Biological dentistry treats the mouth as part of the whole body rather than a separate repair site. In practice that means metal-free restorations, protective protocols when removing existing metalwork, and treating chronic dental infection as a possible contributor to illness elsewhere in the body. Parts of the approach are now mainstream: the UK has agreed to phase out dental amalgam by the end of 2034, the EU banned it outright in January 2025, and ceramic implants have clinical guideline recognition. Other parts, including jawbone cavitation surgery, are not endorsed by professional dental bodies.
How does biological dentistry differ from conventional dentistry?
Conventional dentistry treats decay, bite and structure. Biological dentistry does the same technical work and adds a second question: what the material, or the infection, may be doing to the rest of the body. What a patient actually encounters is metal-free fillings and implants, cone beam imaging rather than standard X-rays, elaborate protective measures during amalgam removal, and a consultation that asks about sleep and diet.
Dr Dominik Nischwitz is a German biological dentist based in Tübingen and the founder of the Biodentistry Global Standard training programme. Asked for the simplest possible description of the field, he gave this.
“Biological dentistry basically just means that the mouth is part of the body and we’re not just repairing your teeth for smiles and bites. We’re looking at your teeth in your mouth as an extension of your brain, or the entrance to the body — because on every tooth there is a body attached to it.”
Dr Dominik Nischwitz
He calls the gap between the two disciplines “a huge knowledge gap, not necessarily a technical gap”, and argues it amounts to a separate field rather than a specialism within dentistry. Conventional dentistry does not accept that framing.
There is one point of overlap. Jawbone cavitations are not taught in dental schools, and practitioners on both sides of the argument say so.
What materials are used in biological dentistry?
Biological dentistry uses four material families: resin composites and glass ionomers for direct fillings, lithium disilicate and zirconia ceramics for crowns and inlays, yttria-stabilised zirconia for implants, and autologous blood concentrates as surgical adjuncts. The unifying principle is the absence of metal alloys, not any single proprietary system.
Direct restorations. Amalgam alternatives are resin composites — methacrylate monomers filled with silica, barium or zirconia particles — and glass ionomer cements. The systems in routine use are made by the same manufacturers supplying conventional practice: 3M’s Filtek range, Dentsply Sirona’s Ceram.X and its SDR bulk-fill materials, Ivoclar’s Tetric line, Kuraray’s Clearfil. There is no separate biological-dentistry supply chain for fillings; the difference is which materials a practice declines to use, not where it buys the rest.
Indirect restorations. Crowns, onlays and veneers use lithium disilicate glass-ceramic — Ivoclar’s IPS e.max is the dominant system — or polycrystalline zirconia. Zirconia is specified by yttria content: 3 mol% yttria-stabilised tetragonal zirconia polycrystal (3Y-TZP) is the strongest and most opaque, while 4Y and 5Y partially stabilised grades trade strength for translucency. A practice offering metal-free restoration is choosing among these.
Implants. Zirconia implants are the substantive claim, and the evidence has improved. A retrospective study following 67 implants in 55 patients for a mean of 60.6 months, with individual follow-ups to ten years, reported 100% survival for both one-piece and two-piece designs — Straumann’s PURE Ceramic Monotype and the CERALOG Hexalobe. One-piece implants showed greater initial marginal bone loss (1.39 mm against 0.4 mm), with both stable thereafter. The International Team for Implantology reported 97.2% five-year survival in 2023, comparable to titanium. Other manufacturers in the field include Z-Systems and Swiss Dental Solutions, the latter founded by Ulrich Volz, who trained several of the practitioners now teaching ceramic implantology internationally.
Biological adjuncts. Platelet-rich fibrin is prepared by centrifuging the patient’s own blood without anticoagulant, producing a fibrin matrix used in extraction sockets and around implants. A 2026 meta-analysis of eighteen randomised controlled trials found PRF reduced alveolar ridge height loss by 0.95 mm at three months and increased new bone formation by 11.36%, but graded the certainty moderate for height and low for width and bone formation, describing the findings as “suggestive rather than definitive.”
The question metal-free does not answer. Most resin composites are built on bisphenol A-glycidyl methacrylate (Bis-GMA) and related monomers, and trace bisphenol A can be released — chiefly in the first 24 hours after placement. The FDI World Dental Federation’s position is that patients “could be exposed to minute amounts of BPA,” that the literature on systemic effects is “limited,” and that it “strongly discourages the use of BPA in the manufacture of dental materials.” The IAOMT, the leading advocacy body for biological dentistry, publishes its own review of BPA in composites. The material that replaces amalgam therefore carries an open question of its own, which is rarely mentioned in coverage recommending it.
On longevity, the trade-off is real. The BDA’s position on the amalgam phase-out is that “there are currently no alternative restorative materials that compete with amalgam on speed and ease of placement or longevity.”
One additional note that offers context on why biological dentistry chooses not to use amalgam: dental amalgam is roughly 50% mercury, and once it leaves a mouth it has to be handled as hazardous waste. Asked why a material that becomes toxic waste the moment it is removed is considered safe while it is in place, Nischwitz answered this.
“I have to call a guy who brings in the toxic hazard suit and gets rid of that stuff. But in the mouth, it’s super healthy and it doesn’t dissolve. This is just complete bullshit and absolutely not medically scientific.”
Dr Dominik Nischwitz
The ADA’s answer is that hazardous waste rules address environmental mercury rather than patient risk, and that no properly designed study has demonstrated harm from fillings while they are in place. That position has not changed. The regulation around it has. EU Regulation 2024/1849 banned the use of dental amalgam from 1 January 2025 — except where a dentist judges it strictly necessary for a particular patient — with manufacture and import prohibited from 1 July 2026. At Minamata Convention COP-6 in Geneva in November 2025, parties agreed a global phase-out by 2034. The FDA has advised since 2020 that pregnant and nursing women, children under six and people with neurological or kidney conditions avoid amalgam where possible, and in July 2026 the Center for Medicaid and CHIP Services emailed state Medicaid directors encouraging them to consider restricting coverage of amalgam procedure codes — a funding decision rather than a safety reclassification. Amalgam remains legal in Great Britain, where the British Dental Association has opposed rapid withdrawal on practical rather than safety grounds, warning that an abrupt ban could break NHS dentistry.
On implants the evidence is stronger. The International Team for Implantology’s 2023 consensus reports zirconia implants surviving at 97.2% over five years, comparable to titanium, and mainstream periodontology has separately begun investigating titanium particle release and its effect on local immune surveillance. The guideline support applies to zirconia as a material. The immediate placement protocol Nischwitz specialises in, implanting at the same appointment as the extraction, is not yet covered by it.
What does the evidence say about biological dentistry?
The claims are usually assessed as a package, by both sides. They are better assessed one at a time, because they do not rest on the same quality of evidence.
| Claim | Mainstream position | Current status |
| Mercury amalgam is harmful | The American Dental Association: no properly designed study shows long-term health effects. In the UK, SDCEP (NHS Education for Scotland): “no evidence that dental amalgam presents a direct health risk to individuals who have amalgam restorations.” Oral Health Foundation: no “significant health risk” | Regulators have acted regardless. The EU banned amalgam from 1 January 2025, with a clinical-necessity exemption; Minamata COP-6 agreed a global phase-out by 2034. Both on environmental grounds |
| Intact fillings should be removed | FDA advises against. ADA Code of Ethics calls removal for detoxification in non-allergic patients “improper and unethical”. SDCEP: “no reason to replace clinically sound dental amalgam restorations, except in patients with an allergy or adverse local reaction”. Oral Health Foundation advises against replacement because removal “can weaken the teeth” | Not supported. The evidence supports protection during removal, not removal itself: particulate from drilling amalgam off-gasses mercury vapour for over an hour |
| Root-treated teeth cause systemic disease | American Association of Endodontists finds no valid scientific evidence. British Endodontic Society calls the claim “unfounded and malicious” and root canal treatment “one of the best documented and safest procedures” | Not supported. Weston Price’s 1920s research used no controls and bacterial doses far beyond physiological levels. Current work links untreated infection to inflammation, which argues for treatment rather than extraction |
| Cavitations are common after extraction | The AAE “cannot condone surgical interventions intended to treat suspected NICO lesions”. Sekundo et al. (Oral Diseases, 2022) found the evidence poor with no diagnostic gold standard. No UK dental body has published a position | Open. Ghanaati’s university research, published 2025 and 2026, confirms sockets frequently fail to ossify fully, while leaving open whether that is pathological |
| Ceramic implants are preferable to titanium | Accepted as an alternative. The ITI 2023 consensus reports zirconia five-year survival of 97.2%, comparable to titanium | Supported. Mainstream periodontology is separately investigating titanium particle release and its effect on local immune response |
| Dental metals amplify electromagnetic fields | No position. The question is essentially unstudied in dentistry | Unevidenced. Field enhancement around jaw metalwork is measurable (Jovanović et al., 2025); no study connects it to any health outcome |
Read down the table and the split falls along one line. Where biological dentistry concerns materials — what goes into a mouth, and how it is taken out — it is on reasonably solid ground. Where it concerns mechanism, meaning the claimed effect of a dental condition on a distant organ, it is not.
What do UK dental bodies say about biological dentistry?
No UK professional body endorses biological dentistry as a distinct discipline, and the General Dental Council does not recognise it as a registrable specialty. But UK institutions have taken clear positions on the individual claims.
On amalgam safety. The Scottish Dental Clinical Effectiveness Programme, part of NHS Education for Scotland, states that “there is no evidence that dental amalgam presents a direct health risk to individuals who have amalgam restorations.” The Oral Health Foundation’s policy is that it “does not consider that the use of dental amalgams containing mercury poses a significant health risk,” and that “none of the claims linking dental amalgam to illnesses such as Alzheimer’s disease, Autism, Muscular Dystrophy and Parkinson’s disease have been substantiated.”
On why amalgam is being restricted. SDCEP is explicit that the UK restrictions “aim to help reduce environmental mercury pollution and are not a result of any safety concerns.” This is the distinction most often missed in consumer coverage: regulators say they have acted on mercury in the environment, not on mercury in patients.
On removing existing fillings. SDCEP advises that “there is no reason to replace clinically sound dental amalgam restorations, except in patients with an allergy or adverse local reaction.” The Oral Health Foundation “advises patients not to have their amalgam fillings replaced unless they are certain they are allergic to dental amalgam, as the process of removal can weaken the teeth.”
On root canals. The British Endodontic Society maintains a position statement under the heading “Exploding Endodontic Myths,” describing claims that root-treated teeth cause systemic disease as “unfounded and malicious” and root canal treatment as “one of the best documented and safest procedures.” The British Dental Association wrote to members in 2019 warning that the Netflix film Root Cause was “propagating misinformation about systemic health problems supposedly caused by root canal treatment.”
On the phase-out. The BDA has “long campaigned for a pragmatic phase down, rather than an abrupt phase out,” warning that “there are currently no alternative restorative materials that compete with amalgam on speed and ease of placement or longevity” and that the transition will require significant investment in NHS dentistry.
On cavitations. No UK dental body has published a position on jawbone cavitations or NICO. The professional statements available are American.
What are cavitations, and are they real?
A cavitation is a site in the jawbone where an extraction wound has not fully healed, leaving soft or fatty tissue where solid bone should be. Clinical names for it include ischaemic bone disease, NICO — neuralgia-inducing cavitational osteonecrosis — and, most recently, covered socket residuum. Diagnosis is by cone beam CT. Treatment is surgical: the affected tissue is cleaned out.
Nischwitz has described what he finds when he opens one.
“It’s completely yellowish, fatty greenish. You can literally suck it out. It’s not really bone, it’s complete mushy tissue in there.”
Dr Dominik Nischwitz
No professional dental body endorses the surgery. The American Association of Endodontists states that it “cannot condone surgical interventions intended to treat suspected NICO lesions”, and that extracting root-treated teeth to prevent them is unethical. Sekundo and colleagues, writing in Oral Diseases in 2022, screened 4,051 papers and included 29; they found no gold-standard diagnostic method, high risk of bias throughout, and up to a third of surgical patients showing minimal improvement or recurrence. In 2025 David Keith, at Harvard School of Dental Medicine, published a paper in the Journal of Pain Research titled “Neuralgia Inducing Cavitational Osteonecrosis of the Jaw: Scientific Controversy or pseudoscience?” and came down on the second.
Then the research moved. Professor Shahram Ghanaati, deputy director of oral and maxillofacial surgery at Goethe University Frankfurt, published a randomised split-mouth study in November 2025 and a review in January 2026 describing what he calls covered socket residuum: extraction sites that close over at the surface but remain incompletely ossified underneath. The review is co-authored with Johann Lechner and Jerry Bouquot, the two researchers most closely associated with cavitation work in biological dentistry.
Ghanaati’s work confirms that tissue does remain in the socket after an extraction. It also says these areas may represent a physiological outcome of incomplete healing rather than a pathological condition, and calls for prospective controlled trials before conclusions are drawn from them.
Nischwitz’s own estimate is that in ninety-nine percent of extractions the wound never fully heals. That is an observation from his caseload rather than a published figure, and Ghanaati — whose research is the strongest support the field currently has — is explicitly unwilling to call the same tissue pathological.
Do dental metals affect electromagnetic sensitivity?
No study has shown that they do. The physics underneath the claim, though, is real and has been measured. Jovanović and colleagues, in Electronics in 2025, simulated a titanium plate of the kind used to reconstruct a fractured jaw and found it roughly doubled the peak local electric field during mobile phone use, raising peak specific absorption rate by around 2.3 times. The study models reconstruction hardware rather than a dental implant, and it quantifies exposure only. It demonstrates no clinical consequence, and no peer-reviewed study connects metalwork in the jaw to any symptom, illness or patient outcome.
Asked directly how to separate what is science-based here from what is not — the antenna claim sits close to conspiracy territory, and the question said so — Nischwitz conceded the point.
“If you hear that, it sounds woo-woo completely. Is this easy to demonstrate in research? It’s almost impossible, because you cannot have a double-blind placebo control study for this. There’s no study showing these effects.”
Dr Dominik Nischwitz
Two adjacent findings are worth having. The World Health Organization’s position on electromagnetic hypersensitivity is that the symptoms are real and can be severe, but that there is no scientific basis for linking them to EMF exposure; both sides of this argument tend to quote only one half of that sentence. And the claim that phone or MRI exposure increases mercury release from amalgam fillings was tested by Burkett and colleagues in Magnetic Resonance in Medicine in 2024, at 1.5, 3 and 7 tesla. They found none.
Oral galvanism is a different matter, and better established. Dissimilar metals in saliva generate measurable currents, and a 2023 paper in Maxillofacial Plastic and Reconstructive Surgery accepts the local symptoms — metallic taste, burning, disturbed smell. It does not establish anything systemic.
Can dental treatment improve chronic illness?
Some oral–systemic links are accepted. None is established as causal.
Periodontal disease is associated with cardiovascular disease, though the American Heart Association restated in December 2025 that “there is no direct evidence of causality or that periodontal therapy will help prevent” it. The link with diabetes is stronger and runs in both directions: periodontal treatment measurably improves blood sugar control. Treating gum disease during pregnancy, on the other hand, has not been shown by Cochrane review to reduce preterm birth.
One distinction is worth holding on to, because both sides tend to lose it. The research reviving interest in oral–systemic links studies apical periodontitis — untreated infection at the root tip — and its association with systemic inflammation. That work supports treating infected teeth. It does not revive the older claim that a successfully root-treated tooth is itself a reservoir of disease.
The clearest caution comes from Alzheimer’s research. Gum disease bacteria were identified in the brains of Alzheimer’s patients in 2019 and a drug programme followed. It missed both co-primary endpoints in October 2021, was placed on clinical hold by the FDA over liver toxicity in January 2022, and was discontinued that August.
Nischwitz’s own framing is cumulative rather than causal.
“It’s not that the root canal or the metals or filling the hole was designed to kill you. It just added up, added up, added up, and your body can compensate so much until it can’t.”
Dr Dominik Nischwitz
Should you see a biological dentist?
For a metal-free restoration or a ceramic implant, yes: the materials case is sound and the guideline recognition exists. For protective protocols during any amalgam removal, also yes, because the particulate produced by drilling out an old filling goes on releasing mercury vapour for more than an hour afterwards, and that is worth containing whatever you make of the rest of it.
Removal of intact, sound fillings to treat symptoms elsewhere in the body is a different proposition. The FDA advises against it. The ADA’s Code of Ethics calls it improper and unethical in patients who are not allergic, where the dentist alone has recommended it. Cavitation surgery has no mainstream endorsement, and the researchers doing the most sympathetic work on it are asking for controlled trials before it is offered routinely.
Nischwitz’s own caution about his field is a reasonable test to apply to anyone practising in it.
“To be fair for conventional dentists, I understand why they’re attacking it — because oftentimes a biological dentist doesn’t have the skills of a conventional dentist.”
Dr Dominik Nischwitz
UK guidance is narrower than the biological-dentistry case for removal. SDCEP restricts new amalgam placement in children under 15, pregnant and breastfeeding women, and primary teeth — but on environmental rather than clinical-safety grounds, and it does not advise removing sound fillings already in place.
BIOLOGICAL DENTISTRY: KEY FACTS
Also called: holistic dentistry, biological dental medicine. Core practice: metal-free restorations, protective protocols for amalgam removal, treatment of chronic dental infection as a systemic issue.
Regulatory position: In the UK, amalgam remains legal but has been restricted since 1 July 2018 for children under 15, pregnant and breastfeeding women, and primary teeth. At Minamata Convention COP-6 in November 2025, England, Scotland, Wales and Northern Ireland were all set a phase-out deadline of 31 December 2034. Northern Ireland holds a ten-year derogation from the EU ban, and from 1 July 2026 amalgam imports there became category one goods requiring full customs procedures. The EU ban has been in force since 1 January 2025 (Regulation 2024/1849), subject to a clinical-necessity exemption. The FDA has advised avoidance for specific groups since 2020.
Contested: jawbone cavitation surgery (not endorsed by professional dental bodies); removal of intact fillings for detoxification (opposed by FDA, considered unethical by the ADA).
About this article
Dr Dominik Nischwitz was interviewed by Unfiltered in 2026. He runs a clinic in Tübingen, trains dentists through the Biodentistry Global Standard programme, and has commercial interests in dental education and supplements. Mainstream positions are drawn from the FDA, the American Dental Association, the American Association of Endodontists, the International Team for Implantology, the American Heart Association, the World Health Organization and the peer-reviewed literature linked above.
