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How Your Mouth Connects To Your Heart with Holistic Dentist Dr. Stuart Nunnally
When it comes to heart health, there is not much more important than dentistry. Holistic dentistry is the key. Holistic, biologic or whatever you want to call it. This is what we need to discuss because heart disease and oral health play hand in hand so well. That’s why I brought on Dr. Stuart Nunnally on to the show. If you don’t know him, you haven’t been paying attention to the oral health summits and all the different programs that are out there on YouTube videos and all the different ways you can get access to Dr. Nunnally. He is board certified in Integrative Biologic Dental Medicine and a board-certified naturopathic medical doctor. He has all these different fellowships and content on the internet. I’ll let Dr. Stuart go ahead and introduce yourself. Stuart, welcome to the show.
Thanks, Jack. It’s a joy to be with you.
Tell me some of your histories. Why did you become a dentist and a naturopathic medical doctor? Most dentists, I wouldn’t say they’re holistic or biologic, so tell me how you’re different.
I had to get into this line of dentistry by default and that is I got sick. As a result of my illness, which was many years ago, I made the career move from traditional dentistry to holistic dentistry. Here’s what happened. I began to have neuromuscular issues. I was an incredibly fit and a competitive triathlete. All of a sudden, I began to have lots of weakness, particularly on my left side. Muscle fasciculations which are twitching muscles that people can see. Most often, we see them around our eyes but I began to fasciculate in every muscle in my body from the bottom of my feet to the top of my head. After many months of seeing a neurologist, I was finally referred to the Lou Gehrig’s Center in Houston. We were all convinced I had ALS. I was convinced of it for sure. As it turns out, I had a mercury toxicity issue. I hadn’t put a mercury filling in, in twenty years, at the time. I had always considered myself a holistic dentist but I didn’t know what holistic dentistry was all about at that time. I had a Master’s in Nutrition. I was intensely interested in nutrition and doing those things to help me from a competitive standpoint, especially in triathlons. I was not practicing from a holistic standpoint in dentistry. I was removing mercury fillings but taking no precaution myself.
Why did you stop doing mercury amalgams? Obviously, there are a lot of dentists that are still putting in mercury amalgams. They’ll go to their grave literally early believing that there is no problem with mercury amalgams. Why did you decide that twenty years earlier?
I had been a chemistry teacher. I knew that when you mixed metals together, they didn’t all stay together. Metals do not react in a strong fashion. They tend to disassociate. I knew that mercury leached out of these fillings even though we were taught in my dental training that it did not. As a result of the aesthetic issue, as a result of the fact that mercury fillings tend to crack teeth over time and as a result of honestly knowing better, I abandoned mercury fillings early on in my practice.
From a heart standpoint, I’ve got a whole chapter in my book and the chapter is called Heavy Metal Madness because I want people to understand that it is evidence-based. It’s all over the literature that mercury leads to cardiovascular disease and brain disease, as you found out. The medical doctor is giving you the label of Lou Gehrig’s. They give it the label of ALS. As you quickly found out, you weren’t born to get that. Something caused that constellation of symptoms. It sounds like a lot of that for you was mercury. Where did mercury start with dentistry?
It started hundreds of years ago. It was used because it was a cheap filling material. Mercury, it’s mixed with the other four constituents and that’s tin, silver, copper and zinc. When that’s mixed, it’s an amazing mixture and a blind idiot can put it in a tooth. It takes almost no skill whatsoever. That’s why you can have people all around the world who placed these mercury fillings who have had very little dental training. You simply stuff it in the tooth and there it sits. It’s not going to fall out until all the mercury leaches out of it, which is a long time from now. As a result, it was used because it was cheap and because it was easy to place and lasted a long time. That’s what happened.
There’s been a fight after fight over this in dentistry for the last several hundred years as to whether not only is it safe, but does it cause more harm than it does good for by the fact that it cracks teeth. If you stick a hard metal down in the middle of a tooth and you hit on it repeatedly for years and years, you tend to crack teeth. It’s honestly one of the things that keep dentists in business. You put the filling in when the child is eight or ten. The tooth cracks when they’re 35. You do the crown. You get to do the root canal a few years later. It’s one of those things, in my opinion, that perpetuates itself.
Obviously, cardiovascular disease as well. In my line of work, how somebody comes in angioplasty and stent and then a few months or even years later, they’ll need another angioplasty and stent. Then they’ll eventually need a bypass and a pacemaker. It is like this annuity. All along the way, the cardiologists are doing stress tests on these people and other tests that people don’t need. In the metal filling, obviously the major constituent there was mercury, or at least 50% of it is. Let’s say it’s mercury. It compromises the integrity of the tooth. That’s one negative thing. The common thing I would think that people are concerned about is the leaching of the mercury from the amalgam into the body. What is the evidence that is the case?
To me, that’s the real issue. It’s a substantiated in the peer-reviewed literature over and over again. The organization which I admired most in my own profession is the International Academy of Oral Medicine and Toxicology, IAOMT.org. If you were to go to their website as anyone can go and see the library there, that has close to a thousand documented peer-reviewed references on the impact of mercury in our system that kills. Much of the literature in that library being associated with dentistry, the mercury amalgam that comes off of those fillings and its impact on our systemic health. It’s one of the reasons why I had the issues that I did neurologically. It’s one of the reasons why dentists have one of the worst track records of all professions. It has the worst track record health-wise of all professions. We’re number one in divorce, suicide, depression, and cardiovascular disease. We’re way up there. In my opinion, it’s because of exposure to mercury.
We agree that obviously, the literature says that mercury is getting into the system. It’s getting certainly into the brain leading to inflammation of the brain, cardiovascular tissue. I assume there are links to cancer and everything else that’s there. If people are reading and now they agree that mercury is bad, the amalgams are bad and they’re convinced of that, should everyone get their mercury amalgams taken out?
Probably not for several reasons. One is I have elderly patients who are robustly healthy. They’ve had mercury fillings for years. They’re fine. They’re doing well. We have other patients who report having one mercury filling, doing nothing else. They can’t recall anything else. These patients have a neurological event afterward. It may be something like MS. It may be something like Lupus. It may be some bizarre autoimmune issue. It may be heart disease. No one can put their finger on it. We all know that the literature in terms of Mercury’s predilection for heart tissue and for neurological tissue. Your question is a great question. Should the general public rush out and get their mercury fillings out? I would say if their dentist is accustomed to removing these in a safe manner, then absolutely.
There is a protocol that’s been established by the IAOMT. Again, you could go to that website, IAOMT.org. You can search for a SMART certified dentist. SMART is an acronym for Safe Mercury Amalgam Removal Technique. Every dentist that’s SMART certified has gone through the training process and should be doing this properly in his or her office to make sure that the patient doesn’t suffer a mercury exposure when the mercury amalgam filling is removed. Because if they are not removed in a safe way, the patient is exposed to a higher level of mercury than if the fillings were left alone.
I definitely want to get to your explanation of that with how it should be done in the appropriate way. I do want to ask you once again, there are plenty of 75-year-olds that are out there, 65-year-olds that are out there that say, “Why would I get my amalgams removed? They have been there for 45 years. I feel fantastic. I don’t have heart disease. I don’t have cancer.” Stuart, I’m sure you would agree that everybody is healthy until they wake up one day and they’re not. If we want to be proactive, is it not best to have them removed?
It is. I grew up in a house that was built with all kinds of asbestos in it. As far as I know, I have no asbestosis or mesothelioma. As far as I know, my lungs are clear but would I want to move into a house that would still have asbestos in it or if I lived in one now, would I continue to do that? Wouldn’t I do something about it? I would. We know the issue. Would I live in a house that had lead-based paint? No, I wouldn’t. There are these common sense things that we would do. Our mercury amalgam filling is 50% mercury. If they know it, I don’t think anyone would say, “Go ahead and put a little dose of mercury in my teeth because maybe I’ll beat the odds.”
Can you imagine that? The medical authorities, everybody would say that mercury is dangerous. Mercury used to be in the sphygmomanometer. Mercury was in light bulbs. If a light bulb breaks, you’ve got to basically call in a HAZMAT team. For some reason, mercury is safe when put in the mouth or inside of a vaccine.
Let’s take it a step further. If you had a mercury filling and you came into my office and I removed it safely, all the pieces that I took out of that tooth would be put into a special jar. It would be hauled off by someone who has a HAZMAT license. Does that make any sense? It’s one of the most remarkable things in all of medicine or dentistry.
There are online videos that people can see of you and others performing safe amalgam removal. Can you give us a couple of things on what our audience could look for or question their own dentists with? The obvious thing is to go to the website, find a holistic biologic dentist and then ask them the questions. Start with that group of people. Tell us what the protocol is. Can you describe some of the protocol?
The most important thing would be the fact that when the dentist sits down to do the dentistry after that patient is numb, they would put a rubber mask over the tooth. That’s known as a rubber dam. It isolates the tooth and it keeps the particulate that’s drilled out from going down the hatch and the patient being exposed systemically. The patient would also be draped. In fact, in our office, no part of the patient’s skin is exposed. Every millimeter of the patient is draped and covered because some of the particulates does escape into the room. For that matter, my staff and I are completely draped.
In my opinion, if a patient goes in and they don’t see or experience a rubber dam over the tooth, or if the dentist says, “Yes, I’ll protect you, but I don’t feel the need to put anything on.” That would raise a red flag for me. One other thing would raise a red flag for me, and that is if the patient said, “What happens to all of the mercury waste that goes into your suction here at the office? Does that go into our municipal water supply?” The truth of the matter is in most places it does. We as dentists are one of the largest contributors to environmental mercury burden that there is. If he says, “No, we suck it right up.” “You don’t have a mercury amalgam trap on your vacuum devices so that you collect the mercury amalgam?” That would be a question for me that I would want to ask.
What about for people that may have amalgam under a cap or a crown? How would people best be able to find that out? A lot of dentists would say, “It’s safe. Now, it’s enclosed and it’s encased.”
That’s the typical response because we as dentists we forget our chemistry and our biochemistry after we graduate. The truth of the matter is there is no barrier to mercury. When we encase it with a crown, it simply percolates through the tooth into the surrounding tissues. That’s very well-documented in the literature. What we would say to that patient who wants to know is there is a meter. It’s a microamp meter. It measures a current in millions of an amp. We can literally take that amp meter. We can put it on the tooth and most places, it’s known as a Rita Meter. This little meter we’ll go onto the tooth and you can measure literally the current that’s coming off of that. At a certain current, we have a very high predictability of whether there’s mercury underneath that crown or not. Interestingly enough, there are some crowns that are translucent enough that on an X-ray, you can see the mercury filling still underneath it.
Would a cone beam CT be able to pick that up?
Not typically. We like a cone beam. We use it routinely but it’s not great for that.
Stuart, I’ve got to thank you for being on because I promised this was going to be a somewhat short episode, but I’m afraid I lied. I’ve got a lot of things that I want to ask of you. This is all so critical that people don’t understand how important the teeth are to total health. If anyone’s reading this with children and grandchildren, please make sure to take care of those children’s teeth now before they are literally screwed as an adult.
As a grandparent, it makes me cringe to think about one of my grandchildren having some kind of burglary assault whether it would come from a filling or whether it would come from a vaccine. It petrifies me to think of that.
Tell me how detrimental is sugar consumption for the child? I was at an event a few years back and it was a fundraiser for John McCain. It was cosponsored by Delta Dental Insurance. Delta Dental had a three-pronged approach that they said they were doing for children’s oral health and wellness. One was regular dental checkup, number two was fluoride in the water and number three was regular brushing and flossing. Not one of those three had to do with the child’s diet.
That’s where it starts. Delta Dental and I wouldn’t agree on too many things. The first thing is we wouldn’t ever want to expose a child to fluoride mainly because fluoride is such an incredibly active element. It is the most active element on our entire periodic table. It loves to compete with that child’s iodine for the child’s thyroid. We can go on and on. We would never want to expose a child to them especially to the amounts of fluoride that you would get in a typical dental office.
Even worse than that would be to expose them daily to the fluoride that’s put into a municipal water supply. To doctor up our municipal water supply with a known poison, a toxin which fluorine is and to then suggest that we all would drink that when it, believe it or not, has no impact whatsoever on caries. We’ve all been led down this path to believe that fluoride in our municipal water supply prevents caries. It does not. There’s only one peer-reviewed paper ever that showed the possibility that it did, but there have been multiple papers to demonstrate that fluoride applied systemically by drinking, does not impact incidents of decay. It does impact other issues including causing fluorosis of the teeth, including the fluorosis of the bones, including osteosarcoma, especially in young boys.If the mercury amalgam is not removed in a safe way, the patient is exposed to a higher level of mercury. Click To Tweet
There are a number of issues including lowered IQs for people who ingest fluoride. Fluoride would not be one of the things that I would recommend at all. Instead of devoting that time and the time the hygienists would spend delivering a fluoride tray if she spent that time with the mom and child suggesting that maybe we eliminate sugar from the diet. Maybe we don’t have a Coke a day. Maybe we do water with a little Stevia in it or something. We have so many things we could do to improve decay issues and health issues rather than what we’ve done traditionally.
Can you imagine myself and all the other millions of children that would sit in that dental office? I can remember it like it was yesterday with the fluoride tray and you’ve got to pick your different flavors. That was after they filled one of your cavities and they gave you the fluoride tray. You’ve got this little piece of paper from the dentist that said, “Good for one free ice cream cone.”
The other thing they said is, “Be sure you don’t swallow this. Make sure you spit it out.” One of the major reasons for children to be admitted to ERs in this country is ingestion of fluoride.
I haven’t looked into the links of fluoride usage and increased cardiovascular risk. I know if we dig enough, we will find those links. I’ll probably do a blog post on that. I’ll send it to you for review and commentary as well. How all that plays out and that’s undoubtedly true. Tell me about root canals. Obviously, root canals happen so often. There’s a whole profession of dentistry. All they do is root canals. They will defend that to their grave as well. Tell me the general issues with root canals. I want to ask, did you ever see the movie, Root Cause?
I did see the movie, Root Cause, and I was interviewed for that new movie. I’m very familiar with it.
I know that Tom Levy had so much screen time. It was a funny movie. I’m sure you remember that one scene where he talks about how he sees 50 different providers for his health problem. He’s going to a shaman. He’s going to a massage therapist. He’s going to some other like Buddhist monks. He’s done everything. Those of us that have been around people that have done everything, including patients and family members. To see this guy up on the screen go through that, it was hilarious. You were in Root Cause and everybody should go see that movie.
I do think so. The producer-editor of that who’s an Australian did a fabulous job on conveying that story. It’s not an easy story to tell. There’s a lot of emotion within that story for many people. Tom Levy, who you mentioned had a life-changing experience after he had his root canal teeth removed. He’s a cardiologist. He’s written a fabulous new book called Hidden Epidemic. It’s one of the most well-documented books that we have in dentistry in the last few years. It has many peer-reviewed references in terms of the systemic health issues related to root canal treated teeth. Root canal treated tooth is the tooth that’s had the nerve and blood vessels removed. Most times it does a pretty good job of eliminating the pain and the tooth.
Typically, these are infected teeth. The root canal relieves the pain because the nerve is removed from the tooth, the source of blood supply. The problem is that there are many intricate miles of little microtubules that the dentist cannot get to. A single rooted tooth has two to three miles of microscopic tubes. Under a transmission electron microscope, it looks like a honeycomb. There are so many porosities in teeth. We think of them as being hard as a rock and like a piece of granite. They’re not. They’re honeycomb. Through the root canal procedure, you’ve eliminated the body’s own mechanism of cleaning this tooth up because you’ve severed the blood supply to it through the root canal treatment in itself.
You’re left still with a tooth that has bacteria in it. There’s no known way to sterilize a root canal system. It may be for example, when ozone is injected into root-canal-treated teeth or around teeth, maybe it eliminates all of them. We don’t have a good study to show that. If the tooth is left unchecked, dead in the mouth, there are plenty of bacteria that can again re-infiltrate this tooth and re-infect it. We don’t know yet whether ozone completely eliminates. We know it helps. We don’t know whether that, for example, helps eliminate the infected tooth.
We know that antibiotics will only work on a very temporary basis because you cannot deliver them into the tooth. There’s no blood supply. The problem with root-canal-treated teeth is that the bacteria sits there. They have a heyday and their end-products which are exotoxins will then pass out through the tooth. They get into our systemic circulation. They can cause a whole host of problems. Most dentists don’t want to acknowledge that fact. I was one of them, Jack. I did hundreds of root canals until seventeen years ago when I became acquainted with the literature associated with this. I read for the first time Weston Price’s book, 1,200 pages on this issue of a root canal or infected teeth and systemic health issues. I couldn’t believe it.
Weston A. Price, when you go into a dental school, that should be the first book that you read almost as much as when I went into osteopathic medical school. I wish somebody would have stood up in front of the class and said, “We’re going to teach you about twenty different skin lesions and fifteen forms of hepatitis and twenty different forms of cardiomyopathy, but we want you to know that all illness, all disease is because of poor nutrition, environmental pollutants and an unhealthy lifestyle.” Wouldn’t that have been amazing if they would have said that at the beginning of your training as well?
If those much time had been devoted that as it was pharmaceuticals, think how enlightening it would have been.
My book is called The Paleo Cardiologist: The Natural Way to Heart Health. It is about eating like the wisdom of our ancestors. Everybody talks about all these different diets and should we go vegan? Should we go Keto? Should we go Mediterranean? Weston A. Price documented it. The explorers, Captain Cook and Magellan, they documented how these native populations ate. Why do we have to try and reinvent the diet if we follow Mother Nature?
You and I have seen this, Jack, time and time again. The healthiest patients that I see in my practice are those who have followed their ancestral diet. If I see an Asian in my practice who has adopted a European diet here, a diet that’s high in meats and saturated fats and those sorts of things, they’d have a tough time and vice versa. If I take a good old Texas boy whose ancestors came from Germany, you try to put that patient on a high-carb diet. I’m talking about a complex carb diet. I’m talking about a diet that’s common to those in the Philippines, he doesn’t do well on that either. I love what Weston Price discovered. It’s that when people stay on their indigenous diets, they thrive. They have great strong skeletons. They have a jaw that will accommodate all of their teeth and they thrive. In America, we’ve adopted our own special, sad American diet, which is pitiful for any culture. Nutrition is the number one most important thing in terms of dental issues and systemic health issues.
If somebody with a root canal who gets them removed, does everybody get the root canal? Having a metal amalgam removed or several, that’s something you can sell to a patient. I can sell to a patient, “I’ve got to get you to a holistic dentist and have that done.” Now, you start talking about tooth removal. You start getting some pushback.
You do. I don’t blame them because when we remove a tooth, you’re presented with a whole new set of problems. You have to weigh the tradeoff. In my opinion, would I have a root canal treated tooth? Absolutely not. I would not. I had done one for my wife 25 years before I knew the research. We removed that too because I could restore it in a way. She has a beautiful little bridge there. She doesn’t even know she had a tooth removed now. It’s not always that simple. What if someone has six root canal treated teeth? I got to come beam on a patient with fourteen root canal treated teeth. What are we going to do for this lady? Now she can barely get out of bed. Can we attribute that to her root canal treated teeth? The truth of the matter is we can’t unless we remove all of them and then we see her have an amazing recovery.
These are not easy issues. When you say, “Do we encourage every patient to have the root canal treated teeth removed?” This is what I say, “No, I absolutely not.” What I do is I inform my patients. I give them an incredible educational journey and let them help me and them make an informed decision. Will I tell them about Tom Levy’s newest book? Absolutely. I’ll tell them about it. There are at least four very recent studies, peer-reviewed studies in there, that point very directly to root canal treated teeth and cardiovascular disease. There’s another study in there, peer-reviewed study that points to cerebral accidents. In other words, having a stroke and root canal treated teeth. We could go all the way back to Weston Price and his work and say, “Look at this incredible body of work. The evidence that systemic health issues can result from our teeth, root canal treated teeth, is one of the most toxic of all entities that we could have in our body.
I’ll see someone who’s 85 years old, robustly healthy and has probably multiple root canal treated teeth. We’re not all impacted by the same token. The biggest thing is let’s say someone presents to you, they’ve had an MRI. They’ve had a heart attack. No one has ever even thought about, “Could a root canal treated tooth have been either the cause or the thing that exacerbated that heart attack or caused the inflammation which led to the heart attack?” The problem is there are not enough people like you who are looking at teeth as a possible issue. It’s not an easy treatment to say, “If this person gets it, the next one is going to get it to.” I want to have that discussion with them and let them make an informed decision.
Not only obviously is root canal removal a lot of work, but there is also an expense to it. We’ll talk about do we do an implant? Do we do a bridge on those people? Is it causation or is it association? The people that eventually need a root canal done, maybe they’re living the unhealthy lifestyle compared to others and therefore they have increased cardiovascular and stroke risk. That being said, let me tell you what my approach is for someone in general. It’s to say, “You either are at risk for cardiovascular disease or you’ve had cardiovascular disease. I want you to follow this diet as close as possible.
I want you to live the healthiest life as close as possible. I want you to go to sleep with the sundown, awake with the sunrise, get the sunshine, get away from stress, get away from environmental pollutants and chemicals and toxins. I want you to get chiropractic care. I want you to see a holistic dentist. I want you to do all these things.” Let’s check your markers of inflammation. If there’s still inflammation, if you’re still on fire, if you’re still feeling sick for those that are symptomatic, then you’re the person who should have that root canal tooth removed. We try to find maybe a little more objective evidence. We’ve cleaned out so much of this stuff, but there are residual problems here. It’s got to be coming from the tooth.
That’s a great approach unless you suspect that the tooth is the direct cause of the heart issue, which occasionally as you know, you will see a robustly healthy person who maybe I hear and/or see these people all the time. They say, “I’ve been perfectly healthy. I didn’t even have any elevated inflammatory markers like C-reactive protein and others. I didn’t have anything elevated. I had a root canal treated tooth and I had a heart attack.” I see that that patient gets referred to me a lot. In these cases, I wish the surgeon, whether they did a stent or whether they did a bypass, I wish they would take a sample of that and hang onto it so that we can DNA test that against the extracted tooth, see if we can match those bacteria. Levy’s book points to this, that you can absolutely match those bacteria.
I’ve not read Dr. Levy’s book but certainly, the bacteria that are in the mouth, they wind up in the heart. Are they innocent bystanders there? Are they causative? I’ve got no doubt that obviously, the body is one. The body is all linked, therefore it’s causative. I’m sure you’ve seen those cases as well where somebody had a root canal done and a month prior, they had a heart attack. Now, they’re seeing you and you’ve got that history that they were temporarily interrelated.
I see it all the time.
Out of those fourteen teeth that you’re talking about in your patient, can we focus in on which one or two or three are the real problem ones? Are there ways that we can look at meridians? Are there homeopathics or any scans that we can use to give us some guidance on that?
Once again, I’ll refer to Levy because his book is fresh off the press and because he makes a statement. I have a quote that he makes in the book. He says, “The vast majority of the adult population of the world has at least one significant tooth infection.” He says, “Yet these teeth nearly always go undetected as you and I know and are rarely addressed.” He says, “Nevertheless, it is these teeth along with infected tonsils and infected gums that caused the vast majority of heart attacks and cases of breast cancers.” He made a bold statement. He backs it up with the research.
I will say that there are some teeth and he makes this point in the book that seemed to be more infectious than others. Those are root canal treated teeth or non-root canal treated teeth, dead teeth that have a radiolucent lesion on them. In other words, when you take an X-ray of these or a cone beam, you see an infection at the tip of the root of the tooth. In this book and in the literature that’s commonly referred to as chronic apical periodontitis or CAP is the acronym. When a patient has a tooth with CAP associated with it, chronic apical periodontitis, Levy makes the point that those seem to be the most infected. Those seem to be the teeth that caused the most systemic health issues.
We don’t see many of those on our typical standard dental radiographs, two-dimensional X-rays that we all took for years that most dentists still use. When you have a cone beam X-ray taken, 40% of the X-rays that looked normal to the dentist will now show CAP associated with them. Seventeen studies had been done to determine how often these two-dimensional X-rays are not accurate. 40% of the time in these seventeen studies, there were lesions or areas of infection associated with the tooth that could not be seen with a normal X-ray. Those are the teeth that looked like they cause the most problems.
Would an abscess in that area be the next space above? Does that mean an abscess will be worse than that or are they almost like sister diagnoses?
They’re sisters. Whether it’s an acute abscess, it’s draining or where the patient has swollen or whether it’s chronic. This is a chronic abscess. In other words, the body has encapsulated this with either a little cystic lining or very dense bone around it called condensing osteitis. Whatever the body has done to help protect you from it, it’s still a chronic infection, chronic apical periodontitis.
I’m going to assume without reading Dr. Levy’s book and I will, that Dr. Levy’s saying pull the tooth?
Whether it’s CAP or we call it an abscess, the cone beam shows it, the tooth has to go. There’s no way to sterilize that. There’s no way to fix that. Could people undergo a radical lifestyle change to try and save that or do you think once that that is diagnosed, are we at the point of no return?
We’re at the point of no return. I hang out with a lot of holistic dentists and holistically-minded physicians like yourself. We’ve tried lots of things like ozone injections into those areas. I’ve seen a patient repeatedly for ozone therapy. It’s interesting. That does seem to help quell the infection especially for someone who has an acute infection. Let’s say for example you’re leaving for Europe for three weeks. You come into my office with a toothache and we identify the fact that truly you have an abscess or maybe you have one of these chronic lesions or chronic apical periodontitis and now it’s become acute. You’re in pain. You’re about to get on a plane and be gone for three weeks. The last thing you want to do is to have a tooth removed a few hours before you leave. What we will do in that case is we will inject ozone around that. We’ll put a little anesthetic and ozone. Oftentimes that will bring that infection right down. The patient will be fine for weeks but typically that reoccurs. You’ll have a rebound.
You can inject that with ozone in lieu of going on antibiotics?
Yes, positively. I will say as a backup, if the patient is going to Europe, I would give him a script for an antibiotic. Go get it and put it in your bag. If this isn’t gone and you’re on your trip, you might have to resort to the antibiotic. We try to avoid them.
Any experience with things like a natural antimicrobial, Berberine, oil of Oregano or using silver hydrosols? Any of the therapies that you would say that we can use instead of the antibiotic?
I love those when we have an issue that’s more topical, like periodontal issues. I especially like using silver products. Some of those can be very helpful especially when we use the Waterpik and we jet them under the gum line. When we’re talking about a lesion that’s intrabony, it’s not in the gum tissue, it’s in the bone, ozone can get to those but the other products don’t do that well.
Isn’t that the problem in the first place because that area is not well-vascularized? Even antibiotics sometimes can even fail to get into that area to control the situation.
Many times, the bacteria associated with these have become resistant to antibiotics. It’s not uncommon to see a patient who’s had a root canal treated tooth that’s flared up repeatedly over the years to be on multiple antibiotics. Amoxicillin, one after another, clindamycin, one after another. These bacteria become resistant.
What does the endodontist think when they see someone who had a root canal tooth who comes in with an infection in that area? Do they have to shake her head and say, “What am I doing? What’s my career choice?”
What’s happened as we associate success with lack of pain, root canal treated teeth most oftentimes are fairly free of pain but not always. If you ask a patient, “Can you chew on that root canal tooth like you do all your other teeth?” “No, I can’t.” “What happens when you tap on that tooth?” “It bothers me a little bit but I can live with it. I’m fine.” That’s fine but many times the patient is not totally asymptomatic. I published a study on this very thing five years ago that showed the very best root canal treated teeth, when we submitted those to the University of Kentucky for a toxicology study, these were all extracted teeth on patients who had been referred to our office. These were the best of the best. Perfectly done root canals, 100% of them had a high degree of toxicity. These are the best. These were asymptomatic. The patients couldn’t tell the difference between this tooth and any other tooth. A lack of pain is not synonymous with success. It’s not synonymous with success in cancer treatment. Most cancers aren’t painful until they’re end-stage. It’s certainly not synonymous with success in terms of periodontal disease or diabetes or most any other disease. Somehow we have begun, in dentistry especially, to think that if it’s not painful, it must be fine.
It’s the same thing with cardiovascular. Nothing is ever painful for us until the very end. We decided that there is inflammation, there is an illness. We think it’s related to the root canal tooth. We decided to have it extracted. What is the protocol for the extraction? What are the things that the dentist needs to do during that extraction?
The dentist needs to be skilled at removing teeth. Many times, that’s best left to an oral surgeon who does that routinely. We want them to clean that site out really well. One of the biggest game changers for us in the last ten years in terms of getting these extraction sites to heal properly has been the use of platelets. We love to concentrate the patient’s platelets. We draw extra blood before we do the procedure. We spin their blood down in a centrifuge. We collect their platelets into a plug that’s called a platelet-rich fibrin technique, PRF in the literature, platelet rich fibrin. We pack those platelets into the surgical site. I’ve never seen anything heal like this in my life. We’ve been doing this for six years. It’s been a game changer. Oftentimes too in dentistry, when we take the tooth out, we don’t take the time to curate out and get the infection out.
It’s important to clean out what’s called the periodontal ligament, which supports the tooth to the bone. Cleaning that out then filling it with platelets is key. I like to even use other things. We love to use intravenous vitamin C because that’s such a great detoxifier and because it speeds healing. I like to do other things like having an acupressurist or acupuncturist see the patient immediately after to reopen that meridian to reassert reestablish the energetic pathway. Dead teeth are culprits in blocking energetic pathways. These are incredible meridians that God put in us where these wonderful lines of communication can get blocked when you have a dead entity.
You mentioned oral surgeons. I had an oral surgeon remove my wisdom teeth. It happens to be a very close friend of my father. I said to my friend, “Can you ask your father if he cleaned out my periodontal ligament? The response came back and he said, “I don’t remember and who cares?” Just like anything, whether it’s a cardiovascular surgeon, a brain surgeon or a dentist, it’s about your brains but it’s about your hands. I’m sure there are some oral surgeons out there that you wouldn’t trust to operate on a mouse let alone on a human’s teeth. You’re not an oral surgeon yet you do this stuff every day.
I do it by default. I do it because I’ve visited years ago with my oral surgeons who said, “I’d like to follow this protocol,” but they were very resistant. Interestingly enough, they become much more amenable to this because it’s more common in the literature. People are more aware of the fact that we need to clean these areas out. It’s very helpful to put platelets back in. I do it because I had a lot of extra training doing mission work in Central America, removing lots of teeth and I felt comfortable with it. Then I began to see the benefits of doing this in a way that I was exposed to when I got sick myself. I said, “I can’t go back. This is what I’ve got to do from now on.” There are many dentists who do this beautifully. In fact, we’re having more and more oral surgeons join the International Academy of Oral Medicine and Toxicology because they said, “There is something to this fact that when teeth are removed, it doesn’t always heal. Sometimes it precipitates into what’s called cavitation or osteonecrosis of the jaw bone. We want to prevent that at all costs because now you have another a chronically infected area.”
This goes back to also the amalgam. If they’re going to have the amalgam removed or if they’re going to have a root canal tooth removed, how should we best prepare ourselves for that? Also what are some of the strategies that you use?
I’m very fortunate in that I had many physicians like yourself who help prepare patients before they have something like this done. If the mercury filling is removed properly, the patient’s not going to have a mercury exposure and they should do very well. The flip side of that is once you don’t have a 24/7 mercury exposure, your body can start to detoxify and a patient can have some bizarre may be flu-like symptoms, even though they didn’t get exposed, they’re becoming re-exposed. They are retoxified as the body begins to get rid of the heavy metals. That can happen. It’s nice to have a patient being seen by a healthcare provider who knows how to recognize that and may give some patients gentle things to help bind those metals and help eliminate those metals.
Typically, those were eliminated through the feces, some of it through the kidneys. In terms of what can someone do to help get these bony areas to heal properly when they’re operated on or when teeth are removed, there’s nothing like leafy green vegetables to help build good bone. I love to see patients on beautiful, healthy green vegetables especially follow their ancestral diet. Follow that diet where you know you feel robustly healthy. Where you feel like you can eat and run a 400-meter dash an hour later. That’s what I want to see. I want to see a patient eat like that and they will have their body prepared in advance. If I see a patient as we do so many who are chronically ill or who have Lyme or who have so many different autoimmune issues, I do like to see those patients supported by a healthcare provider who’s helping them with their sleep, who’s helping them with their nutrition, before they get to us. It makes everything easier.
It’s so needed for people to hear this kind of information. This is so huge. Obviously, Stuart is not only practicing holistic dentist outside of Austin, Texas. I would assume obviously you’ve got books. You’ve got materials. You’ve got videos. You’ve got a thriving practice down in your area.
We are. We’re incredibly busy. We love the part of the world that we live in. It’s a beautiful rural area. There are parts of the world that do still have fairly clean air and clean water. We’re in one of them. We love it for ourselves and we love it for our patients.
The root canal tooth is removed. The PRP and the things you do, number one, you want to make sure that the bone that’s left, you do strategies and techniques to increase the bone growth and to make that as healthy as possible. You can decide on an implant. There are two different types of implants. There’s zirconia and there are titanium implants or you can do some bridge or other appliance. If you are going to go for an implant, it always blows my mind when people basically they’re going do a root canal tooth removal. Then they’re going to do an implant. Is it recommended to do it the same day or the next day that the dentists are doing this?
There are many who do. There are some implant dentists who I admire who fill out and who do get good results doing that. It’s because they get the sites out. One of my dear friends in Munich, Germany does this routinely. I see his patients sometimes from the United States. Their implants seemed to heal flawlessly. It’s a matter of who’s doing that treatment and how comfortable they feel doing that procedure. Most of the implant dentists that I work with in this country like to have a healing time after you have a tooth removed. The reason is the area from around an infected tooth becomes very acidic. When you have an acidic situation with a low pH in the bone, it tends to dissolve the bone rather than create new good bone. We want to make sure that’s resolved before the implant is placed. Most dentists would use that particular treatment method where you remove the infected tooth, wait a few months, come back and put the implant in. I have seen it done otherwise and quite frankly, to my surprise, most times it seems to be working. In my own mouth, I would opt to have the tooth removed, let a period go by and then come back and have the zirconia implant placed.
As a cardiologist, I would agree because that only makes sense. I’ve seen people who have got upper and lower dentures. It’s not the old-time dentures that my grandmother had that were removable. These are the ones that are screwed into the post that’s inside the bone. Those bone posts were very inflamed. Therefore, the post had to be removed. In the same day, they were going to put a new post. I said, “That doesn’t jive.” He chose to follow my advice. He’s doing well.
I think that’s smart.
Zirconium versus titanium? There is a holistic dentist that I know in my area where I practice in Arizona. Her opinion is that something happens with the zirconia it starts to break or it starts to crumble, it starts to fracture. She says it’s impossible to clean out. She said it’s even worse than mercury. Maybe give me your two cents on the reality of that situation.
I have had to remove some zirconia implants. It’s not a fun part of the day because they’re not easy to get out if they’re fractured. The truth of the matter is very few of them fracture. I understand her point. To me, I honestly wouldn’t have a titanium implant. We know that titanium has been used as a prosthetic device joint for years and years. There’s no good study that shows what the health impact has been off all these titanium devices. We don’t know. We do know more and more. There’s more data in the literature about toxicity associated with titanium. The fact is most titanium implants are not pure titanium. They’re alloyed with other metals that can be a real health issue. I have an issue with titanium implants because of that and because of the fact that they can block these beautiful energetic channels again that I spoke about a while ago.
If they’re on a meridian for example, that is on the same meridian as your gallbladder, I see this frequently, people can have digestive issues because of gallbladder issues. Interestingly enough, people who are skilled at testing this, who are skilled at testing for these wonderful energetics will say that zirconia does not have that same impact. To me that’s significant. It’s not significant so much in Western medicine. We don’t acknowledge that but the Eastern medicine people would say that’s more important than any bacteria ever. These energetics are incredibly important. I’ve seen it over and over and the years that I’ve been practicing,
Zirconia is the way to go if we’re going to do an implant but how do we decide? Should we do an implant or some kind of appliance?
That’s a patient by patient decision. There are not one-size fits all there at all. In my own mouth, for example, I had a tooth removed and the two teeth on either side of that too, let’s assume it was what’s called the first molar. I have a second molar behind it and I have a tooth in front of it called a bicuspid, and one missing in between. If those two teeth happened to already have crowns on them, this is a no brainer for me, I simply take those crowns off and make a bridge because I don’t have to do anything more invasive to those teeth. They’ve already had the invasive procedure done when they had the crown done. All I do is slip those off. I make another new crown on each of those two teeth with a false tooth in between.
We bond that in and that’s a bridge. The patient does not have to go through another surgical procedure to have an implant. What if those two teeth have never had any treatment done on them and I’m missing a tooth in between? Would I grind to perfectly good teeth down and put crowns on them to make a bridge? I would not. To me, that’s far too invasive. In that case, I would do an implant. I would only do the implant, zirconia or otherwise, on a robustly healthy patient. I would not put that implant into a patient who had an autoimmune disease, who had Lyme, who had any other degenerative disease where I felt like I was going to impact their immune system negatively or challenge their immune system. We should do implants on a patient by patient basis.
Does it matter the location? We mentioned the movie, if they have got one front tooth, that’s more likely you would do an implant to one of the front teeth because maybe that’s important maybe for the bite or whatever as opposed to something towards the rear.
I have a tooth that I took a blow to in a car wreck. It’s still a vital tooth. At some point honestly, that tooth may die. If that tooth dies, I’m certainly not going to do a root canal on it. I’m going to remove the tooth. I don’t want to grind my two beautiful teeth down on either side of that for a bridge. In my case, since I’m doing so well health-wise, I would have a zirconia implant placed.
My wife pushes this on me as well. She’s like, “The first thing you got to do is address the teeth. You’re like when people come in, you’re not even on a conversation if they got mercury, if they got root canals.” My wife, as a chiropractor, feels so strongly about the teeth I’ve been to conferences where, especially in some of these holistic cancer doctors, they say the first thing that’s going to happen that you’re getting a cone beam CT is to look for chronic infections and to also look at the cavitations. Explain again what the cavitation is, the importance of it and then we’ll talk about what to do about the cavitations.
Cavitation is typically an area in the jawbone. The jawbones are the most common bones for cavitations to develop in. They’re not the only bones were cavitations develop. Cavitation is an area in a bone that has a very sluggish blood flow or no blood flow. It may be completely necrotic or dead. That area is filled with typically with anaerobic bacteria. They’re toxins. That’s what it is. It’s a little cesspool of bacteria that get to live in this wonderful warm environment and does not have much of blood flow there to come to deliver the body’s own immune defenses to it. The jaw bones are common because when we remove teeth, first of all, jaw bones don’t have great blood flow to them. When we remove teeth, we as dentists typically use anesthetics that have a compound that’s known as adrenaline to most people. To us, we call it epinephrine. Anesthetics with epinephrine are used because they make the anesthetic more profound. They also keep the field drier. They help shut down the blood flow.
When you shut down the blood flow to an area that’s been traumatized, you have a recipe for disaster. You do not get the blood flow to these areas that we need. People end up with what’s called a dry socket. It’s a very common thing that happens. It usually happens in the wisdom tooth area or the third molar areas. When it happens there, by the way, that happens beyond the heart meridian. When we see these, what they look like is literally, Jack, it’s very interesting, they look like an oil slick when we opened them up. The reason is inside a bone when you get an anaerobic or dead area, you develop a preponderance of degenerative fatty cyst.
Bone marrow is fatty anyway, but when the area becomes necrotic or it has no blood flow, when it becomes anaerobic, you get this whole area filled with degenerative fatty cysts. When we open these up, we make a small incision. We lift the outer surface of the bone off and then we clean this area out. It usually does look like an oil slick. We clean that out, irrigate it well with sterile saline and ozonated water and those sorts of things. Fill it with platelets and then you can get these to resolve. A cavitation is typically an area in the jawbone which I think oftentimes is caused by us as dentists using too much epinephrine when we do the treatment to remove the tooth.
Obviously, this would be something that’s very common with wisdom teeth removal. Every new patient that I see, we take that intake with them. They have their wisdom teeth removed, which is why 95% of Americans these days have had their wisdom teeth removed. Whoever built us, God, Evolution, or whatever you subscribe to, they made a mistake to give us the wisdom teeth, which obviously is eloquently explained it by Weston A. Price. When your mother drank coffee, smoked cigarettes, and ate coffee cake while she was pregnant, that’s going to lead to a child that will have a small crunched up mouth where the teeth are all condensed and therefore malformed. Should everybody have their wisdom sockets cleaned out because there were definitely cavitations there, there’s definitely infection there or is the cone beam, the arbiter that decides?
That’s like asking should everyone have his root canal treated teeth removed. I would say that some people tolerate the toxins associated with cavitated areas pretty well. When I give a lecture to a room of 500 people, probably 400 of them have cavitations. That’s the truth. Many of them have all sorts of systemic health issues that no one has ever considered. It might possibly be a jaw bone lesion. We don’t know how prevalent these systemic health issues are a result of, say, jaw bone lesions. After doing this treatment, virtually almost every day of my practice for the last several years, I’ve been cleaning out these areas. I’ve seen some of the most dramatic changes in people’s health from that procedure alone than I have anything else.
What I do is I tell patients when they come to see me. If someone like you is not already informed them of these possibilities, I say, “I can see areas on your cone beam that looked like they are necrotic in your jaw bone. They may or may not be contributing to your health issues. Obviously, we don’t know because the toxicity is associated. These can go anywhere and they may not have anything to do with your illness.” I say to them, “I can see them. I think it’s best that we cleaned them out. There’s great data to show that we should clean them out.” I leave it up to the patient. I’d never want to be strong-arm a patient. The problem is we in dentistry, those of us who do this procedure sometimes were maligned for doing the procedure.The healthiest patients are those who have followed their ancestral diet. Click To Tweet
The problem is there are a lot of people that they’re not doing the procedure who never informed the patient that it could be a problem. To me, that’s more of a liability. It’s much more of a liability. You mean you can see a lesion on the mandible or maxilla, but you’re not going to tell your patient about it? It can have all kinds of a system like health issues, like an increase of pulmonary lesions, like an increase of brain lesions, like an increase in deep vein thrombosis as a result of having a job bone lesion. Absolutely.
We’re getting so many pearls, so many gems. I know you’re out there, I know you’re reading, I know you’re scared by this conversation and you should be, but the good news is there are answers and there are doctors out there like Dr. Nunnally that can help you get through all this stuff. Whatever your health issue is, cardiovascular or otherwise, certainly look to the teeth amongst many things, but nothing more important than teeth for this issue. We need to go to quality holistic biologic dentists that believe that cavitations are a problem. I tell that to people too like, “Find a doctor who says, ‘I never do mercury amalgams. I haven’t done it in fifteen years. It’s a travesty what we’ve done. I accept that I’ve been part of that, but now I’m part of the solution,’ as opposed to going to a doctor who’s like, ‘I don’t think it’s a problem, but if you want to have it done, go have it done.’” Doc, how do we make sure that we take care of the cavitations appropriately?
You have to interview the dentist. A good place to start is at IAOMT.org organization because many of the dentists in that organization are either familiar with the procedure and know where to refer patients or they’re doing the procedures themselves. When I had mine cleaned out, I went to Montreal. I’m telling you that there may not have been more than 50 people in the world doing the procedure. Now, there are thousands of us who do the procedure. It’s not that difficult but I would say most dentists, even holistic dentists, don’t do the procedure. Maybe they’re more specialized in the area of taking care of heavy metals or that sort of thing. It’s one of those things where you have to make the ask. You have to call and say, “Is this something that your dentist does regularly?”
This is the concept of routine dental X-ray. My father was a very successful cardiologist in Chicago who in his mid-50s became depressed. The depression didn’t respond to pharmaceuticals. Eventually, we take him to the Mayo Clinic. The Mayo Clinic diagnosis him with PSP, progressive supranuclear palsy, something very similar to Parkinson’s. There’s no treatment. The Mayo Clinic has no idea why. You and I can talk all day long about why my father got this. The Mayo Clinic had no idea why.
My father was a cardiologist. He was exposed to a lot of ionizing radiation in the cardiac cath lab as a cardiologist doing pacemakers angiograms for all those years. When it came to me and learning all the things that I know now, I go to a holistic dentist in Arizona. That holistic dentist sees me and says, “Jack, we’ve got to do a set of X-rays on you.” I say, “I don’t want to do that. My father died of this neurologic disease. I’ve had enough radiation to my brain. My teeth are pretty good. In fact, I’m here for cleaning. Can we go without that?” He said, “Jack, what if someone came to your office and they refused an EKG? What would you do?” I said, “Me personally, that’s their choice and if it was something they did that I did not agree with, maybe I would have them document that and saying, ‘I am refusing to do this particular procedure.’” He said, “If you do not do this, you can’t be my patient.” Then I said, “Bye-bye.” I walked out. Not to mention children that get routine X-rays. We both even agree, you as a grandfather and me as a three-time father that we’re never going to do that. That we’re in total agreement with. I’m 48 years old. I don’t have any symptoms. I’m there for a cleaning. Why do I need an X-ray?
The only reason would be because some dental infections are occult infections. They can’t be seen without a dental X-ray. Let’s say you had an abscess. Let’s say you had chronic apical periodontitis. Maybe you were never aware of it but maybe as a child, someone hit you on your molar. The molar necrosed or died. It’s been sitting there latently all these years and never gave you an acute problem. It’s a chronic abscess. It’s chronically infected. What if then you did have a systemic health issue as a result of that? It wasn’t picked up. It could have been picked up by an X-ray. I can see the reasoning. I couldn’t see your reasoning because I see it daily. We have a patient basis much like you, who are very well educated people. Honestly, if they hadn’t taken their health into their own hands, they may be struggling or dead.
I understand that. What we would say to you if you came to us and said, “I’m not doing an X-ray.” I’ll say, “Go for it. I’m all for you.” I documented it here because, in this litigious society, we have to say, “Dr. Wolfson didn’t want X-rays, let’s honor that. We’re going to take care of him anyway.” I might say, “Jack, there’s one tooth that concerns me. Would you allow me to take one picture of that tooth?” You and I could have a conversation about it. We would never want to strong arm somebody in to take an X-ray who doesn’t want it. It’s your body.
Anything else you would like to mention? We could talk about so many. We can talk about sleep apnea. We could talk about periodontitis and scalar planning and all these other things that we’ve been told I needed it in the past where I’m like, “I don’t know.” With all due respect to a lot of those dentists, everybody, I would assume most people are trying to do their best. They’re not like us cardiologists who love to do things for money. We love to do a stress test for money. We love to put in stents for money. We love to do all kinds of different devices that we get reimbursed for crazy. It’s totally true.
Jack, here’s the story. I tell this to virtually every group to whom I speak, especially lay people. The least amount of dentistry, the better off you are. That’s the truth of it. I don’t take it lightly what we do because quite frankly, people are paying me oftentimes to reverse what’s been done before in my profession. To me, that’s a very sad thing. I don’t take that lightly. I’m sad about it honestly. I’m sorry about it. The truth of the matter is we’re moving forward. We learn as we go. I hope we’re doing things even much different ten years from now than we are now and we’re trying to do our very best as we go. Lots of procedures are done in medicine that is unwarranted. The same is true in dentistry. I don’t like to admit that but that’s the truth. There’s nothing like getting with a healthcare practitioner who you bond with and who you know is telling you the truth and trying to give you the latest data and share the truth with you. That’s a wonderful relationship. That’s what I want my patients to experience.
How do our readers find out more about you?
If you Google Stuart Nunnally, you’re going to run across me someplace or another. My website is HealthySmilesForLife.com. I’m outside of Austin, Texas, a little town called Marble Falls where my wife and I grew up. We love Central Texas. I love your part of the world too.
I’ll let Dr. Nunnally get back to saving lives through the mouth and other techniques that he uses. This has been a fantastic episode. We will see you next time.
- Dr. Stuart Nunnally
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- The Paleo Cardiologist: The Natural Way to Heart Health
About Dr. Stuart Nunnally
Dr. Stuart Nunnally is a graduate of the University of Texas Health Science Center Dental School in San Antonio (1980). He maintains an integrative biological dental practice in Marble Falls, Texas where he and his partners have treated patients from all fifty states and forty-seven countries.
Dr. Nunnally is chairman of the jawbone osteonecrosis committee of the International Academy of Oral Medicine and Toxicology. He holds fellowships in the Academy of General Dentistry and in the International Academy of Oral Medicine and Toxicology.
Dr. Nunnally is board certified in naturopathic medicine and is board certified in integrative biologic dental medicine. He is licensed in intravenous conscious sedation and is a member of the American Dental Society of Anesthesiologists. He serves on the teaching faculty of the Academy of Comprehensive Integrative Medicine and The American College of Integrative Medicine and Dentistry, and he frequently teaches on all aspects of biological dentistry.