Tye Binuyo: Hello. I, first of all, want to thank everyone for tuning in today. My name is Tye Binuyo with www.toprateddentist.org. We are the site that introduces you to excellent dentists and dental professionals from around the country as well as the services they offer.
Today I have a special guest joining me, Dr. Eric Kempter.
Dr. Kempter is co-owner of Kempter Holistic Dentistry located in Concord, North Carolina. He's here today to discuss holistic dentistry. Thank you for joining us, Dr. Kempter.
Dr. Eric Kempter: Hi. Thanks so much for having me today.
Tye: No problem. Now to get started could you give us some background information about your practice as well as your journey in dentistry?
Dr. Kempter: Sure. My older brother John, Dr. John Kempter established the practice here in Concord in 2010. He originally opened the practice actually as a traditional dental practice standard taking insurance. We did that for about two or three years and during that time I was actually in dental school.
I started dental school in 2010 and graduated in 2014 from the University of North Carolina. During that time my brother and I just got talking and started having discussions about dentistry in general and just things that we were noticing. He was noticing out in practice, I was noticing in dental school.
We've all come from a background in chemistry so I was asking him questions about the information I had learned during my education and we got on the topic of the amalgam fillings. During that time my grandfather had dementia and Alzheimer's and my brother had raised some concerns about the level of mercury in amalgam fillings and the occupational hazards that we were exposing ourselves to or would be exposing ourselves to the long term career.
It took us down a path of doing a little bit of research on it and we discovered this organization the IAOMT that is the International Academy of Oral Medicine and Toxicology. Turns out they are the governing body for the procedure to safely remove amalgam fillings which I know we'll get into later and we actually went to our first conference. The rest is history. A lot of what we heard there made sense. He immediately started implementing that into his practice. The transition from a traditional practice to more of a holistically minded practice began at that point.
Tye: It sounds like it was a natural progression into holistic dentistry which brings me to my first question, what exactly is holistic dentistry? How does it differ from traditional dentistry?
Dr. Kempter: It would probably be the approach that is the difference in what I do now versus what I did and what my brother was doing in terms of doing traditional dentistry.
I have colleagues that work in standard dental practices and they're great practitioners and they obviously have a mindset for their patients' wellness. We're really good in traditional dentistry of fixing problems as they come.
What we do in terms of our holistic dentistry approach is that we take more of a wellness approach to dentistry. I guess the basic concept and what I explain to my patients is that once I'm done doing your dental work-- Obviously, everybody shows up with some sort of problem or they may not.
The idea is that when I do dentistry on you, we arm you with the knowledge and we help motivate you to prevent me from having to do dentistry on you ever again or at least doing the minimal amount.
Where some of the shortcomings in traditional dentistry have come up is that if you've ever worked in a traditional dental practice you find that you get a lot of cavities from hygiene. Patients aren't motivated. Patients aren't educated. I think you'd find it surprising the amount of patients that I talk to that have never been taught how to floss properly.
In terms of holistic dentistry, we take a natural look at things not relying so much on different products like fluoride or things like that. We rely more on keeping plaque off your teeth and using some other natural methods to prevent you from having to have dental work long term.
Tye: So it’s taking a preventive approach to reducing problems with my teeth so to speak.
Dr. Kempter: Correct. My goal for every one of my patients is to move them from a six-month recall schedule to hopefully only seeing them every year. That's the ultimate goal for everybody is that they come in and you get them to a point where they're just doing maintenance as opposed to having to constantly get fillings or having to have a crown here or there.
A lot of that has to do with getting to the root cause of issues. Everybody in dentistry is great at treating symptoms but if you don't get to the cause of it, these problems are going to keep coming up.
Tye: Can you talk more about the materials used? Are the dental materials used in holistic dentistry different from traditional dentistry?
Dr. Kempter: We actually use a lot of the materials that are used in traditional dentistry. I know that holistic dentistry sometimes gets that misnomer associated with it but we're using composite restorations. We use porcelain restorations. It's not more of what we use that's different from traditional dentistry it's more of what we choose not to use.
In more of a holistic approach, we try to stay away from metal as much as we can whether that's amalgam fillings or whether that's porcelain fused metal crowns. We try to stay away from those just because some of our patients are coming with different autoimmune issues.
I have a lot of patients that have nickel allergies not taken into account with their dental material. We tend to stay with the most bio-compatible materials we can so composites, porcelain and, like I said, as little bit of metal as we possibly can.
Tye: Yes. That does make sense. If a traditional type dentistry was not using materials where I would have an allergy or something like that, then that seems like it could be a cause of problems and that might not even be picked up on.
Dr. Kempter: Well, right. Again, it's not anything against traditional dentists. I have plenty of friends that are great dentists that still use porcelain fused metal crowns and it's not every single patient that has those issues.
In fact, I'd say it's a pretty small percentage of people that have these allergies, but our philosophy is if there's a small percentage of people that have it, we would rather not take the risk. We would rather just use the most bio-compatible material we can.
Tye: What approach does holistic dentistry take when it comes to dental hygiene? You touched on flossing a second ago, can you expand on that in reference to the approach it takes to hygiene?
Dr. Kempter: From a hygiene standpoint, the number one cause of problems in your mouth is due to plaque. If you keep plaque off of your teeth, you're not going to have dental issues or you're going to have a lot less of a chance of having those dental issues.
From a hygiene perspective, our philosophy is floss, floss, floss. You want to floss the teeth that you want to keep. Obviously brushing is important. We always encourage our patients to use a Sonicare toothbrush, but it's not a plug. We don't get paid by the company or anything.
We just found that that's the best electric toothbrush that's on the market. We have some other ones we're looking into right now too from a cost perspective for our patients that don't want to spend the money on Sonicares. An electric toothbrush is key, brushing your teeth for two minutes every day twice a day.
I've started encouraging my patients to floss first because I'm sure as you know, and if you talk to a lot of dentists, the number one thing people don't do is floss. If you can get somebody to floss, the turnaround is quite significant in a short period of time. I try to have my patients floss first.
Hopefully, we'll get into some ozone later, but one of the products that I love using for our patients from hygiene perspective is if you're building up a lot of plaque, we encourage people to use ozonated olive oil or ozonated coconut oil as an adjunct to brushing your teeth.
If you brush some of the oil on your teeth before you go to bed at night and let that sit in there overnight, it helps decrease inflammation and it kills bacteria. Generally, we've just seen a big turnaround with our hygiene patients using that product. From a general standpoint, we just want you to keep plaque off your teeth and have a really good hygiene regimen at home.
Tye: Good stuff. Now, the type of floss that I'm using does that make a difference? Does that really matter any?
Dr. Kempter: In my opinion, if you're putting a piece of floss between your teeth, whether it's rounded, whether it's the tape floss, whether it's glide versus a different brand or generic brand, in my opinion, it really doesn't make a difference.
The patients we see in our practice, some of them have certain restrictions they can't have mint for one reason or another. Sometimes they won't use minted floss.
The bottom line with flossing is just we want to get that mechanical cleaning action done between the teeth. Regardless of what type of floss it is, as long as you're doing it, that's pretty much all that we care about.
Some people like the tape floss because they have a difficult time getting in between their teeth and others like the rounded floss, they feel like it cleans their teeth more. We really don't have a preference there. It's just as long as you're doing it, that's all that matters to us.
Tye: Now, let's move on to X-rays. I know X-rays are used as a tool to help to diagnose in dentistry. Are X-rays the same when it comes to holistic dentistry?
Dr. Kempter: They are, much like a pilot trying to fly without radar, we in our practice don't like to fly blind. Now, the difference with us is obviously we want to minimize the amount of radiation you are exposed to.
Our cone beam that we use in our office is incredibly low dose radiation. We always tell our patients you get more radiation walking from your car to the front door than you do from our X-ray machine.
We also allow patients to transfer X-rays as long as they're within the prescribed amount of time between their last set of X-rays.
Any dentist will tell you regardless of traditional, holistic you can't diagnose that, you can't diagnose problems if you don't have those X-rays. Again, there are certain situations depending on if somebody's got really good hygiene and somebody hasn't had problems for years, then obviously we will respect their wishes if they don't want to take X-rays.
Most people, we do respect their wishes but we do give that caveat that look, "We're flying blind here. We can't diagnose if we don't have this information."
In the sense that is it different in holistic dentistry? Yes. We make sure we use digital sensors. We use a digital cone beam that has a very low dose radiation every time we use it.
Tye: You also mentioned the time in between X-rays. I'm guessing if I was trying to transfer an X-ray from one dentist to another, what time frame would you say that it would be where it's safe and you could use something like that?
Dr. Kempter: I would prefer to have it within a year. If somebody's just had X-rays within the past year, I'm typically okay with that, unless of course, there's some sort of problem going on or there's some symptom that's there, sensitivity, any kind of dull pain or anything like that.
If it's two years and they don't have any issues, I usually don't have a problem with that. Again, we treat everybody on a unique individual basis. Every case is different. There's no hard and fast rule that we have. We tend to get to know our patients, get to know their oral status at that point and make a determination from there.
Tye: Now, does the holistic dentistry approach apply to kids as well the same way as it would for the adults?
Dr. Kempter: Absolutely, the same approach applies. We want to keep plaque off of kids teeth. Now, kids sometimes take a different approach. They don't quite have the dexterity that adults do in terms of flossing their teeth so we could use some different methods such as using floss picks, the little Plackers.
My only suggestion with that from a microbiology standpoint is that you use several Plackers in each session just because the bacteria does build up on the piece of floss and if you go in between two different sites, you're just moving bacteria around in the kids now. We use ozone treatments for kids.
They've been great to prevent cavities, especially if they have a history of getting cavities but generally, the approach is exactly the same. It's a little bit different in terms of the coaching with them, but we just want to keep the plaque off their teeth and prevent those problems from occurring.
Tye: Now, I've also heard about mercury filling removal and I noticed it's one of the dental services you offer on your website. Can you talk more about what exactly it is and why you would recommend it?
Dr. Kempter: Sure. I mentioned it before. We are both accredited members of the IAOMT which just means that we've done an advanced training in terms of safe mercury amalgam removal techniques. I don't know if most people know the silver fillings that are in your mouth do contain up to 45% of mercury in them.
From our standpoint, the occupational exposure standpoint and from an exposure standpoint of patients, it's in our best interest to do the safest removal that we can. It does involve a couple of different things. Namely, we want to prevent you from being exposed in any possible way.
The couple of ways that we do that is we use a rubber dam on every single removal that will prevent any of the particles that are going to come up when we're drilling it at 200,000 rpms. It'll prevent any of those particles from getting into your mouth.
During that time when we're removing it, my assistant will have high-speed bag with suction on there. What she'll also do is she'll bathe it in water the entire time that I'm drilling to tamp down some of the vapor that's coming off of there because if you can imagine if there's mercury inside of the filling then there's mercury vapor that's going to come off as it's being kicked up at 200,000 rpms.
One of the other things that we do is that we put an oxygen mask on your nose so that you're not breathing any kind of vapors coming off of that restoration whether it's any of the other metals in there, the mercury that's in there. We have you breathe pure oxygen.
We obviously use some eye protection. We don't want anything getting into your eye that goes for any dental procedure that we do. The other things that we do is we put a patient drape on you that will prevent any kind of splatter or anything from the removal process from getting on your clothes and having you take that home to your family and your loved ones.
The main thing that tamps down the mercury vapor exposure for both my staff and for the patient is we have an extra vacuum that we use, specially designed vacuum to suck up all these vapors. We put that about four inches from your face to make sure that it's doing the majority of the vapor removal during the process.
The other thing that we have is we also have an ionizer that helps with the vapor removal during the procedure. From the dental standpoint, as a dentist, what I do is we try and chunk out these silver fillings in big chunks if we can.
We use a carbide bar. We tend to drill around the border of the restoration and just try to get to a point that they can pop out in big pieces. Again, probably the general public doesn't understand those silver fillings are not chemically bonded to your tooth.
They're just sitting in there and they're mechanically held into the tooth. What that means is that when the dentist originally did the preparation for the tooth, they made the bottom of the prep bigger than the top of the prep so that the restoration can physically not come out of the two.
If we can get in there and get underneath that filling they typically just fall right out. We do single tooth mercury filling removal or amalgam filling removal, we do quadrants, we've done half mouths. The main thing for us is making sure that we safely do it. From an occupational standpoint if we don't use that method, every time that we drill out one of the silver fillings we are 3,000 times over the OSHA standard for mercury exposure within the cubic yard of that working space. We wanted to get down to basically nothing if we can.
Tye: Now, is that still common practice?
Dr. Kempter: According to the ADA, approximately 75 million are placed every year. It is still being used. From a market standpoint though, I think more people are obviously asking to not have those placed. To be fair back in the day, back in the 80s and 90s, the composite restorations did not do very well, especially in the posterior of the mouth and the back on your molars.
When they were used as molar restorations they would fracture very easily. With technology, composite restorations have become a much, much better, and technology such as CEREC has made things a lot easier in terms of the materials we can use.
They just didn't have a good material to put back there. Like I was saying, the market dictated, most people don't want the silver fillings. They're not making a choice based on a health standpoint or a safety standpoint, they're taking it more because they just don't like the aesthetic look of it. The market has pushed people away from getting those or at least requesting not to have those placed but they certainly are still being placed in the US at this point.
Tye: Let's say I did have mercury fillings, would you recommend that I absolutely have those removed or is it one of those things where it depends, case by case situation?
Dr. Kempter: Ultimately that's the choice of the patient. My job, and I firmly believe this, my job as your practitioner is to give you the information that I have in terms of, what are your chances of having issues, what are your chances of having systemic issues from having these fillings in your mouth.
Whether or not we remove them or not, that's up to the patient, especially if they're totally fine. We have patients that are in our practice that have chosen to either take a longer path to have them taken out or wait till there's a problem with the restoration before we take it out.
If I had it my way, I would remove everybody just from my perspective. But ultimately I leave that choice up to the patient, and I just give them the information and I certainly don't make that decision for them.
Tye: You also mentioned earlier oxygen 0zone therapy. Could you talk about what exactly that is and how it works?
Dr. Kempter: Ozone therapy has actually been around for a really really long time, actually since the early 1900, back in the early part of the 1900s they actually used to use it to disinfect surgical suites before and after surgery. Basically what Ozone is and I know you've probably heard the buzz word about Ozone in terms of pollution, but that's actually a misnomer.
Ozone is not pollution, Ozone is actually not bad. What Ozone does is actually tries to clean the atmosphere of those pollutants. But essentially what it is from a chemical standpoint it's O3. What we do and how we make it in our offices, we have an Ozone generator in our office that we connect medical grade oxygen to this generator.
It uses an energy source to break apart oxygen molecules O2 into the single oxygen radicals. Those radicals then attach on to other O2 molecules to form O3.
How it works in terms of its interaction in the body is it is a potent anti-inflammatory agent, it's a potent antibacterial anti-fungal an antiviral agent as well, and how it works, especially from a bacterial standpoint, If that oxygen radical when it comes in contact with the positively charged cell wall of the bacteria it's automatically attracted to that cell wall.
Once that oxygen radical hits that cell wall, it breaks apart the cell wall of the bacteria causing an oxidative burst. Essentially the bacteria just explodes.
The reason why it's safe for us to use, is the byproducts of that are only water and oxygen in your body. Plus our own cells, your human body cells have natural antioxidants in them, we have enzymes that protect our cells from radicals oxidizing our cells. In essence, bacteria do not have those enzymes. They do not have any oxygen naturally inside of their cells. They are 100% vulnerable whereas our cells are not.
Now obviously there's a limit. You can't do a super concentrated amount of Ozone into your tissues because it will eventually damage your cells. But we have a very strict protocol that we use to put the right concentrations for different types of use.
Tye: Is it safe to say its a cleaning agent of sorts?
Dr. Kempter: It is. I'll give you a great example. We as a standard of practice in our office now, whenever we do a filling every single cavity prep that we have in there you can't obviously confirm whether you've killed off microscopically all the bacteria that's in that cavity after you're done drilling it. What we do is, we'll take a syringe that's full of the gas, put a flowable tip on it, and after every single procedure we leave the tooth moist and we actually bathe the tooth, the cavity prep in the gas for about a minute. We slowly pump the gas onto the tube. Whatever remaining bacteria is left over in that cavity prep, will actually oxidize and when you look down at it, it will actually turn white.
The other thing that it does from our standpoint where it's completely fundamentally changed our practice. It will oblate the Denton tibial inside the tooth. Now for those that aren't too keen in terms of dental anatomy, there's these tubes inside of your tooth that actually causes sensation, cold sensitivity, hot sensitivity, those sorts of things.
What it does is, the Ozone actually cuts off those tubes so that the pain signal cannot be sent. The cold sensitivity is basically nonexistent after our fillings are filled. Now if you ever talk to somebody, cold sensitivity after getting a filling is quite a common thing. Since we've implemented Ozone into our practice and into our fillings, we've had an astronomically low rate, I would say less than half a percentage of our patients coming back with cold sensitivity.
Tye: Now is oxygen Ozone therapy widespread? Does my average Dentist use it?
Dr. Kempter: I would say it's a pretty low percentage that use it, especially in terms of a traditional practice. Now if you're talking more of a naturally minded or holistic practice, I'd say about 50% of the holistic practices are using Ozone.
I know a couple of colleagues in my area do have Ozone available at their offices. I know a bunch of colleagues that are in the community that do have it. There are some that don't use it for whatever reason. We just found that we have a very big use for it. There's plenty of other things besides cavities that I can use this for.
I could probably take up another hour and a half of your time talking just about Ozone. But yes I would say about 50% of the holistic practices. Traditional practices, probably not just because it's not a widely known thing, but the research is starting to become more popular. Again, of course, more in the natural community, more so than traditional community.
Tye: Now, what about guidelines? You're saying that it's not as popular throughout the traditional Dentist? What about any safety guidelines or anything like that, any regulations that might stop it and why it's not as popular?
Dr. Kempter: Oh, well, it's actually because it was actually used in medicine before the FDA was officially founded. It's actually a substance that grandfathered in. In terms of regulations, there are boards, there are certain organizations that you should go get certification for, to know how to properly use it because there is a right way and a wrong way to use it.
I got my training through the IAOMT, through a sub-organization from that, so I have my certification. I'm actually going back for my advanced training sometime in the next year or so. As to why it's not used in traditional offices again, I think it's an education thing but it could also be an overhead thing.
Some people probably don't want to make the investment in it if there are other products that work pretty well in terms of sensitivity in cleaning a tooth afterwards, Chlorhexidine and GLUMA, things like that.
In our practice, we want to minimize and use the most natural things and being that Ozone is very natural and found in our environment and the only byproduct after using it is oxygen and water, it's a product that we're definitely more inclined to use than compared to a chemical product.
Tye: Dr. Kempter, this has been very helpful and informative. I'm sure our listeners will get a lot out of the information that you've shared. If anyone wants to follow up with any questions on what's the best way to reach you.
Dr. Kempter: You can check out our website at www.kempterdentistry.com. You can also give our office a call, our staff is very knowledgeable and sometimes my brother and I are available to answer questions. Our number is area code 704-782-0797.
Tye: Thanks again for joining us.
Dr. Kempter: Tye, you're very welcome. Thanks for having me.