The realization that dental aspects could play a role in environmental medicine was only gained after the intestine was subjected to a detailed examination. The assumption that some intestinal diseases could have their cause in the higher part of the digestive tract was quite justified. What is in the mouth ends up early or late in the intestine. A fact that applies not only to food intake or bacterial interactions, but at best to any substances found in the mouth.

The perception of dental practice has long been, and in many cases still is, considered separate from general practice, either because of the emphasis on the manual aspects or because of the separate courses of study. Commonalities often arise only in the recording of the general medical condition in the context of the patient’s anamnesis. The question of whether the patient’s general condition allows this or that dental treatment predominates. Only marginally is it asked whether this or that dental treatment could also have an effect on the patient’s general medical condition.

In the isolated area of the mouth, FDA-approved materials are used with a clear conscience. In contrast to general medicine, where a preparation compatible with the individual organism is sought in consultation with the patient, here the same material is used for everyone. The market offers a wide range of products. The service provider is guided by quality, processing technique or price. The legislator does not require any information about the minimum quantities in the ingredients; in order to maintain factory secrecy, the producer does not disclose them voluntarily either.

Environmental dentistry aims to cause as little harm as possible to the patient or to repair existing damage through the careful selection of treatments or materials used. In doing so, no specialties are transgressed. Rather, treatment takes place in close cooperation with cotherapists, not least the environmental physician. In consultative work, we try to bring the clinical picture, medical and dental findings into harmony. In this process, dentistry plays an unusually important role: hardly any other medical discipline incorporates so much foreign material into the organism, no other medical discipline kills off so much living tissue in order to leave the organically decayed remains in the mouth, as is the case with the devitalization of the teeth. While the incorporated materials may be useful to the oral cavity, they can also cause significant harm. Incorporated materials carry more or less toxic, more or less immunological implications. Whereas in the case of toxicity the dose makes the poison, in the case of hypersensitivity the yes/no answer applies: even a minimal dose can permanently stress the immune system. Unless removable restorations are involved, the patient has no defense against the permanent, 24/7 side effects.

Environmental dentistry makes it its goal to prevent iatrogenic damage from occurring, as well as to specifically eliminate damage that is already present, by means of an unusually extensive anamnesis for classical terms and by means of compatibility tests carried out in advance of treatment. Materials already present in the mouth can be subsequently tested for compatibility by taking samples and, if necessary, replaced by other, more biological and/or more compatible agents. Saliva tests provide indications of corrosion or abrasion of existing materials. LTT and BDT tests provide information about incompatibilities. DVT images are indispensable for diagnosis and treatment due to their three-dimensional representation. Ultrasound examinations (Cavitau) give indications of bone density and not only provide pre-implantological information, but also reliably show existing inflammations in the jawbone (FDOK, Rantes) or on the teeth. In order to achieve optimal healing of surgical procedures, biomarkers (lipid balance, fatty acids, vitamins D/K) are checked preoperatively and postoperatively and, where necessary, the values are corrected by taking appropriate medical preparations or nutritional supplements.

In view of the known damaging effects, no metals of any kind are used. Today, new materials make it possible to fabricate completely metal-free restorations. Zirconium and PEEK are the materials of choice for prosthetic constructions, with or without implantology. Only ‘biological’ raisins with low monomer content and high resistance to the enzymes in saliva are used as filling materials. Amalgam is completely removed with special precautions and a parallel detoxification protocol. Further detoxification, carried out by a specialist, can follow. Chronic diseases are on the rise. Through new knowledge, techniques and active substances, the environmental dentist is able to recognize the connections and to act causally curative or prophylactically in order to contribute to a better quality of life for those affected and a healthier environment for all.