The dangers of ‘bad science’ in dentistry

Neel Kothari warns of bad science and the 'erosion of trust' between the dental profession and the public as a result of clinicians' claims.

In his latest column, Neel Kothari warns of the ‘erosion of trust’ between the dental profession and the public as a result of claims made by clinicians. We also hear from dentist Victoria Sampson, who offers a response to the article and discussion.

Neel Kothari

Many of you will be aware of two prominent dentists whose controversial views have recently come to the fore in dental and mainstream media. The first is Dr Michael Mew, an orthodontist who offered treatments including his ‘mewing’ technique and ‘orthotropic’ treatments. The second is Dr Victoria Sampson, a self-proclaimed ‘functional dentist’ who claims to be known for her work in developing salivary diagnostics, microbiome testing and incorporating artificial intelligence into everyday care.

Both Dr Mew and Dr Sampson have publicly made claims over their specific techniques that have gained traction with the public, but questions have been raised as to whether these can be substantiated. Fundamentally, I believe two things to be true; the first is that if their methods and techniques have merit, they ought to be shared for the wider benefit of society. However, the second is that if their claims are baseless, they have the potential to cause harm, notwithstanding their overwhelming confidence in their beliefs.

Perhaps any positive press for dentistry must be a good thing, right? After all, is there really any harm? Well, I’m not so sure. Let’s remember that Dr Mew has now been struck off by the General Dental Council (GDC) following complaints after a six-year-old boy’s treatment. Maybe this is the extreme end of the spectrum, but do we really know the risks of novel approaches without testing?

Strong suggestions

Likewise, Dr Sampson went on to a well-known podcast strongly suggesting links between oral microbiome in saliva and several medical conditions such as fertility issues in men and women, rheumatoid arthritis, erectile disfunction etc. Or as the podcast put it, ‘the shocking link between our mouths and some of the world’s most destructive diseases’.

At face value, this may seem harmless, especially as Dr Sampson uses language to strongly suggest associations between oral microbiome and a wide range of medical issues but is less clear in stating whether a causative link absolutely exists. It’s not just that the boundaries of correlation and causation are blurred, but Dr Sampson is doing so as a ‘Dr’ with accredited letters behind her name and there is an expectation by the public that she can substantiate her claims.

It’s noteworthy that Dr Sampson is also the founder of THS (The Health Society) Labs, whose website states: ‘We now understand the links between oral health and general health, and how improving the oral microbiome can have direct links on both.’  The same laboratory markets directly to patients a kit called Oralis 1 for a sum of £350 which claims to be ‘all backed by leading dentists’.

I’m not suggesting that Dr Sampson is acting disingenuously, but I am mindful that she is making claims that even the world’s most respected scientific researchers backed by leading research institutes with vast teams, who have invested millions in funding researching this area, wouldn’t even dare to make. This begs the question, is there a conflict of interest?

‘False hope’

Many aspects of the podcast promoting good oral and general health I found to be laudable, but linking oral microbiome to cancer, fertility issues and purporting claims such as: ‘I cured their gum disease and they walked again’ isn’t a trivial matter and could lead to incredibly vulnerable people seeking care out of sheer desperation. The risk here is that if the claims cannot be substantiated, this could be peddling false hope to some of the most desperate members of the public who would pay anything for a solution.

A common criticism often raised by those purporting new techniques, such as Dr Mew, is that that they are the only ones doing this because mainstream organisations are not willing to engage. Perhaps this is true, but any one of us could carry out academic research and have it independently verified without impediment. Further, the onus is and always has been on the person making the claim to substantiate it, not on others to debate or disprove it.

In my opinion, both Dr Mew and Dr Sampson have made claims that they have failed to substantiate. This article isn’t intended to be a personal attack on either dentist, but rather to highlight the dangers bad science poses to them as individuals, to patients, as well as the erosion of trust that may result between the public and the profession.

The advent of social media has had many benefits, but it also allows views of any merit to be broadcast far and wide. The question is, are these views scientific findings or simply personal opinions that they wish to be true?

Victoria Sampson

Neel Kothari warns of bad science and the 'erosion of trust' between the dental profession and the public as a result of clinicians' claims.

I appreciate the opportunity to respond to your article addressing my work and comments on the oral microbiome and general health. I share the concern of how information that has been shared across platforms, particularly social media, can exclude important details from research, or be taken out of context, that may lead to confusion and misinformation. However, I feel that several points in the article require clarification and context to present an accurate picture. 

Information about me

I graduated from Barts and The London School of Medicine and Dentistry with a bachelor’s in dental surgery and further developed my education through a post graduate diploma in periodontology. I spent six months at the world renowned Karolinska Institute in 2017, where research into the connection between the mouth and the rest of the body was the forefront. This is where I started to see a different side to dentistry, and the rise of salivary diagnostics.

Fast forward eight years, and I now have the privilege of serving on four advisory boards associated with microbiome testing and salivary diagnostics. I work with NASA and the European Space Agency on helping incorporate salivary diagnostics into space, as well as most recently being invited to join the Harvard School of Dental Medicine Clinical Innovation Board.

Lastly, I have worked as an advisor for the largest dental chain with over 800 practices in the US on incorporating salivary diagnostics and medical integration to help improve diagnostics and prevention. I am also on the board for Food for the Brain, a charity aimed at helping prevent Alzheimer’s.

Information about the test and how it was created

Your article raises concerns about my laboratory, THS Labs, and its Oralis 1 salivary diagnostics kit. Far from ‘peddling false hope’, these tools are rooted in established scientific principles. Saliva has been shown to be a promising diagnostic medium for helping oral diseases as well as an insight into general health (Bingham and Moni, 2013; Fu et al, 2022; Papale et al 2022). Prestigious universities such as Harvard, UCLA and Plymouth University are focusing heavily on the use of saliva as a diagnostic medium, in the hope of integrating medicine and dentistry.

In 2022, I partnered with a UKAS accredited lab to create a saliva test. I worked with my team of advisors who range from microbiologists, professors in periodontology, members of the Forysth Institute, medical doctors, and nutritionists to build the test; Oralis 1. Oralis 1 uses shotgun metagenomics, proteomics and gene sequencing to look at:

  • Over 300 hundred bacteria
  • Top 10 genetic mutations associated with gum disease, inflammation and plaque accumulation
  • Strain level with certain oral bacteria such as Aggregatibacter actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg) and Fusobacterium nucleatum (Fn) to identify pathogenic strains and virulence factors associated with these bacteria
  • Ratio of commensal and pathogenic bacteria compared to healthy and diseased subjects.

Immune responses

By going to strain level with certain pathogenic bacteria, we are able to identify virulence factors such as gingipains released by Pg and JP2 clones of Aa that can significantly increase the risk of periodontal disease, tissue degradation, and also have been shown to have a strong connection to general disease. By assessing genetic mutations, we are able to understand what the patient’s host immune response may be like and how predisposed to inflammation they may be.

We then collected hundreds of samples from patients to build an algorithm using artificial intelligence where the patient’s bacteria, strains, genetic mutations, dental history, family history, medical history, oral hygiene practices, diet and age were factored in to predict the patient’s risk of oral diseases. The report then provides recommendations on how to reduce these risks.

The underpinning recommendation is always to see your dental professional for support and treatment. We also will give recommendations to patients on how to handle a dry mouth, how to use interdental brushes, what diet recommendations could help improve their inflammation, and what supplements could help improve either how their body responds to inflammation, and/or supplements known to improve prognoses of diseases such as gum disease (like vitamin D).

Misinformation

THS Labs provides patients and clinicians with valuable insights into their oral microbiome, empowering them to make informed decisions about their health, something particularly important when access to care is limited and the trust between dentists and patients has been eroded. I have always emphasised that these tools are not diagnostic for systemic disease but serve as an adjunct to oral and systemic care. It encourages patients to seek management and prevention from their dental professionals.

Our secondary aim is to help create more research and evidence of the oral systemic link. We are in close connection with The Forsyth Institute, Harvard Dental School, University of Antwerp and Imperial College to create research. We have hired a team of biostatisticians who will be strengthening our algorithm daily as well as finding areas of research or connections that we can look further into.

‘Not a claim of causation’

Your article states that, during the podcast, I suggested: ‘I cured their gum disease and they walked again.’ This is a misquotation and sensationalisation of the discussion. In the podcast, we explored associations between the oral microbiome and systemic conditions such as arthritis, as supported by peer-reviewed studies (Mercado et al, 2000; Bingham and Moni, 2013).

The headline about ‘walking again’ was not a claim of causation but an anecdotal example of how addressing inflammation in the body – including oral inflammation – can be one aspect of a broader health improvement strategy. Unfortunately, if people take my conversation out of context or sensationalise it, I am unable to control this.

You correctly pointed out that I often highlight associations rather than causative links between the oral microbiome and systemic diseases. This distinction is fundamental, and I am always careful to communicate it. While robust causative studies are still underway, there is ample evidence supporting correlations that warrant attention. 

I hope this response clarifies that my work is firmly grounded in research and ethical practice. By exploring the links between oral and systemic health, we can elevate the role of dentistry in improving patients’ lives holistically—a goal I am deeply passionate about. 

Sincerely,

Dr Victoria Sampson

References

Bingham CO 3rd, Moni M (2013). Periodontal disease and rheumatoid arthritis: the evidence accumulates for complex pathobiologic interactions. Curr Opin Rheumatol 25(3): 345-53. doi: 10.1097/BOR.0b013e32835fb8ec. PMID: 23455329; PMCID: PMC4495574

Fu Y, Maaβ S, Cavallo FM, de Jong A, Raangs E, Westra J, Buist G, Becher D, van Dijl JM (2023).Differential Virulence of Aggregatibacter actinomycetemcomitans Serotypes Explained by Exoproteome Heterogeneity. Microbiol Spectr11:e03298-22.https://doi.org/10.1128/spectrum.03298-22

Mercado F, Marshall RI, Klestov AC, Bartold PM (2000). Is there a relationship between rheumatoid arthritis and periodontal disease? J Clin Periodontol 27(4):267-72. doi: 10.1034/j.1600-051x.2000.027004267.x. PMID: 10783841

Papale F, Santonocito S, Polizzi A, Giudice AL, Capodiferro S, Favia G, Isola G (2022). The New Era of Salivaomics in Dentistry: Frontiers and Facts in the Early Diagnosis and Prevention of Oral Diseases and Cancer. Metabolites. 2022 Jul 12;12(7):638. doi: 10.3390/metabo12070638. PMID: 35888762; PMCID: PMC9319392

Wong, DT (2012). Salivaomics. J Am Dent Assoc 143 (Suppl 10): 19S-24S. doi.org/10.14219/jada.archive.2012.0339

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