FDC2022 Speaker Preview: Focus on Successful

focus on successful treatment outcomes of adjunctive clinical homeopathy

By Diana Bronstein, DDS, M.S., M.S., M.S., DABP, DICOI, FICOI

In these unprecedented times, the challenges for dental practitioners mirror the need for implementation of new pathways to serve their patient population and all who depend on their leadership and work. Being successful with patient treatment is imperative for all practicing dentists. Treatment success is determined by the outcome for the patient who cares primarily for levels of morbidity and only then for aesthetics, function and cost. Fear of pain during and after the procedure will deter a patient from seeking care until it is the pain that will force the patient to present as an emergency.1,2

Even before the opioid crisis, NSAIDs have been routinely used in indicated cases. Contraindications in general are GI, urogenital and nephrotic conditions, as well as allergies and sensitivities to these drugs. These cases leave little choices for postoperative moderate to severe pain management.3,4

Many patients are familiar with Arnica as an antiphlogistic and analgesic in herbal as well as homeopathic form. They often are better informed than their dentist. This can impact rapport and trust. Regardless of application and use, it behooves each provider to present to the patient upon request, rounded knowledge of pain management and treatment modalities.13 To differentiate and define alternative versus complementary versus integrative medicine and herbalism versus homeopathy, on the one hand, will demonstrate the provider’s competence and, therefore, increase patient’s trust. On the other hand, it can provide another tool in the dentist’s toolbox, which has a great cost-benefit ratio.5,6

As credible professionals, we practice evidence-based dentistry, which is clinically applicable, ergo translational, as well as it being reliable and reproducible in its successful treatment outcome. Before implementing any procedure or change, we strive to ascertain resulting improvement for the patient and therefore for us. Dogmatism is a sign of inexperience.7

Meta-analysis reviews hold the highest academic level of evidence, yet most conclude righteously with the statement that more research is needed, while expert opinion, clinical experience and case reports, for example, hold the lowest level of academic empirical evidence and are considered anecdotal. The dentist in the trenches will appreciate safe and reliable means to achieve clinical treatment success.

Homeopathy has been used as a treatment modality since the 1800s and evidence of its safety and efficacy has been documented extensively,8 yet, it remains the most controversial treatment modality in the field of complementary medicine. The reasons for the polarized, at times hostile, controversy are rooted in fear of the unknown, which is the greatest fear of all,9 and lack of understanding of how a nanoconcentration can affect an organism inversely to its level of dilution. The higher the dilution, the lower the concentration, the stronger and deeper the effect. The ArndtSchulz law,10 while it is currently being applied to laser and phototherapy,11 seemingly contradicts the dosage-dependent rule of toxicity, which says the dose makes the poison. In fact, there is no contradiction, as toxicity has dose-dependent inhibiting effect on the organism. At the other side of the spectrum, the question arises how micromolecular dosage and Brownian motion energy can affect an organism at all.

In clinical practice, the most experienced and successful practitioners use, endorse, and promote pre- and postoperative intraoral topicals and ingestible preparations containing homeopathic dilutions of Arnica montana with great and reproducible success.14 Current and classic research is providing evidence-based grounds for clinical application.8,12-17

„ “ Homeopathy has been used as a treatment modality since the 1800s and evidence of its safety and efficacy has been documented extensively,8 yet, it remains the most controversial treatment modality in the field of complementary medicine.

What is holding back progress, innovation and reduced postoperative patient morbidity is lack of education in unfamiliar concepts. Even if the dentist does not change the way he practices after learning new modalities in a continuing education course,18 the next time a patient mentions dental homeopathy, the average patient will not know more about the subject matter than the dental provider, which the patient hopefully chose for his expertise in all oral-related questions.

Dr. Bronstein is a Diplomate of the American Board of Periodontology and a Diplomate and Fellow of the International Congress of Oral Implantology with a Master’s Degree in Oral Biology, Medical Education and Health Law. She is an adjunct clinical professor at Nova Southeastern University College of Dental Medicine and practices in the Tampa Bay area.

Dr. Bronstein will be speaking at the 2022 Florida Dental Convention and will be presenting her course, “Science of Evidence in Homeopathy and Applications in Dentistry,” on Thursday, June 23 at 9 a.m.

References:

1. Bürklein, S., Brodowski, C., Fliegel, E., Jöhren, H. P., & Enkling, N. (2021). Recognizing and differentiating dental anxiety from dental phobia in adults: a systematic review based on the German guideline “Dental anxiety in adults.” Quintessence International, 52(4), 360–373. https://doi-org.ezproxylocal.library.nova. edu/10.3290/j.qi.a45603

2. Sambuco, N., Costa, V. D., Lang, P. J., & Bradley, M. M. (2020). Assessing the role of the amygdala in fear of pain: Neural activation under threat of shock. Journal of Affective Disorders, 276, 1142–1148. https://doi-org.ezproxylocal.library.nova. edu/10.1016/j.jad.2020.07.110

3. Sabounchi, S. S., Sabounchi, S. S., Cosler, L. E., & Atav, S. (2020). Opioid prescribing and misuse among dental patients in the US: a literature-based review. Quintessence International, 51(1), 64–76. https://doi-org.ezproxylocal.library. nova.edu/10.3290/j.qi.a43697

4. Policy on Acute Pediatric Dental Pain Management. (2018). Pediatric Dentistry, 40(6), 101–103. 5. Lennihan, B. (2017). Homeopathy for Pain Management. Alternative & Complementary Therapies, 23(5), 176–183. https://doi-org.ezproxylocal.library.nova. edu/10.1089/act.2017.29129.ble

6. Bronstein, D. (2017). The Role of HOMEOPATHY In Oral Health Care. Dimensions of Dental Hygiene, 15(8), 55–58.

7. Ciurczak FM, & Smith E. (1984). Dogmatism, age and change: a perspective of a nurse practitioner program. Journal of Nursing Education, 23(9), 374–379.

8. https://homeopathyusa.org/uploads/Homeopathy-Research-Evidence-Base-09-01-2021.pdf

9. Rusbatch V. (2000). Fear of the unknown. Vision (11749784), 6(10), 21.

10. Schulz, H. (1888) “Uber Hefegiste”, Pflügers Archiv Gesammte Physiologie, Vol. 42 pp.517 Zur Lehre von der Arzneiwirkung. (1887) [Virchows] Archiv für pathologische Anatomie und Physiologie und für klinische Medizin, Berlin,; 108: 423-445.

11. A. Michtchenko; M. Hernandez (2006) Photobiostimulation Effects Caused for Low Level Laser Radiation with 650 nm in the Growth Stimulus of Biological Systems. Electrical and Electronics Engineering, 2006 3rd International Conference, Sept. Page(s):1 – 4

12. Zhou P, Chrepa V, Karoussis I, Pikos MA and Kotsakis GA (2021) Cytocompatibility Properties of an Herbal Compound Solution Support In vitro Wound Healing. Front. Physiol. 12:653661. doi: 10.3389/fphys.2021.653661

13. Tatch, W. (2019). Opioid prescribing can be reduced in oral and maxillofacial surgery practice. J. Oral Maxillofac Surg. 77, 1771–1775. doi: 10.1016/j. joms.2019.03.009

14. Muller, H. D., Eick, S., Moritz, A., Lussi, A., and Gruber, R. (2017). Cytotoxicity and antimicrobial activity of oral rinses in vitro. Biomed. Res. Int. 2017:40 19723.

15. Lee, H. S., Yoon, H. Y., Kim, I. H., and Hwang, S. H. (2017). The effectiveness of postoperative intervention in patients after rhinoplasty: a meta-analysis. Eur. Arch. Otorhinolaryngol 274, 2685–2694. doi: 10.1007/s00405-017-4535-6

16. Lee, C. Y., and Suzuki, J. B. (2019). The efficacy of preemptive analgesia using a non-opioid alternative therapy regimen on postoperative analgesia following block bone graft surgery of the mandible: a prospective pilot study in pain management in response to the opioid epidemic. Clin. J. Pharmacol. Pharmacother. 1:1006.

17. Fujioka-Kobayashi, M., Schaller, B., Pikos, M. A., Sculean, A., and Miron, R. J. (2020). Cytotoxicity and gene expression changes of a novel homeopathic antiseptic oral rinse in comparison to chlorhexidine in gingival fibroblasts. Materials (Basel) 13:3190. doi: 10.3390/ma13143190

18. Bronstein, D. (2016). Modifying Behavior to IMPROVE OUTCOMES. Dimensions of Dental Hygiene, 14(10), 45–49.