For this essay, our guest is Dr. Daniela Fontes, an anaesthesiologist who later dedicated herself to integrative functional medicine, initially for personal reasons, but which eventually led to her professional career. Here, she shares her personal experience, where dentistry played an important role in the diagnosis and treatment of general health.

Dr. Daniela Fontes, in the first person

What I’m going to share are facts and evidence.

In 2012, I faced one of the biggest challenges in my life thus far.

Accustomed to anesthetising patients with breast cancer, I saw conservative surgeries and increasingly earlier diagnoses taking place on a daily basis… That year, while breastfeeding my second child, I realised that, from one day to the next, a large hard nodule had appeared. I underwent the same process as my patients, with anguish, and did several confirmation exams in order to truly believe that what was happening to me was real.

My world collapsed for two reasons. The first reason was its size: the nodule presented large dimensions and, in addition to its size, it already had metastases (which indicated a state of advanced disease). The second and most important reason: I had two small children and I didn’t want them to suffer.

The first two weeks were hard. My days were spent lying on the couch or in bed, only leaving the house for exams and chemotherapy sessions. My mind and body were in shock. I couldn’t think, I couldn’t even feel.

After those two weeks I had to face the situation rationally and with courage, just like on a battlefield – this battle was not against anyone, but for me.

I wanted to understand what had happened in my body for it to develop this disease and, above all, what could I optimise in my body to help it win this battle. I chose the best conventional medicine practised in the world, from Oncology and Genetics, to General Surgery and Radiotherapy. I needed to know numbers, statistics, possibilities and probabilities. I realised, even before getting my genetic study back, that an external factor must have influenced the emergence of this disease.

What was I missing?

I decided to investigate all the existing evidence beyond conventional medicine to find the missing link.

The first book I read in the area of integrative medicine was “Anti Cancer” by David Servan-Schreiber1. Interestingly enough, there was not a single reference to dentistry…

In the integrative medicine books I read, great importance was given to supplementation, especially Vitamin D2. Bearing in mind that an unbalanced diet, with a deficit of vitamins and minerals could have an impact on the development of my disease, I booked a consultation with Dr. Cristina Sales who put me on the path of integrative functional medicine. At the first appointment, after a detailed evaluation, I was immediately informed that for my treatments to be successful, I would have to remove the eight amalgams I had at the time. No one had ever even told me about mercury toxicity. It was then that I realised that this toxicity had already migrated to all my organs, namely the liver and central nervous system.

In 2014, I began the process. All the amalgams were removed without any protection – I was told that there was no one in Portugal who performed the SMART (Safe Mercury Amalgam Removal) protocol. After the unprotected removal of amalgams, I experienced clinical worsening of various symptoms and pathologies between 2015 and 2017. Little did the dentist who removed my amalgams know that he became even more intoxicated than I was! The International Academy of Oral Medicine and Toxicology (IAOMT) has developed a very rigorous protocol for safely removing amalgams. White Clinic is a certified dental clinic that has the material necessary and the appropriate knowledge to perform the SMART protocol.

In addition to this personal journey, there is the journey with my patients. As an Anaesthesiologist, our training has the treatment of Acute and Chronic Pain as a central role. Hence my involvement with Chronic Pain and Medical Acupuncture. In the Chronic Pain Unit and in Medical Acupuncture I have already come across the importance of dentistry in all its range of absence of infection/inflammation, good temporomandibular function, and how the trigeminal branch could influence major neuralgias such as the trigeminal, which are always the greatest challenges in terms of treatment.

Due to my personal clinical condition, I turned to integrative biological dentistry in 2018, with the aim of undergoing treatments that were as biocompatible as possible. It was then that I came across a bone infection in my jaw, which dentists call NICO (Neuralgia Inducing Cavitational Osteonecrosis) due to a badly positioned tooth that was extracted when I was eight years old. The diagnosis was made using a three-dimensional X-ray or CBCT. The radiological image clearly showed the presence of infection. The more I studied, the more I realised the impact that having silent infections/inflammations in our oral cavity has on general health and the impact of having titanium implants that can generate galvanic or battery response like other metals.

I confess that I was a little sceptical at first, until my clinical and personal experience showed me that having infections in the jaw, due to poorly performed tooth extractions and teeth with insufficient endodontic treatment, could compromise my general health.

Oral health = systemic health

There were two events that revolutionised the way I thought about my clinical and personal path:

  1. Bad dental treatments and infections in the oral cavity that compromised my immune system and influenced the onset of chronic diseases.
  2. The case of a 35-year-old patient of mine, who was diagnosed with unilateral sacroiliitis, with no markers of systemic inflammation, no history of trauma, no myofascial syndrome in the lumbar, abdominal or lower limb chain. The patient responded therapeutically to weekly acupuncture, but was unable to space out treatments and relied heavily on them. She challenged me to understand why.

Taking into account my personal experience, I asked the patient to send me her latest orthopantomography. She had a NICO lesion in a tooth that is functionally attached to the sacroiliac. I explained the link I had established and sent it to a colleague who was a reference in integrative biological medicine with a letter of referral explaining the entire situation. I later received a letter that I still have today. The colleague’s thank you note for the referral from a non-dentist regarding a NICO with a high impact on the patient. The result, after the surgical intervention and the strengthening plan that we established for the following month, namely with vitamin C and D, and the detoxification of all the microbiological material that was eliminated was excellent, with no need to submit the patient to further treatments. The key was eliminating the tooth infection.

Understanding the relationship between dentistry and integrative medicine is essential for our daily clinical practice. Above all, I learned that knowledge of this link has a major impact on diagnosis and treatment planning. It is important that the clinician has knowledge of techniques (such as ART, Autonomic Response Testing, done in Portugal by Dr. Ana Paz), and technology such as ozone, Er:Yag laser and the use of plasma rich in growth factors and stem cells in order to achieve successful results.

It is essential that the patient understands that more important than having a beautiful smile, it is important to have a healthy smile and a healthy body.

*Dr. Daniela Fontes, Anaesthesiologist (OM 39119) Medical Acupuncture (OM competence), Integrative Functional Medicine
  1. David Servan-Schreiber. Anti Cancro. 2007.
  2. Dr Robert Kulacz, Dr Thomas Levy MD., “The Roots of Disease: Connecting Dentistry and Medicine.”