MD, PhD, FMedSci, FRSB, FRCP, FRCPEd.

Hurray, homeopaths have a new study to be jubilant about!

But how far can we trust its findings?

Let’s have a look.

The aim of this study was to evaluate the effects of homeopathy (H) as an adjunct to non-surgical periodontal therapy (NSPT) in individuals with type 2 diabetes (DMII) and chronic periodontitis (CP). Eighty individuals with CP and DM II participated in this randomized, double-blind, placebo-controlled study. They were randomly divided into two groups: control group (CG) and the test group (TG), and both groups received the NSPT. TG also received homeopathic therapy, including Berberis, Mercurius solubilis/Belladonna/Hepar sulphur and Pyrogenium, while CG received placebo, while the TG received placebos. Clinical and laboratorial examinations were evaluated at baseline and after 1, 6 and 12 months of treatment.

Both groups showed significant improvement throughout the study for most of the parameters studied, but TG presented a significative gain of clinical attachment at 1 and 12 months compared to CG. Mean glucose and glycated haemoglobin significantly decreased in both groups after 6 and 12 months. However, there was a significant further reduction of these parameters in TG, as compared to CG.

The authors concluded that homeopathy as supplement of NSPT may further improve health condition, including glycemic control, in DMII patients with CP.

Over the years, I have learnt how to ‘sniff out’ studies that are odd. This is one of them, I fear; it smells strangely ‘fishy’.

Here are some of the reasons why I remain sceptical:

  1. There does not seem to be an approval by an ethics committee.
  2. I also could also not find any mention of informed consent.
  3. There is no mention of conflicts of interest
  4. Neither is the source of funding disclosed.
  5. There were zero drop-outs which I find hard to believe.
  6. The trial started in 2013, but was published only recently.
  7. The treatment with homeopathy lacks biological plausibility.
  8. The authors conducted > 50 tests for statistical significance without correcting for multiple testing.
  9. The clinical relevance of the findings is unclear.

Even if we accepted the results of this study, we would require at least one independent replication before we allow them to influence our clinical practice.

36 Responses to Homeopathy for chronic peridontitis? I have my doubts!

  • This is also an A vs A+B trial, isn’t it? And we know the results they deliver.

    • no, the controls also received placebos

      • What both groups got placebos? I mean what else can a homeopathy treatment be called?

      • Let me get this straight?
        Both groups received both the usual therapy (NSPT) AND the placebo-placebo. The test group received homeopathic remedies in addition, right?
        If so, the test group received more intervention!?
        Or am I misunderstanding?

        • both groups received NSPT
          the verum group got homeopathics in addition
          the control group got placebos in addition

          • Thanx Edzard for correctly clarifying what really happened here, while your colleagues do their best to be confused and share their confusion.

            That said, it is surprising that you continue to beat the drum about the “implausiblity” of homeopathic nanodoses, even though this old excuse rings hollow now that there are multiple bodies of evidence to provide reasonable explanations for how homeopathic medicines work that do not break presently established laws of nature.

            In addition to the good work published in LANGMUIR, the body of evidence about the 4th phase of water by one of the leading experts in water science in the world, Gerald Pollack, PhD, professor of bioengineering at the University of Washington.

            Anyone who suggests that homeopathy is “implausible” is simply showing their own ignorance and strong biases. It is time to look for other excuses to not believe in homeopathic nanopharmacology.

          • Dana, I call it the plausibility fallacy. The most extreme version goes as follows (And I have seen it being used): “Sure your data shows that treatment x works, and the study was done correctly, but the mechanism is implausible and thus we need to reject it nonetheless”. This happens when scientists have let go of the basis of science, namely discover what is. Instead, those scientists have replaced it with their opinion based on their understanding of biology which by definition is limited to what they have learned and rejects the notion that we might not know everything…..

            So, instead of succumbing to critizining healing modalities based on implausibility and placebo, what we need to do is examine whether a treatment is better at assisting people with their healing then others. Really, is it so difficult to see that if I can assist a person with having less pain so they do not need opioids that that is a good thing to start with, even if it is with a implausible placebo driven modality? And once we know that a treatment is beneficial, we can start figuring out what exactly in that treatment that is beneficial and then develop new or better modalities based on that.

          • by that token, you would need to run a clinical trial to proven me wrong, if I claimed that bungee jumping cured cancer.

          • I think you missed something in what I wrote. I never claimed we didn’t need any evidence of efficacy or effectiveness prior to making a claim.

            If you claim that bungee jumping cures cancer better than chemo, you would have to show that that people who go bungee jumping instead of going for chemo have a higher remission rate. After that, we can start figuring out why bungee jumping has this greater beneficial effect, how many bungee jumps are optimal, etc.

          • we are not talking of a comparison!
            all I need is a few cancer patients who say they feel that their cancer got better. this should be enough according to your line of thinking.

          • Not according to my line of thinking. That would be bad science.

            I wrote: “examine whether a treatment is better at assisting people with their healing th[e]n others”

          • Dana

            Will you stop referring to “homeopathic nanodoses”.

            It has been explained to you many times why homeopathy is NOT nanomedicine. That you keep banging this drum demonstrates only your own wilful stupidity.

            And if you can explain to us where the nanodoses are in homeopathic light of venus and homeopathic dolphin sonar we’d be grateful. These are proper homeopathic remedies for which “provings” have been carried out.

            And Langmuir? Still? That nonsense has been deconstructed repeatedly. And when was the paper published? 2012, Dana. Plenty of time has passed for others to replicate the findings and for the world of science and medicine to sit up and take notice.

            Hasn’t happened, has it?

            Could it be that the world of science and medicine disregarded it as the piece of fatuous nonsense that it is, Dana?

            Continue to stamp, sputter and wave, Dana. Keep going with your insignificant delusions of relevance. We’ll keep laughing at you as you dig your hole ever deeper.

            Homeopathy is to medicine as rain-dancing is to precipitation.

          • And Langmuir? Still non-replicated nonsence

          • @Lenny

            “Homeopathy is to medicine as rain-dancing is to precipitation”

            Lenny, you are entitled to your opinion, just like the rest of us.

          • so generous of you

          • @RG

            All people are entitled to their own opinions.

            What they are not entitled to are their own facts.

            That homeopathy has no effect beyond placebo is a proven scientific fact. You somehow believe that your opinions trump this. This is your problem, not mine.

          • @Lenny

            As I’ve stated here many times, I make no claims to advocate for homeopathy, but I do respect those who do.
            And yes, I do support the homeopathy and CAM therapies if for nothing else, the placebo effect. In my humble view, the risk/benefit is in the patients favor in many cases.

  • What both groups got placebos? I mean what else can a homeopathy treatment be called?

  • Homeopaths may be jubilant in Brazil but as we all know this study will have zero impact in the UK and other western countries. This study could be repeated dozens of times and the results would all be irrelevant due to Edzard’s point 7.

    Homeopathy research will therefore probably in future only continue in those countries where there is some medical and political support for homeopathy and where point 7 doesn’t invalidate the research.
    Hence the huge amount of ongoing homeopathic clinical and non clinical work going on in the BRIC countries.
    So yes Edzard you will need to keep going for the next 10 years as you will have lots of papers to review.

    • Yeah, the almighty plausibility fallacy…. A sure sign of bad science….

    • 8. The authors conducted > 50 tests for statistical significance without correcting for multiple testing.

      This is the main problem here. Mathematically the results are meaningless, regardless of plausibility or ethical considerations. You can take any dataset and analyse it until you get the result you want. It is called torturing the data until it confesses, and is rather akin to seeing faces in clouds.

  • I have looked at this and cannot make not head nor tail of it. I have however, read hundreds if not thousands of expert reports on periodontal disease and I am fully aware of the fact that those with chronic conditions are in the grip of a process which extends to behaviour, diet, oral hygiene and frequently co-morbidities of addictive substance abuse. In the worst of these cases the patients are often phobic of dental treatment and have a pattern of established traumatic emergency dental treatment for periapical infection and abscess. This results in a feedback loop of continued suffering as the distrust of dental treatments is reinforced by the inevitable trauma of untreated infections and the consequential last minute extractions.

    In most of these cases the furcation of the gum matrix is lost through years of calcified sub-gingival deposits which are admitted by poor brushing technique or zero flossing. This allows further deeper infection until the minerals of the root structure themselves are subject to microbial attack. Usually the teeth then become mobile and are lost.

    The treatment for acute and chronic sufferers is very different. It is for acute cases, unpleasant, painful to some degree and severely uncomfortable it requires an approach to descaling that requires the gums to be surgically peeled. In chronic conditions it requires an expert to assess, utilising the British Periodontal Exam scoring system and carefully planning a dental recovery that may involve a range of treatments both restorative and periodontal. There is no 1 simple solution for all cases.

    I am aware of several patients. (both existing and former clients) who are struggling with the regime of treatment. It’s very sad.

    Given that in most of these cases, antibiotics are of limited value without adjuvant surgical treatment, I doubt that any homeopathic treatment is ever going to have any impact on the disease. What it will do though is break a very important link of trust between the Dental Surgeon and the patient. It will endanger the fragile treatment arrangements and will likely lead to the re-establishment of negative habitual behaviours.

    I will of course defer to a GDS if they wish to correct my view.

    If anyone, diabetic or otherwise, has been diverted from treatment by such quackery, contact me. You will have free representation.

    • (A dentist writes)

      Graham is absolutely correct in what he writes. Misdiagnosis and mistreatment of chronic periodontal conditions is also one of the most common reasons for patients taking legal action against dentists. As with so many chronic conditions, with a lot of patients, there is no cure, just a long-term management of the condition which involves frequent costly and invasive procedures.

      I had such a patient last year get fed up with the constant circle of treatment and she asked me to extract all her teeth and fit her with full dentures. After lengthy discussion and making sure she understood the implications, she was still adamant that this was what she wanted. So this was the treatment provided. Six months down the line, she told me it was the best decision she’d ever made.

      The aetiology of chronic peridontal conditions is complex. And so is the treatment. The nonsense of magic shaken water has no role to play in it. It would be interesting to learn from Graham if any cases come his way on this matter.

  • “The study was reviewed and approved by the Ethic and Research Committee (CEP) of Veiga of Almeida University (UVA), RJ/Brazil (CEP/UVA protocol number 285-11).”

    So isn’t this an ethics committee approval ?

  • Hello
    I am very happy to know that our work has generated some discussion. The topic of homeopathy is really controversial. And perhaps that is why few journals have the courage to publish work on homeopathy (publication bias).
    The fact is: homeopathy works different than allopathy. Active components of homeopathic remedies are nanoparticles of source substance in water-based colloidal solution, not bulk-form drugs (doi: 10.1186/1472-6882-12-191). So, the dose-effect relationship of allopathy does not fit homeopathy.
    Well, if we don’t understand, should we just give up?
    Several colleagues cite very favorable results from the use of homeopathy in the daily clinic which makes us believe that we must move on.
    Brazil is not just a jungle. We are proud of our jungle, of course, but we are also proud of our science. Our work was approved by an ethics committee and all patients signed the consent form. There are no conflict of interest. We just wanted to contribute to science. Does the paper have problems? Okay, let’s do better next time. Biological plausibility? We don’t really know much yet but we are trying to build bridges and not walls. Perhaps together we can better understand homeopathy and so many other treatments without “biological plausibility”.
    Homeopathy for chronic peridontitis? I also have my doubts!
    I am a researcher and doubts are very important to me.
    Thank you. Take care and stay at home.
    Canabarro.

    • if you are a researcher. as you say, should you not respond to the issues I raised?
      There does not seem to be an approval by an ethics committee.
      I also could also not find any mention of informed consent.
      There is no mention of conflicts of interest
      Neither is the source of funding disclosed.
      There were zero drop-outs which I find hard to believe.
      The trial started in 2013, but was published only recently.
      The treatment with homeopathy lacks biological plausibility.
      The authors conducted > 50 tests for statistical significance without correcting for multiple testing.
      The clinical relevance of the findings is unclear.

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