at the moment and things are changing. So who knows in the future, but you do not want infections qround implants.
Pete Williams: 37:34
And I suppose this comes back to recent COVID podcasts that I listened to produced by the Institute for Functional Medicine, brilliant, actually, really robust review. And their first line was exactly what you're saying, is that vaccinated or not? You're going to have to really look after yourself. Yeah. And so I think what we're saying here is that it you know, if you want your implant to last, you have to think about how you're looking after yourself, not just locally in the mouth, but systemically through your lifestyle. Yeah, and
Dr John Roberts: 38:06
it comes down to choices. You know, I enjoy a beer now. And again, I don't smoke, I don't eat junk food, generally, that's my life choice. And I expect a certain health from that. But if people are smoking, drinking, wanting implants and wanting the teeth look beautiful. Don't expect them to last. So you have to be honest and blunt with a patient and scousers You know, we're not blunt, we're honest. Yeah, you're telling them look, unless you change this, it's not gonna work. Unless you come back every three months, and we clean them for you. It's not going to work. If you're going to have a root canal, fine, but expect that it drains a little bit of your health. So with yourself again, you're doing all the things you can to stay well, and you've still got an infection, but are you dealing with it. But if you were smoking and having a few beers and eating dare I say fast food takeaways three times a week, and you've got an implant with an infection. I'm going to assume that's a lot worse for you than then as you are at the moment. So it's, as you said, it's on a patient to patient basis, and give them the choices and give them the facts. And I'm just keen on people getting the facts. Yeah, what they do with it is their choice.
Pete Williams: 39:16
But obviously, this is a world where again, I think depending on where you go and look, it seems to be dictated more about from general public advice rather than, you know, robust scientific advice. And look, that doesn't mean to say that many organisations are may be stuck in I suppose blinkered thinking, if you like they're not Systems Approach. I mean, how has that affected you, John? Just just on your history, because obviously, you are a BDA registered dentist. Yeah. But you're a systems thinking dentist, your a health orientated dentist, so I'm assuming again, probably like me, you've been exposed to criticism probably for most of your Working life I
Dr John Roberts: 40:01
expect Absolutely. And I think I've gotten to this age by being somewhat cautious by not being too outrageous. But of also speaking my truth, if you're going to have differences of opinion, back it up with the science, and I don't want conflict, I like to give people choices. And when they make that choice that I help and you know what, sometimes it doesn't work, but anyone who says they get 100% success, don't go and see them either. But you have the situation where 25/28 years ago, I stopped using mercury fillings. I wasn't convinced there was enough evidence to say they're healthy. You go fast forward to last year, the FDA in America said 60% of the people are probably being harmed by mercury fillings.
Pete Williams: 40:44
Yeah. And I think if we go on to that, because obviously this is the this is the work that we've been working on, haven't we? And I think you know what, we're already 55 minutes into this. And we're only just touching the surface review, John. So I think what we're going to do is I think we'll do Dr. John podcast, number two as well, because there's so much I want to get out of you, which I think is incredibly valuable information, not only for me to be reinforced me, but I think everyone will come off this thinking, holy cow. So there is quite a lot more to think about on this is that, as you know, the FDA have in the US have come out and said that certainly that mercury and that the term they use is susceptible genotypes. Yeah, and that is something that we're looking into strongly with regards to certain what we call polymorphisms. So certain gene variants, like the APoE4 would be one, like some of the methylation, gene variants, which are some of the other some of the detoxification genes as well. And this is what we've discussed a lot, haven't we is that, you know, you can have an individual who has a complete mouthful of mercury fillings, off gassing, like there's no tomorrow. But inherently, the total toxic load is sort of offset by number one, great genetics and a really good lifestyle. So that's what keeps them underneath the radar. But you can have someone with one filling with not a lot of outgassing, but poor genetics and poor lifestyle. And they can have real problems from from that. And I can't
Dr John Roberts: 42:15
agree more. The APoE4 protein has been talked about in the merch 25 years. And now that you can actually simply test it. And I'm going to defer to practitioners like yourself and functional medicine, people who understand the genetics, then all we're saying is are you concerned about your fillings, get a test done, if your APoE4 plus two, then you've got a more serious consideration than if you are you are APoE22, you know, it's as simple as that. If you methylate well, you can detox with whatever you want. If you're not methylating, well, then you've got to go and see someone who knows how to get your methylation cycles. Otherwise, you're detoxing your mercury, you're pushing it from pillar to post, you're not actually getting it out your body. Yes. Great for a while. And then another symptom will come because you put the mercury somewhere else.
Pete Williams: 43:03
Yeah. And that's not to say that, as you say, that's not to say just because you've got poor genetics, you're going to have poor, you're going to have increased problems. But I think what you're saying is, you know, by the scientific literature, your risk for adverse effects long term with mercury goes up. I think that's what we're looking at. And what we're trying to do aren't we John, is we're trying to say, look, we can't give you 100% Answer. But we're trying to give you a more informed answer, based on what we're understanding with the literature.
Dr John Roberts: 43:33
Word is we inform you, and we give you choices. And if you're better informed, and you know what your choices are, then you can make your health decision. And it is not unreasonable to say I don't want amalgams out, but I'm now going to eat healthy, or whatever healthy eating is, but I'm going to change what I do, I'm not going to smoke anymore, I'm going to clean my teeth more you can give people choices, but to deny them the choices, which is I'm going to suggest a lot of mainstream healthcare does be open and talk about it. And then it's your choice. Everyone should be given total health for one week, and then they can have the choice as to how far down the slope they want to go.
Pete Williams: 44:12
So why why do you I mean, I actually asked this question to Pat hanaway who I had on on another podcast, and we were talking about that. Actually, the biggest things the biggest changes that can do for your health are generally the lifestyle orientated changes, and that evidence is conclusively clear. Through all the major and medical organisations like the American Heart Association, the W H O the, you know, the American and you know worldwide diabetic Association, that stringent lifestyle interventions are the key therapeutics that you intervene and what they call first line therapy. So, John, why do you think when we're looking at dentistry that clearly you know, you're an expert in your field You are understanding the literature over 40 years. And yet, some of your major organisations aren't discussing dental care in the way that that you discuss it. I've obviously
Dr John Roberts: 45:13
got to be careful what I'm sayiny. Just because we've always done it that way doesn't mean it's right. And unfortunately, dentistry is evolving into, I'm going to say with the best love in the world, people are more interested in beautiful smiles, and having all their teeth drilled and crowns and root filled because they smile well. And they're interested in having Botox injected in the face because they look good. But that's not biological in any sense of the word. I will often actively discourage people from having their teeth straightened, because it's a massive effect on the body. I obviously won't encourage people having Botox and stuff put in, why would I? But it's someone's choice, but they're not they're not told of the harm. And if you're asking why is the profession because always done it that way? And what if we were to come out and say, mercury fillings actually, maybe potentially harming your health, medical legal issues through the roof. And if I can give a taste of for, if we do this, again, taking children's teeth now to give them straight teeth and braces is lining them up for health issues. 40 years down the line. And this is all in the literature. It's all over the place. And this is my excitement, but dentistry going forward. Yes. And if I could share that with you on another podcast, I would love that
Pete Williams: 46:35
I John, I think I'm going to get you on pretty damn soon again, because, you know, as I say, I think we're literally just touching the very surface of if you like a profession of medicine and healthcare that, you know, I mean, even for me who you know, thinks he's pretty good at what he does. I mean,a scouser would say that wouldn't know they. It was a world where I had no idea of, and, you know, it's completely why we got into this area in a pretty big way. So it's, we're over an hour in John, the footy is going to kick off in a couple of minutes. So talking about our favourite team, I just want to I just want to bring Jurgen into the picture. Because I know what you must think when you watch Jurgen, and I know what you think I find I first saw Bobby for me, you know, with that sort of put your sunglasses on smile? Yeah. So here's a question for you. Because if we're if we're sort of post new teeth, Juergen, it was clear for me because I'm I get completely obsessed with looking at people his teeth weren't in great shape. I think we're pretty clear about that, particularly the bottom teeth. You know, Pete Well, his top teeth are really bad as well, he had piecemeal dentistry. And you know, a bit here a bit there, we
Dr John Roberts: 47:49
all run busy lives, and you're looking at one tooth at a time, rather than than the whole mouth, or in fact, the whole biological person. And he got to the point where, because you're doing little bits, it's a bit like putting bits on a car bit here, bit there. And you've lost sight of what the car is, and what Jurgen had done. I'm going to suggest he's had all his teeth taken out and implants put in, I don't know, I'd love to meet the man. I'd love to shake his hand as well.
Pete Williams: 48:14
But John, how do they do that, because clearly, he's had both upper jaw and lower jaw completely put in. So did they extract all his teeth and then shave the jaw down and then screw it screw in? How does it work?
Dr John Roberts: 48:29
You take all the teeth out, you shave the bone down, you screw in implants. And in the same day, you screw teeth back in again, it is as simple as that. It'll take you eight hours, maybe four hours for the top four hours to the bottom, I chose to duck it at that stage. Although I can do it and I've done the training, it just doesn't do it for me. But literally, you can do these 3d X rays. Now, you can then get a stent made which is like take all the teeth out, fit it and then drill here so you know where the good bone is going to be. You can drill in four, six, eight implants. And then because you knowwhere you put the implants in, you've already pre made teeth, double screw into that. It is a fantastic art and skill. And I'm not saying it shouldn't be done. But Mr. Fermino with the bright white teeth. I do believe there are practitioners in our great city, the capital of England, Liverpool, that are taking out good healthy teeth because I can put this tooth in a better place and it'll last forever. Well keep the living biological things. Your teeth are Peasy all electric things that create vitality in your life. The moment you drill them a moment you cut into them, the moment you take the nerve out, the moment you take the tooth out, you're losing vitality, and I'm getting a bit alternative and woowoo here, but it well I'm not an I'm not a tooth carpenter. I'm not a gum gardener. I'm actually someone who cares for people's health. And just taking the teeth out because you want bright white teeth You know, in the perfect place might be good now while you're an elite sportsman, or you can afford good diets, but what's he going to be like when he's 40? Or 50? And is he going to regret those decisions? I don't know. No one knows.
Pete Williams: 50:15
So are you saying that by taking out the original teeth and putting in, I mean, again, I don't know the process. But anatomically, you may be changing some of the anatomy and structures and physiology of maybe the way the airways work, maybe the way the jaw muscles work, maybe the way the tongue works.
Dr John Roberts: 50:35
100%. And I was fortunate to lecture at an international conference about implants. Because what we do is we put implants in willy nilly without any consideration to how the teeth fit together, without consideration to how someone breathes, tongue function, swallowing, does that then lead to more breathing disorders? Does that lead to more sleep apnea? And we can talk about that next time?
Pete Williams: 50:58
I think so. Because you're talking about everything that I've got wrong with myself at the moment.
Dr John Roberts: 51:03
And, you know, the biggest thing in dentistry at the moment is sleep. Yeah. People clenching, grinding, not sleeping, right. Sleep apnea. And that's the dentistry we're doing now is creating problems for the future. So the dentist who's who isn't doing a mercury fillings anymore, will still have a lifetime of dentistry because of all the other things we're doing. And, you know, I hate to say that there are good guys who take teeth out and do implants and might reason for it. Juergen might be, his building was rotten & everything, because he'd been too busy doing football. That was a benefit to him in his house. Yeah. Yeah. And that makes complete sense. Was any consideration given to what materials were put in? If you're going to do it? Are we going to improve his bite? Are we going to perhaps help with any clenching and grinding, sleep, snoring, and if you change someone's bite, you can help with headaches head, neck, shoulder problems. Lot's of dentists do that, if you're going to do the work, consider how it affects the person biologically. Not just because they look good.
Pete Williams: 52:05
John, here's one more one more question because as you say, I think we're gonna, I feel we're probably gonna have to do several podcasts. How many? Because I know there is a massive groundswell because I think this is sort of moving on to the next time we chat. There's a massive groundswell in dentistry with regards to understand the local and the systemic effects. And I think what we're very clear is you just cannot ignore the literature. It's too profound. It's too big. Yeah. And how many of you, of your type, are practising within the UK?
Dr John Roberts: 52:41
We all have our own things. And I don't want there to be other John Roberts, but there are, I'd hate to say less than 100, who are actually this system thinking. And before COVID, as you know, we were going to run a big international conference international on Liverpool Street, because the best thing in Manchester is Liverpool Street, because it goes to Liverpool. And we have lectures from all over the world. And we were going to talk about lasers and gum disease and nutrition, and you know testing infections for root canals. And it never happened. And I think that was going to be a movement to change dentists, not from mercury free, at least if we're going to be mercury free and mercury safe. But then realising if you're going to redo the fillings, do them in the right bite with no disease, no infections. And so I would like if any of your listeners want their dentist to give me a call, give me a call. I'll talk to anyone, I'm a scouser, I'll talk to anyone. I won't rob them yet, but I'll talk to them. And I'll share the information I've got because it's no good having all this knowledge if no one uses it.
Pete Williams: There are some pretty big organisations, particularly in the US, which have been developed around more Systems Thinking health orientated dentistry.
Dr John Roberts: 54:00
Yeah, I mean, the American Academy of Oral and Systemic health, a society that just looks at gum disease, and how it affects the rest of the person. Pregnant women diabetes, you mentioned before, heart disease, stroke, we sort of pay it lip service in this country, but no one really dares say anything.
Pete Williams: 54:17
Yeah, and I suppose you know, the interesting thing for us and you know, why, why me and you have a relationship is simply because as our practice, particularly me, it's standard of care that not only do we ask about their dental health is that we investigate deeper, because it's so profound, the literature is so profound, but
Dr John Roberts: 54:33
I either want to be a dentist to give someone a bright white smile, or I want to do something that will positively affect their health, potentially for the rest of your life. So if I was to say everything from seeing week/day old babies to release tongue ties to 80 year old men who are overweight and snoring, there's so much we can do as a biological dentist to improve people's health and you get there first by things like this. Educating people, giving people choices, empowering them with the knowledge and then it's up to them as to what they want to do.
Pete Williams: 55:05
Okay, mate, I think that's a perfect place to finish because there's no doubt you're going to be on again and again and again. Because the information you're bringing out John is way, way too valuable not to be kept in your little, you're up in Huddersfield aren't you?
Dr John Roberts: sunny Huddersfield, yeah
Pete Williams: So what we'll do is that when this podcast goes out in the future, we'll put your practice details on there. Is that okay if we do that?
Dr John Roberts: 55:30
Yeah and if someone contacts me and says, Is there someone closer? I'll help you however I can.
Pete Williams: 55:36 Sure. Yeah. I think that would be great, buddy. Great to have you on.
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