Environmental Dentistry

Environmental Dentistry Alpine Biodental

Environmental dentistry deals with the interactions of dental materials on the human organism, considering both toxicological and allergological aspects. The goal is to reduce triggers and irritants affecting the body, thereby optimizing the relief of the organism.

No other medical discipline uses as many different materials as dentistry. A dentist incorporates more foreign materials into the body than any other medical professional. Therefore, it is crucial for the dentist to monitor the materials used and be aware of their impact on health.

In addition to biological and holistic dentistry, environmental dentistry forms an important pillar of our treatment plans and methods.

Excursus - Dental Materials and their Impact on Health

In dental practice, a variety of different materials are used, whether silicones, metal alloys, or plastics. Regardless of the specific material, they all consist of a mixture of various foreign atoms or molecules. When these substances are introduced into the oral cavity, a certain proportion inevitably enters the organism. The absorption occurs both locally through the mucous membrane and through swallowing into the intestines. A small percentage is also inhaled through the lungs.

Toxic and immunological Effects

Most dental materials are foreign, non-physiological substances. After entering the body, they have both toxicological and immunological effects. On a toxic level, processes such as the blockade of different enzymes can occur. On an immunological level, there is an activation of immune cells with an increased production of inflammation-promoting messengers – the result is chronic inflammation with a continuously activated immune system.

If the patient reacts allergically to any of the ingredients, it manifests in various local symptoms. Redness, gingivitis dry mouth, or burning of the oral mucosa may become noticeable.

However, local allergic symptoms often remain absent, and systemic immune reactions take place. These systemic symptoms are very nonspecific and instead lead to headaches, fatigue, lethargy, joint and muscle pain.

Leaky Gut – Permeable Intestinal Mucosa

Chemicals swallowed into the intestines have the unpleasant property of making the intestinal lining more permeable. The essential intestinal barrier is disrupted, and undigested food, bacteria, and intestinal toxins flood the organism. A Leaky Gut syndrome is the consequence.

A permeable intestine leads to inflammation in the intestinal lining itself (irritable bowel syndrome), inadequate nutrient absorption, oxidative stress, and liver dysfunction. Over time, this condition leads to serious physical damage – autoimmune diseases, systemic inflammatory reactions, and cardiovascular diseases are just a few examples.

Leaky Gut can be easily diagnosed through laboratory tests, specifically by an increased detection of the protein Zonulin.

Metal Burden in the Mouth

Metallic dental restorations are problematic both from a toxicology and immunological perspective. In this article, we explain what metals in the mouth can do to the body.

Metal dental prosthetics can be released into the body in different ways, impacting health. Through abrasion during chewing and oxidation processes (corrosion), metals enter the surrounding tissues and the entire organism.

The released metallic ions and metal particles can locally lead to gum inflammation in the oral cavity.

The metallic substances swallowed can induce chronic inflammation of the intestinal mucosa. Consequently, the permeability of the intestinal walls (Leaky Gut) increases, allowing undigested foods, intestinal bacteria, and intestinal toxins to enter the organism.

This increased intestinal permeability then acts systemically on the entire body and can cause various nonspecific symptoms.

One example of health-harming metals is amalgam.

Toxic Effects of Metals

Many metals are capable of causing oxidative and nitrosative cellular stress, resulting in the body being flooded with free radicals. These are highly reactive and can severely damage various building blocks, enzymes, and cells. Furthermore, metals can compete with vital minerals and trace elements, displacing them from their functions, negatively influencing metabolic processes.

Influence of Metals on the Immune System

The body responds to the invaded metal ions or metal particles by ramping up the immune system. Various immune cells, such as lymphocytes or macrophages, begin to combat the metallic invaders. This, in turn, causes even more oxidative and nitrosative cellular stress, draining the body of a considerable amount of energy. The activation of macrophages, upon contact with titanium, for example, is determined by the titanium stimulation test. The activation of lymphocytes, upon contact with metals, is detected through the lymphocyte transformation test (LTT). Such prolonged exposure can take a toll on the body’s health, leading to the manifestation of chronic diseases.

Ceramic instead of Metal

According to the definition, the term ceramic refers to inorganic non-metallic materials, clearly distinguishing ceramics from metals. The ceramic mainly used in dentistry is zirconium dioxide, an extremely biocompatible and compatible material.

Ceramics consist of metal oxides and have strong covalent electron bonds in their internal structure. These bonds fix the atoms in the framework, preventing them from being released. Due to the high oxidation state of the atoms, ceramics have no tendency to react further or corrode and behave neutrally.

In contrast, metals exist in the elemental state. Electrons show no strong bonds but move freely within the metal lattice. As a result, the structures are not fixed, and metal ions can be easily released from the alloy into the organism. This process is called corrosion and can lead to allergic reactions and toxic effects. These chemical differences result in completely different properties between ceramics and metals.

Completely Different Properties

  • Unlike metal alloys, ceramics have no ductility, so they do not deform under stress but break – similar to glass.
  • Ceramics cannot conduct electricity as they lack free electrons.
  • Ceramics poorly conduct heat and are therefore good thermal insulators. In contrast, metals exhibit good thermal conductivity.
  • Ceramics are chemically inert and have no tendency to react with other reactants. A reaction with other materials is excluded.
  • Zirconium dioxide is nearly insoluble and thus extremely biocompatible. In contrast, metals release ions into saliva. If multiple different metal alloys are present in the oral cavity, the release increases significantly, showing enhanced corrosion.

Ceramic should always be preferred

Even though zirconium belongs to the group of metals, zirconium dioxide is no longer a metal but exhibits all the properties of ceramics. It is comparable to sodium and chlorine forming table salt (sodium chloride). The properties are absolutely different. For biological reasons, we use ceramic implants, ceramic crowns, and ceramic bridges in our practice instead of metal.

Dental Plastics

Today, most fillings are made from dental plastics (composites). These plastic fillings consist of a large variety of different chemical substances that can have toxic, allergenic, and mutagenic effects. Some of the health-damaging substances in composites include:

  • Triethylene Glycol Dimethacrylate (TEGDMA)
  • Hydroxyethyl Methacrylate (HEMA)
  • Urethane Dimethacrylate (UDMA)
  • Bisphenol Glycidyl (di)-Methacrylate (Bis-GMA)

Impact on the Body

Due to the high complexity of plastics, the health condition of the affected patient can vary significantly. For example, in the form of:

  • Headaches
  • Concentration disorders
  • Energy deficits
  • Skin irritations
  • Joint complaints

The extent of the symptoms depends mainly on:

  • Degree of curing of the filling
  • Choice of plastic
  • Immune status / detoxification capacity of the patient

Curing Degree of the Filling

Composites are in a plastic state during placement in the tooth. Special UV lamps cure the plastic monomers into polymers. Dr. Just Neiss, a dentist in Heidelberg, has researched composites extensively and found that almost all placed plastic fillings are inadequately cured, i.e., they have too low a degree of polymerization. Insufficient cross-linking/polymerization leads to the presence of reactive monomers and co-monomers, which can enter the living body system. This significantly increases the health burden. A high degree of polymerization is thus a crucial factor for biocompatibility.

The Choice of Plastic

In addition to thorough curing of plastics, attention should also be paid to the product itself. Many composites contain TEGDMA, HEMA, UDMA, and BIS-GMA, which are particularly reactive and toxic substances that should not be present from a health perspective.

Our plastic is free from Bisphenol A, Bis-GMA, TEGDMA, HEMA, and fluoride. Furthermore, we ensure that the ceramic content is as high as possible.


From the perspective of environmental dentistry, which focuses on human health, the use of metals in the mouth should be avoided. Even with plastics, regardless of how much attention is paid to the material, they remain chemical compounds with an increased burden on the body. If plastics are used, it is crucial to ensure thorough curing, as this reduces toxicity.

The ideal material in dentistry is ceramic, which exhibits optimal properties in terms of biocompatibility, durability, and aesthetics. Whenever possible, ceramic should always be preferred over plastic and metal.

Dr. med. dent. Artur Hein

Environmental Dentistry deals with the materials used and their impact on health. Our specialists are happy to assist you.

Dr. med. dent. Artur Hein Dentist Winterthur

Further Information

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