Homeopathy in dentistry? No, thanks!

The objective of this review (entitled ‘Systematic Review on the Use of Homeopathy in Dentistry:
Critical Analysis of Clinical Trials‘) was to map the literature on homeopathy in dentistry and to evaluate the effectiveness of using homeopathy in dental practice through the critical analysis of clinical studies.

The search for scientific articles in any language, year, and place of publication was made in the databases of Public Medline (PUBMED), Web of Science, Cochrane, and Virtual Health Library; the articles selected were later classified according to the type of study. Gray literature was accessed through Google Scholar. Clinical trials were analyzed for methodological quality. Two trained reviewers accomplished the entire process independently.

Of the 281 studies retrieved by means of the search, 44 met the eligibility criteria. The included papers were:

• literature reviews (56.8%),
• clinical trials (34.1%),
• cross-sectional studies (6.8%),
• laboratory research (6.8%),
• longitudinal observational studies (4.5%).

The clinical trials were published from 1965 to 2019, using homeopathy in several dental specialties:

• Endodontics,
• Periodontics,
• Orofacial Pain,
• Surgery,
• Pediatric Dentistry,
• Stomatology,
• dental anxiety.

Qualitative failures, in all criteria investigated, and positive influences of the individual prescriptions on the results of treatments reported were observed.

The authors concluded that there is still a scarcity of studies about homeopathy and dentistry. The clinical trials selected showed positive effects on oral health; however, when they were critically evaluated, it was possible to recognize qualitative failures, mainly relative to double-blinding. It is necessary to encourage research on the subject, using standardized methodological procedures, to obtain better evaluation of the clinical applicability.

According to the authors, their review adhered to the PRISMA guideline of systematic reviews. This is, however, not the case. The authors correctly point out that the primary studies had many flaws: methodological failures were observed in the clinical trials, mainly related to double-blinding (66.7%). Significant failures were also observed in similarity (61.1%), randomization (27.8%), description of losses and exclusions (27.8%), and exclusion criteria (27.8%). They do not seem to realize that flaws of this nature and frequency should prevent positive conclusions.

So, what does this paper actually demonstrate? In my view, it shows that:

• the peer-review process at the JACM continues to be a joke;
• poor quality trials run by enthusiasts tend to produce false-positive results;
• in so-called alternative medicine (SCAM), people get away with publishing even the most obvious falsehoods.