When most people think of dentists and dentistry, they imagine fillings, extractions and other treatments related to the teeth. But it’s not uncommon for us to venture away from the mouth a little. Some musculature problems associated with the jaw joint present as pain around the temple or behind the eyes and can often be treated using a variety of night guards or splints. And if you’re in the market for a solution to the wrinkles around your eyes, you’ll find that many dentists can and will offer Botox injections or similar treatments. However, we must not reach beyond our competence and make unsubstantiated claims regarding treatment. Occasionally, we hear dentists claiming to cure medical issues by removing amalgam fillings or taking out root treated teeth. Sometimes, a dentist will go much further than this.
Back in 2019, the Evening Standard reported on a dentist claiming to be able to treat MS and ME. As the article states, Mohamed Amir examined the reporter by employing an applied kinesiology muscle test. He then advised that their low energy levels were due to a misalignment of the jaw. One special nightguard later, and all was fixed. The article continues with another patient’s testimonial reporting recovery from paralysis. This miracle cure was down to something called ‘cranial symmetry.’
An archived version of Mr Amir’s now-defunct website goes into more detail regarding this treatment, which appears to be a unique combination of splint therapy with chiropractic and cranial osteopathy. The therapy aims to correct a misalignment in the jaw joint, which is said to be the cause of multiple conditions ranging from asthma and allergies to fibromyalgia and learning difficulties.
The use of dental splints, removable mouthguards usually made of plastic and taking on various forms, is standard practice. There’s some evidence (albeit not great quality) to show that correct splint therapy can improve many disorders of the jaw joint and associated musculature. It’s common for patients using a splint to report a reduction in their jaw-related pain and even better quality of sleep. The other components of Mr Amir’s unique form of practise are more questionable.
Most Skeptic readers will be aware of chiropractic, but cranial osteopathy is less well known. Cranial osteopathy, also known as craniosacral therapy, claims to manipulate the bones of the skull using light pressure to produce a variety of therapeutic effects. These claims fall at the first hurdle of scientific inquisition, mainly since the bones of the head are fused from early childhood. The craniosacral therapists will assert that their treatment works due to altering the brain’s flow of cerebrospinal fluid. Unsurprisingly, there is no realistic mechanism for how this may happen, let alone credible evidence to back up the claims. Predictably, Mr Amir attracted the attention of the General Dental Council (GDC.)
In the UK, healthcare professions are governed by a group of regulators. For doctors, it’s the General Medical Council; Pharmacists have the General Pharmaceutical Council, and we dentists have the GDC. The regulators exist, amongst other things, to ensure patient safety and maintain public trust in their relative professions. One of the ways they do this is by bringing fitness to practice proceedings against professionals who have fallen below the standard of care expected of them. In the case of the GDC, at least, many dentists believe that they’re often heavy-handed with their rulings, with the fitness to practice process often taking two years to reach a substantiative hearing.
Mr Amir appears to have been the subject of a single patient complaint to the GDC regarding their treatment. The unnamed patient suffered from a form of spinocerebellar ataxia. This degenerative condition is incurable and causes a loss of coordination and issues with movement. By their own description, the patient was desperate to find a solution for their problem and was suffering symptoms of anxiety and depression related to their ataxia. According to the patient, Mr Amir made no examination of their mouth but carried out a pseudoscientific applied kinesiology muscle test and advised the patient that their medical condition could be treated using a specific appliance to expand the upper jaw at the cost of £8,000. No other treatment was offered. It was this treatment or bust.
The GDC found that Mr Amir’s fitness to practise was impaired for several reasons. There were technical inadequacies in record keeping and clinical issues resulting from the lack of comprehensive examination and discussion around treatment options. But the regulator also looked at Mr Amir’s website. Here the GDC felt that the claims concerning treating conditions such as depression, ataxia, and MS were misleading. The standard of care given to the patient was found to be far below that expected of a dentist. The Fitness to Practise committee initially suspended Mr Amir for three months, which, following further review, was extended by a further 12 months. This meant Mr Amir was unable to practice for this time but would be able to update his knowledge and give evidence at a future review to show the GDC that he could practice safely. Failing this, he would be faced with erasure from the register, commonly known as being struck off.
In the dental world, the GDC has a reputation for being heavy-handed. Occasionally, however, they don’t go far enough, and the Professional Standards Agency (PSA), the Regulators regulator, becomes involved. This was one such case, which was reviewed at the High Court in November 2021. Here, the PSA asked the presiding judge to look at the GDC’s ruling. They felt that a dentist offering unsubstantiated treatment to a vulnerable patient for considerable financial gain warranted a more severe sanction. Mr Justice Lane found that Mr Amir acted dishonestly and that the claims being made for treatment were unjustified. Furthermore, the judge found that the GDC were overly lenient in their initial ruling of a three-month suspension. The court felt that the case against Mr Amir warranted immediate erasure from the Dentist’s Register of the GDC.
I do not doubt that Mr Amir felt, and probably still feels, that the treatment he was providing helped many of his patients cope with their conditions. His patient reviews were, in the main, positive, and he still has significant support. But as it stands, Mohamed Amir can no longer practice dentistry in the UK. And the High Court ruling shows that other dentists making extraordinary claims can expect a similar outcome.