Chapter 19- Complementary and Alternative Medicine.

Other forms of treatment/ medicine not part of conventional medicine are called Complementary- if used in addition to conventional medicine or Alternative- if used instead. They are known collectively as CAM.

All conventional medicines/ treatments in the UK have to be evidenced based before they are advised or recommended for use. That is there has to be enough proper scientific evidence that they work and they are not going to do the patient any harm. If the treatment is experimental then the patient has to be told and give their permission for use.

NICE- is The National Institute for Health and Care Excellence it is ‘an executive, non-departmental public body of The Department of Health in England. NICE guidelines are recommendations based on the best available evidence for the care of people by health care and other professionals’. It has a high reputation internationally.

The Cochrane Policy Institute is a British international charitable organisation formed to organise medical research findings to facilitate evidence based choices about health interventions involving health professionals, patients and policy makers. It includes 53 research groups that are based at research institutions worldwide’. ‘Cochrane reviews are systemic reviews of primary research in human health care and health policy and are internationally recognised as the highest standard in evidence based health care. They investigate the effects of interventions for prevention, treatment and rehabilitation’.

Conventional Western Medicine is known Allopathic Medicine but other ‘systems ‘exist such as Ayurvedic and Traditional Chinese Medicine.

CAM is becoming more widely used in the west so much so that some disciplines are now considered quite mainstream for example Acupuncture and Hypnosis often being recommended by ‘conventional’ doctors/ dentists myself included.

All I would say is that the evidence for the efficacy for some CAM therapies is thin, however that doesn’t necessarily mean they don’t help to make the patient feel better, emotionally if nothing else.

Most of us have, I am sure used one or more of the following;- acupuncture, homeopathy, massage, aromatherapy, herbal medicine, music therapy, deep breathing exercises, hypnotherapy, meditation, yoga can’t think of any others but there are more, these are just the ones I have used myself.

What I would say is get the correct diagnosis first, go to someone who is properly trained, qualified and is happy to show you the evidence. Any properly trained CAM practioner will send you to a ‘mainstream’ clinician if they feel your problem requires conventional expertise. Beware of anyone who thinks their particular discipline will cure everything, it won’t, but it may help.

Herbal Medicine.

Many conventional drugs originally came from plants, some used for many hundreds of years before being produced synthetically. For example digoxin used in the treatment of heart disease came from fox gloves, aspirin from willow bark and the humble Madagascan Periwinkle has given us 2 very important anti-cancer drugs Vinblastine and Vincristine. Vincristine has helped increase the chances of surviving childhood leukaemia from 10%- 90%!

More and more research is being done into the almost magical properties and ingredients some plants have.

BUT NATURAL DOES NOT NECESSARILY MEAN SAFE some plant products are toxic and some addictive.

Bleeding– some herbal products prolong bleeding eg;- evening primrose, feverfew, garlic, ginger, ginkgo biloba, ginseng, green tea and turmeric.

Cardiovascular probs– some herbal products interact with drugs used in the treatment of cardiac disease eg;- foxglove, hawthorn, willow bark, garlic, gingko.

If you do self-medicate with natural/ herbal supplements/ remedies you should be very careful to buy from a reputable source, always read the label instructions very carefully as to dose and especially any warnings/ contraindications. Always tell your GP, Dentist or any other clinician if you take these products.

Some natural products/ treatments you might use that affect your treatment at the dentist;-

Aloe Vera– used for its anti- inflammatory, antiseptic and pain relief [analgesic] properties, vitamin content [A, B12, C, E, folic acid], minerals [calcium, copper, selenium, magnesium, potassium, sodium and zinc amongst others]. Often taken to help with conditions such as; – dermatitis, psoriasis, herpes, burns, wound healing, acne, lichen planus and mouth ulcers. Aloe Vera can have quite a few side effects and should not be taken by pregnant or nursing mothers. Aloe Vera should not be taken for 2 weeks before extractions or other surgery as it increases bleeding. As it is often used by some people ‘straight from the plant’ it would be a good idea for anyone who uses it regularly to look it up especially if they have other medical conditions.

Gingko Biloba– taken to prevent or reduce retinal problems, age- related macular degeneration, Alzheimer’s disease and to improve cognitive function. Needs to be stopped 2 weeks before surgery.

St John’s Wort– taken to help with mild to moderate depression. There is a long list of drugs not to be taken with St John’s Wort, it is imperative that you follow instructions and you tell your GP if you take it. Should be stopped at least 5 days before surgery.

Some natural products/treatments sometimes used in dentistry.

Hypnotherapy– can be very useful in helping people who are very fearful at the dentist. Some dentists are trained hypnotherapists as well and specialise in helping people with dental phobia. To find a dually qualified practioner contact The British Society of Medical and Dental Hypnosis on

Patients can be taught and can teach themselves to self-hypnotise. I have a couple of patients who have been taught to self-hypnotise which is a very useful technique to have up your sleeve if you find dental visits stressful.

Propolis– is made by bees who collect resin from trees and plants, add wax to it and transform it into a complex biological product which protects the hive by providing its immunity. Both the Greeks and the Egyptians used it in medicine and there has been a growing interest in the last 30 odd years in its healing powers. Its composition is approx 50% resin [particularly from the poplar tree] and the rest is composed of wax, essential oils, pollen, organic and amino acids, vitamins and bioflavonoids [thought to be an active ingredient in the healing process]. The bees coat the inside of the hive and seal up any holes with propolis [bee glue] thus protecting the hive from outside while also providing a combined antibiotic, antiviral and antifungal defence for its inhabitants.  There has been quite a lot of ‘proper’ research on propolis in amongst other institutions the Universities of Manchester, Oxford, Strathclyde and East London.

There is a range of products for use in ‘medicine’ and I use the liquid very successfully to treat such things as ulcers and pericoronitis [infection around an erupting wisdom tooth].

Homeopathy– I don’t myself subscribe to the ‘science’ behind homeopathy, however it is something that a lot of patients feel helps them and who am I to dispute that. If homeopathy or any other CAM helps my patient whether I subscribe to it or not, then surely that is a good thing and to be facilitated. Lots of patients like to bring their remedies with them and use them before or after their treatment and that is fine by me, I want them to be happy, at ease, feel cared for and safe.

Voltaire-‘The art of medicine consists of amusing the patient while nature cures the disease’.

We have an immune system to keep us healthy but we can’t expect it to manage by itself if we don’t keep it healthy. The right food, fresh air and exercise. Any type of CAM that increases our feeling of well-being while also reducing stress in our lives also boosts our immune system. It doesn’t matter if it’s effects can’t be proved if it makes you feel better, it doesn’t do you any harm and any practioner you go to has a qualification from a regulated body then the ‘medicine’ you choose is your choice.

Just remember you do not need ‘a pill for every ill’, our bodies are wonderful at defending us all by themselves!

Also remember vaccinations and modern medicine have rid the western world of amongst outer things;- smallpox, cholera, typhoid, diphtheria, scarlet fever, measles, mumps, German measles, rickets, polio, rabies, anthrax, whooping cough and TB all of which are deadly and which the collective consciousness has forgotten about. Anyone as old as me will remember children at school in callipers from rickets, or who were polio victims or with diabetes Type 1 who were not expected to live past their early 40s. Diseases such as these and others leprosy, syphilis, gonorrhoea, haemophilia the list is endless that blighted peoples lives can now be cured/ managed quite easily by modern medicine. So be thankful and appreciate it.

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