HEALTH / In the teeth of troubles: Is there an alternative to the dreaded drill and fill? As NHS charges rise, holistic dentistry may be more appealing. Victoria McKee reports

SILVIA Robinson suffered from intense migraines - until she went to the right dentist. After she had 14 amalgam fillings removed over an 18-month period and replaced with a white composite material, her headaches disappeared. 'I'd been having migraine every other day for three years,' she says, 'but now I feel wonderful. I don't get colds and I'm full of energy. I've been laughing more, too, since I don't have a mouth full of ugly black teeth]'

The woman Silvia has to thank for her happiness is Catherine Price, a homeopathic dentist and a member of the International Academy of Oral Medicine and Toxicology (IAOMT). In November, she and fellow members are organising a seminar in London to spread the word about holistic dentistry. Evangelising delegates will argue that traditional mercury fillings are poison and should be banned; others will simply be advocating a new approach to oral health, with a greater focus on patient involvement using state-of-the-art technology.

At Catherine Price's surgery in Watford, Silvia Robinson was able to watch a computerised video image of her mouth on 'Dentascope', a CD-ROM program that allows dentists to record their work and view it in full colour and fine detail. Another patient, Ann Chapman, was able to administer her own pain relief via electronic impulses from a device called 'UltraCalm', avoiding the needles that terrified her.

Ann had 15 amalgam fillings removed and replaced by Ms Price over 12 months. 'When she got half- way round my mouth,' she recalls, 'I felt so much better. I had so much energy. She's the first dentist who has made me feel all right about visiting a dental surgery.'

In Denmark, where amalgam fillings have been banned because of their alleged dangers to health, holistic dentistry as practised by Catherine Price is common. At Dr Jorgen Steen Hartz's practice north of Copenhagen, for example, an initial consultation takes one-and-a-half hours - far longer than is usual in Britain. Patients are encouraged to talk about other health problems, the dentist's aim being to treat the whole person rather than localised symptoms.

Dr Hartz, one of the speakers at November's seminar, first gets to know a patient's eating habits. These he largely deduces from examining dental plaque and the appearance of the teeth and gums. He asks about any physical or psychological problems a patient might be experiencing. 'Teeth reflect emotional stress,' he claims, 'and stress can effect biochemical change.'

One technique Dr Hartz uses is cranial osteopathy - a stress-

relieving head massage that makes the patient more relaxed. He is less likely to drill than to insert electric probes into the mouth to measure the current created by existing metallic fillings. 'If you have a current above three micro-amps, you have a battery in your mouth,' he warns his patients. 'The saliva becomes the battery acid, the teeth the electrodes, and the metal ions leak out of the fillings.'

The enamel layer of the teeth is like quartz crystal, Dr Hartz explains, so the mouth can transmit and receive like an old-fashioned crystal radio set. Schizophrenics have sometimes claimed that they are able to pick up messages from the security services through their fillings, and Dr Hartz believes this may not be as ludicrous as it at first seems. Some wrongly diagnosed psychiatric patients, he says, have discovered that the 'voices' they were hearing were indeed the impulses picked up through the radio receiver in their mouths.

Dr Hartz also believes that each tooth is linked to a specific meridian, or energy channel, in the body. An imbalance in the one can affect the other. An unhealthy colon, he says, can cause disturbances in certain teeth which can lead to toothache and decay. A high electrical current in an amalgam filling in those same teeth can cause aggravation of the large intestine, leading in turn to constipation and more serious bowel problems.

In Britain, holistic dentistry is only available privately - and at a price most patients have not been prepared to pay. With NHS dental charges rising, however, it is becoming a more attractive alternative.

One way to find a practitioner is to contact the British Homeopathic Dental Association (BHDA), which embraces the same holistic philosophy as Dr Hartz and has 100 members. Not all of them are committed to mercury-free practices, however, hence the formation of the IAOMT.

Anthony Newbury, the IAOMT's president, is a Harley Street dentist from Australia who prides himself on keeping up with state-of-the-art dental developments around the world. A sign in his surgery proclaims: 'Mercury is treated in this practice like nuclear waste.' Indeed, when amalgam fillings are being removed both he and his patient look as if they are dressed for protection against nuclear attack.

The dentist is kitted out in goggles, rubber gloves and a plastic full-face mask. His patient wears dark glasses (with a motor to blow mercury vapour away from the eyes), goggles and a mask to allow clean air to be breathed. There is a large suction funnel in front of the patient, powered by a vacuum, and a specially designed mercury filter in another corner of the room. An American suction 'Clean-Up' device fits around each tooth being treated, to suck up any stray bits of amalgam filling so they are not swallowed.

After the amalgam fillings are carefully removed and disposed of, the cavities are filled with glass ionomer cement as a temporary measure. 'Later, a surface layer of harder composite can be put on top,' Mr Newbury explains. His patients are prepared to pay pounds 150- pounds 350 for one tooth to be filled with what Mr Newbury considers the very best material available.

Experts are divided on what is the best alternative to amalgam. Glass ionomer fillings (available from around pounds 20) are made of a soft material that lasts six to 18 months, and can be topped up with stronger composites. Made from silica or epoxy resins, composite fillings (at around pounds 35 each) last for about five years. Some dentists, however, doubt their suitability for back teeth in which strength is required.

Laboratory-formed inlays can be made of porcelain, gold or isosit (a quartz-like material). They last between 10 years and a lifetime and cost pounds 140- pounds 350, depending on their size and complexity. Crowns are made with just a thin layer of 'biocompatible' gold beneath the porcelain, or in some cases totally of porcelain, instead of using a base metal. They cost pounds 160- pounds 300.

Patients are unlikely to part with such sums unless they are convinced of amalgam's dangers. But what evidence is there that the material is unsafe? In the wake of a powerful Panorama programme broadcast last month, which focused attention on the possible dangers of mercury fillings, the British Dental Association (BDA) issued a statement: 'Any mercury released from amalgam fillings does not give rise to disease or any other adverse effects; there is no significant effect on the immune system; allergic reactions are extremely rare . . . there is no justification for stopping the use of amalgam; there is also no justification for replacing existing fillings.'

Despite these assurances, the BDA recognises the importance of further research. 'We are not complacent about this important issue,' the statement continues. 'If the research produced by Panorama or at any time in the future is proved to be valid to the satisfaction of international experts, then the BDA will be the first to call for its use to be discontinued.'

For the time being, though, mercury amalgam is here to stay. The best way to minimise its possible dangers is to play a preventive game, hoping that better education about dental hygiene will stop our children having their mouths full of heavy metal, as we did. Professor Aubrey Sheiham, an epidemiologist writing in the British Medical Journal last July, argues that 'dental disease is readily preventable without dentists'.

Improved diet, oral hygiene and the fluoridation of water and toothpaste, Sheiham predicts, are the factors that may make a visit to the dentist a rarity in the 21st century.

The International Academy of Oral Medicine and Toxicology (IAOMT) at 72 Harley Street, London W1N 1AE, will provide the address of a member practising near you. Its information pack, 'Dentistry Without Mercury', is available for pounds 5 including p & p. For a list of members of the British Homeopathic Dental Association (BHDA), write to Catherine Price, 12 Wellington Road, Watford, Herts WD1 1QU, enclosing a large sae.

(Photograph omitted)