by Dr. Reza Ardalan, Host of the Dental Slang Podcast
Dr. Katie To is a trailblazer in cosmetic and wellness dentistry, known for her commitment to continuing education and her dedication to staying at the forefront of dental innovation. As one of the first dentists to earn a master’s in biological dentistry while also mastering digital smile design, Dr. To combines advanced techniques with a holistic, biocompatible approach to patient care. She is highly trained in cosmetic bonding, non-invasive cosmetic dentistry, dental ozone therapy, biological dental therapy, and clinical nutrition, always prioritizing the safest, least toxic options for her patients.
Tune in to hear how Dr. To’s journey began and what inspired her commitment to safer, non-toxic approaches in dental care. Topics include:
Material Choices: Specific examples of products she avoids, the reasons why, and the innovative alternatives she uses.
Navigating Cost Concerns: Strategies for discussing the higher costs of biocompatible options with patients, especially those who are price sensitive.
Top Learning Resources: Recommendations for resources and continuing education organizations leading the field of biocompatible dentistry.
A Sneak Peek into Dr. To's Book: Hear more about the lesser-known innovations in biocompatible dentistry.
The Art of Ceramic Implants: Learn about the unique techniques required to work with ceramic implants compared to traditional titanium ones.
Marketing a Niche Practice: How she identifies and connects with an audience receptive to biocompatible dentistry concepts and products.
Leading Companies in the Field: A look at suppliers offering comprehensive biocompatible product lines for general dentists.
Tune in to gain a deeper understanding of this growing movement and Dr. Katie To’s passion for creating healthier smiles through biocompatible solutions.
To connect with Dr. Katie To and stay updated on her journey, you can reach out via Instagram at @DrKatieTo or visit her website at katietodds.com
Listen to the full podcast on DentalSlang.com, or read the conversation below.
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Dr. Ardalan: Katie, thank you so much for taking the time to join us on the Dental Slang Podcast.
Dr. To: Reza, thank you so much for having me, especially on a weekday like this. Having a conversation with you is the best.
Dr. Ardalan: I first met you at a dental meeting, seated next to you at dinner. By the time the salad arrived, I was captivated by your passion and journey in dentistry. I can’t recall what we ate—just that I spent hours asking you questions, and you graciously answered them all. By dessert, I knew I had to have you on the podcast to share your story. You’re known nationally for focusing on biocompatible products as a wellness and biological dentist. Could you share your journey with our audience and what led you to this approach?
Dr. To: Thank you for always being so curious and open-minded. I remember that dinner because we talked for so long and realized, oh my God, they’re closing! An interesting story: when I was in dental school from 2006 to 2010, everyone in my class thought I would pursue a pediatric residency. But then Bar, my husband now, got into an ortho residency program in Oklahoma, which had no pediatric program. So, I said, “You go ahead and do your ortho, and I’ll do my residency when you’re done” During those three years while he was in residency, I was practicing and realized, Oh, I don’t really like pediatric dentistry.
The number one lesson I learned is that things happen for you, not to you. Through that perspective, I found my passion. I also discovered my love for cosmetic dentistry—particularly working with composite—thanks to an incredible mentor, Dr. Nasser Barghi, a renowned professor who taught for many years. I feel very fortunate.
I practiced cosmetic dentistry until 2018 when I became extremely sick. My doctor kept saying, “You’re fine. You’re a mom, a business owner—you’re just stressed.” But deep down, I knew it was more than that.
Lesson number two: listen to your gut. Don’t question it—look for the answer and dig deeper. I followed my instincts, and as it turns out, people don’t come into your life by accident. One of my patients asked, “Have you seen a functional physician?” I had no idea what that was. They explained that functional medicine goes deeper with more thorough testing.
I decided to make an appointment and was blown away by their process. The new patient exam was two hours long and included questions about everything—from birth details to whether I was breastfed. It was incredibly thorough. When they got to my occupation, they decided to test for heavy metals. At first, I thought it was unnecessary—I didn’t even have metal fillings. But the results showed I had 10 times the acceptable limit of lead and five times the limit of mercury.
I was in denial until two more medical professionals confirmed the diagnosis with similar testing—hair, urine, and blood. I also realized I had 20+ symptoms of mercury and lead toxicity. I discovered the exposure came from dentistry. At that moment, I faced a choice: either practice safely or quit dentistry because my body couldn’t handle it.
This leads to lesson number three: medicine and dentistry should be personalized, not one-size-fits-all. For example, my husband has amalgam fillings and is perfectly fine—his body can detox and excrete heavy metals. Mine cannot. For me, the choice was clear: I couldn’t give up dentistry, so I had to change how I practiced to protect myself, my patients, and my team.
In 2018, I began my journey into wellness and biological dentistry. Initially, it was for selfish reasons—I needed to protect myself. But as I dove deeper, it all made sense. I realized why European countries banned amalgam fillings and why federal law mandates amalgam separators in dental offices. The pieces came together.
Now, I enjoy treating patients from across the country. This week, someone flew in from Nebraska. Last week, a patient came from Seattle. I thought, There are so many dentists in Seattle, the birthplace of the Seattle Study Club. But people are seeking answers—they want to live not just longer but healthier lives.
Dentists play a crucial role in overall health as the experts of the mouth. My personal journey taught me this, and I’ve since collaborated with medical colleagues on cases involving Alzheimer’s, autoimmune diseases, and cancer. I’ve realized that we are not inferior to medical physicians. In fact, in many ways, we’re on the same level—or even superior—because we manage the health of the mouth, a critical component of overall wellness.
Dr. Ardalan: Correct. You know, one of the fascinating things about our conversation that we had at that dinner was the way that you collaborate with the medical professionals. Now, as a pediatric specialist, I have a lot of interaction with them, but sometimes it's not on the same level. Most of the time, as general practitioners, we're just maybe asking for a clearance to do a particular procedure. But the way you are doing it is completely different. The amount of testing that you're doing and the things that you're interacting with them on are amazing.
As we mentioned earlier, we could go in a thousand different directions—talking about the airway, holistic approaches, and more—but I want to give our listeners some specifics. Can you provide examples of particular products you won’t use in your practice? And how did you replace them?
Dr. To: Oh, absolutely. As I mentioned, medicine and dentistry should be personalized. Our number one rule in the practice when we're seeing a patient is that each patient's body accepts different material. So, in general, our practice is a metal-free practice. We don't do any metal fillings, amalgam restoration, PFM, no gold, no stainless steel. We also remove it safely if they are in the patient's mouth. So, that's the number one rule in our practice: no metal.
If the patient needs an implant, we prefer zirconia over titanium implants. More and more patients are showing that their immune systems are not optimized and not ideal. So, anything that can trigger reactions or burden their body, we stay away from.
Then onto the topic of fluoride: we use fluoride-free toothpaste and have incorporated hydroxyapatite, which I’m glad has become a common ingredient in toothpaste. Instead of topical fluoride, we focus on alternatives like MIPaste for hygiene and prevention, both in-office and at home.
We’ve also added nasal hygiene and sinus cleaning to our approach, along with mouth-taping to support a healthier oral microbiome. These measures help patients take greater ownership of their health rather than just visiting the dentist every six months and saying, “They put fluoride on, and I still have cavities.” Let’s be real—flossing once every six months isn’t going to work, no matter how much fluoride we apply.
So, while we’ve removed certain products, we’ve given patients more responsibility. In our practice, every patient has homework.
Dr. Ardalan: It's funny because I think many times, especially in recent years, the terms “holistic dentist” or “biological dentist” get pigeonholed into a certain perception. A lot of what you're doing seems to emphasize putting ownership and responsibility on the patient, helping them understand how to take care of their body. Across dentistry, we always talk about the mouth-body connection, and it seems like you’re taking that concept to the next level.
As dentists, we tend to be very price-conscious—some might even say frugal. Biocompatible products often cost more than the alternatives. How do you address the cost issue with your patients, especially those who are also price-sensitive, when discussing these options?
Dr. To: Yeah, I love that you asked this question because many dentists ask me the same thing: how do you get patients to accept your fees, or how do you manage the higher overhead with these materials that are more expensive, less widely available, and offered by only certain brands? I always say, first and foremost, as a dentist, you cannot compromise clinical outcomes. As a business owner, you cannot compromise running a practice, paying rent, or covering payroll. So, there’s a balance to strike between understanding your numbers and the clinical impact, including material cost and time.
Some materials take longer to use, which increases costs—not just the purchase price but also the time required for implementation. For us, we calculate the unit of time, the cost of materials, and ensure those are offset appropriately. Patients seeking biological or wellness dentistry may have concerns about price, but they also recognize there aren’t many places they can trust to provide these services. That’s why I love sharing this information with anyone willing to listen. So many patients are looking for practitioners who are open-minded and understanding, like you.
If you meet patients where they are and don’t compromise clinical outcomes, even price-sensitive patients will see the value in your treatment because it’s what’s best for them. This is especially true in pediatric dentistry. As parents, we might save money on ourselves, but when it comes to our children, we invest because their health is a priority.
Back in 2018, when my practice was insurance-dependent and I accepted plans, questions would always come up, like: “Ozone isn’t covered by insurance. How do you address that?” Our approach was simple: we tell the patient what they need for the best clinical outcome. If a patient doesn’t agree and it doesn’t align with my clinical philosophy, then I won’t do the case. I draw a very clear line.
When I first implemented safe mercury removal, it was a big adjustment. It took much longer because we placed rubber dams on every single tooth. If I removed four fillings in a day, that meant four rubber dams—removing one, putting another on, and so forth. It’s time-consuming. I also had to wear a respirator, which left marks all over my face. It’s uncomfortable, and you can’t see another patient during that time. The schedule is blocked for that patient, and we charge more for that time.
So, it’s not just about the material or the company you buy from; it’s also about the time spent. In our practice, we personalize fees not just for the patient but also for ourselves. If a case takes longer, whether due to deeper cavities or challenging positions like a distal number 15, we charge more. Medicine already does this with units for sedation and other services, and it’s time dentistry adopts a similar approach.
Ultimately, it’s about setting clear boundaries. As long as you define what’s clinically acceptable and aligns with your practice philosophy, it’s okay if a patient doesn’t accept it.
Dr. Ardalan: I love how informed you are about this and how you emphasize understanding the unit of time. No matter the type of dentistry you practice, as a business owner, you must know the value of your time. If you're performing a procedure, you need to determine its worth and approach it accordingly.
You mentioned the patient from Nebraska—do you find patients seek you out specifically for your alternative approach to dentistry, or do you often educate patients who come to your office unaware of the choices they have?
Dr. To: This is a great question because I have both types of practices. In one practice, I see two types of new patients: wellness patients and cosmetic consult patients.
Cosmetic consult patients often have no knowledge about topics like fluoride, metals, or bacteria in their saliva. They’re not familiar with these issues. For example, two days ago, I saw a 13-year-old cosmetic consult patient who came in for four white spots on her front teeth. The first thing I noticed was that she was a mouth-breather. The second thing was a narrow upper arch. Her inter-molar distance was like an eight-year-old’s, not a 13-year-old’s. She had just gotten out of braces a month ago, and her gums were swollen and bleeding. She wanted whitening and cosmetic work. I sat down with her mom, asking about her journey from birth, her sleep habits, and everything else. By the end of the appointment, she walked away with a digital smile design, a sleep study, and a saliva test. So, while she came in for a cosmetic consult, she left with everything we know would benefit her.
The other type of patient is someone who comes in from out of town, typically referred by a medical professional or someone who has heard about me or seen my credentials in wellness and biological dentistry organizations. They travel specifically for that wellness biological service.
In our practice, regardless of whether the patient is coming for cosmetic or wellness care, we follow the same protocols. We treat all patients the same way. However, some patients are already aware and eager to dive in, while others may say, "I know I’m not breathing well, and I’m snoring, but that’s not my priority right now." And that’s okay—because the patient has to be the one to commit to the journey. If we push it on them, they won’t follow through, and then they’ll blame us when things don’t go well.
Dr. Ardalan: Right, you did the right thing. Even when a patient comes in for a cosmetic consultation, if you notice other issues, you won’t ignore them. You take the time to educate them, not just say, “hey, you might have an airway issue,” but actually show them. What you do next may differ, but you stay true to yourself and your practice philosophy by addressing everything.
When I was in dental school, this topic wasn’t covered much. Are there any resources or lectures on biocompatible dentistry you’d recommend?
Dr. To: Oh God, there’s so much. I’ve said in many interviews that I’m a lifelong learner. In the last few years, I’ve noticed that my CE has been more medical-related than dental-related because we’ve realized how much we don’t know about what our colleagues in the medical field are doing, and they don’t know what we’re doing. For me, a big part of biocompatibility is understanding the patient’s DNA and blood work. You’re right, we didn’t have that class in school. We had genetics in college, but it wasn’t focused on our patients or how we approach them. I believe the future of medicine and dentistry is personalized. DNA and blood work are crucial. We learn that from wellness practitioners, not just primary care physicians or the mainstream. When you get blood work at the lab, they compare your numbers with those from all the patients in their database, which could include cancer patients or other sick individuals. Healthy patients typically don’t get blood work as often. So, your numbers might look great compared to a cancer patient, but if you compare them to someone like Tom Brady, they might not look so good.
You have to understand what the wellness standard looks like. I want to compare my numbers to Tom Brady's—that’s what I want to achieve for my wellness and health.
Dr. Ardalan: And if those numbers aren't there, find a route and a path to try to get to a number like that.
Dr. To: Yes, yes. There are a few organizations that are very big on biocompatibility. One of those is called IAOMT, International Academy of Oral Toxicity. And they study material, especially amalgam, and show you all the studies about amalgam, fluorides, and chlorhexidine, and things that you have used in practice for so long that you can now realize it is so toxic. Another organization is called International Academy of Biological Medicines and Dentistry, IABDM, and they have lots of courses and curriculums on material, a lot of great speakers and resources. And so, I would say start with those groups, and then from there you can keep learning and growing, and then you may find yourself taking medical CE.
Dr. Ardalan: Yeah, and I find that too, a lot of times as I go down different journeys, I end up somewhere completely different than where I started but it's nice to have some resources and say well, I'm going to start here and it's like well, maybe dentistry isn't the path that's going to give me the answer to this and I'll go a different direction.
Now I know that you're working on a book on biocompatible dentistry. Can you just talk a little bit about what we might expect to learn about?
Dr. To: This is a public announcement for accountability! Because I have not made it public, but now you have made it public. So, now I must really get to work on this book! Yes, I'm working on this journey. And we are making it a textbook where photos, video, case studies, right, have main takeaway points to get people to feel comfortable, like, “Oh, I didn't learn this in school, but this textbook's showing me from starting with the basic step to if I want to learn more, where do I go from here?” So yeah, I'm excited about this – it’s going to be a 350-page textbook. It’s a big project, but I love this challenge, and I know that so many can benefit. So, for me, that's a huge honor, and almost like a legacy that I can contribute to.
Dr. Ardalan: And I love the fact that, for you, it's all about disseminating information. You've mentioned that multiple times. Why are people coming to me? You would much rather there be somebody that's similar to you in Seattle, or wherever it is so that they're not having to travel. So, it's really about getting out the information.
One of the things that I find interesting is that as I do more of these podcasts, I learn a lot. As I talk to more general practitioners, I learn about things that I don't do every day like implants. You talked a little bit about ceramic implants and how they have to be handled in the mouth quite differently than the standard titanium implants. How do you go about learning these alternative techniques?
Dr. To: Yes, do you remember in dental school we have a class called biomaterial?
Dr. Ardalan: I remember that well, it was painful.
Dr. To: Painful, I know. And a lot of us probably fell asleep.
Dr. Ardalan: Were you watching me in class? You might have been watching me.
Dr. To: So, what I understand is, first and foremost, it's simple: know which companies work with ceramic implants, like Straumann and Nobel. I love Straumann ceramic implants. In fact, both my sister and my mom have had ceramic implants for a long time.
When a company introduces a new material, they have to invest a lot of time and money into the project. Then they conduct numerous studies, which must go through various approvals from multiple continents before the material can hit the market. Especially in the US, the FDA process is challenging. For me, the companies already have the resources and come with instructions, but most of us tend not to read the instructions because the booklet is like 26 pages long, and in 26 languages.
Dr. Ardalan: Right.
Dr. To: Maybe the English instructions are actually only one page. So, I always encourage all dentists to just take the package out and read the instructions because they tell you step by step by the manufacturer how you should work with the material.
Also, you must understand that if you work with zirconia, you have to understand how it works with materials. Do you have to aerate it? Do you have to use primer, like Z primers or some sort of zirconia primer? How do they bond together?
For example, anytime they say a zirconia crown comes off, I say, where is the cement? Is it in the crown, or is it on the tooth? So that way, you know where the interface failed. So, for me, it's really not fun in dental school learning biomaterial, but now, in real life, you'd be like, I need to bond a zirconia crown to a zirconia implant. How do I do that? And who in the field has the experience and expertise to do that? Well, number one, manufacturers have a lot of expertise and research and studies.
Second, many professors have already studied this in school. For example, Dr. Nassif Barghi, whom I mentioned earlier, always talked about veneers made of zirconia back in 2006. At the time, we were like, no way—it's kind of ugly-looking. But now, it actually works, right? The translucency is really natural-looking. Some pioneers in the field, like him, have tons of experience, research, and studies to show you. But my number one resource is to go to the manufacturer and ask them, "How do I do this?"
Dr. Ardalan: That's the best advice: read the instructions. They're the ones who developed it. So, if you want to minimize your chances of failure and maximize your chances of success, maybe just follow the rules.
Dr. To: Just follow the rules, follow the recipe. Did you change the recipe? It's not going to have the same outcome.
Dr. Ardalan: Katie, in addition to your science background, you also have great business sense. I love your social media posts, so I'm curious: Do you market yourself as a biocompatible dentist? If so, how do you find an audience that's receptive to your concepts and products? Some people may argue or feel that it's not what they were taught. How do you market that side of your business?
Dr. To: You know what, this question alone is like a two-day answer.
Dr. Ardalan: 100%. But I still really wanna know.
Dr. To: We call this the $50,000 tip. If you're listening to this podcast, stop what you're doing and listen closely. The number one rule, no matter if you're doing wellness, biological, pediatric, airway, implants, full-mouth rehab, or any specialty, is that you have to connect with the patient. Especially with social media these days, people want to know who you are outside the office.
I have no problem sharing with patients or on social media that I’m taking CE this weekend. When I go to Amanda Seay’s CE course, I say, "Hey, I’m hanging out with my friend," or "I’m taking a vacation with my family," etc. I’m human, and I’m always trying to connect with patients. I love sharing my children's stories or my own personal story because nothing is more powerful than a provider who’s gone through what the patient is experiencing. “She had mercury toxicity,” or “She had fertility issues,” or “Her kid has immune issues.” When you talk about what they’re going through, they will immediately connect with you.
My second rule in marketing is to educate and provide helpful information. People scroll endlessly every day, and if you don’t provide valuable content, why would they follow you? Connect and educate.
Number three is to position yourself as an authority on the topic. No one wants to go to a newbie. I’m sure your practice is busy because you’ve been practicing for a long time, teaching, and lecturing. Patients want Dr. Reza to do their case. A big part of marketing is authority marketing; you have to overcome your fear of public speaking and share your story, even if it’s just with a ring light in a closet.
Overall, the most important tips are to be honest, connect, educate, and position yourself as an authority on the topic.
Dr. Ardalan: That was solid gold. That was way more than $50,000. I hope our listeners appreciate these nuggets of information. It's about the connection. That's with any business across many platforms.
Are there any particular companies that you find provide a broader array of biocompatible products for the general dentist to use?
Dr. To: For me, there are so many, it doesn't matter from what continent, in Asia or Europe or an American company. These companies are well aware, especially after the pandemic, that people spend more and more time and money on wellness. You know that before COVID, not many people had trackers for their continuous glucose monitor, their sleep, their mood, etc.
Dr. Ardalan: I got one on my finger right now
Dr. To: That's how they get you, right? These companies are aware of the trends, research, and what the consumer is looking for. For example, Ultradent has a lot of great products, and GC from Japan has many great products. But I would say Ivoclar is my favorite. I'm using a lot of Ivoclar products. However, not all patients are compatible with Ivoclar products, even though that's what I have in the practice. So, I carry Voco because many of my patients are compatible with Voco products.
I recommend reaching out to the company and asking about the materials. Do you have BPA in this? Patients are concerned about things like this, and if it's resin, is there PP in it? If it's glass ionomer, how is the fluoride being released?
I would say be genuinely interested in the science. That way, when a patient asks you, you have solid information to provide, rather than just saying, "Oh, that's not what we’re doing." There are emotions and science-based facts. If you're always science-based, people may not like your answer, but they will respect you because science is reliable. If it feels emotional, they’ll think, "Oh, that's just her opinion." No, this is what's been researched.
Dr. Ardalan: Right.
Dr. To: For me, regardless of the company you work with, always ask about the material.
You'll be surprised—they’d love to give you samples. They want you to use it, get educated, and learn more about it. As dentists, our responsibility is to get to know the company and voice what we want and need. That way, they’re not only hearing it from the patients but also from us, the dentists, saying, "We need more biocompatible materials. We need materials that are easy to deliver."
I know SDI, an Australian company, just came out with a material that’s compatible, doesn’t require etching, and doesn’t need light curing. You just mix it, apply it, and you're done. For many cases, especially in pediatric dentistry, I'm like, I want that material!
Dr. Ardalan: Absolutely, it's just a great product, and we can be efficient. You know, one of the things that I've heard you say repeatedly is that this really seems like it's a worldwide movement, right? It's like, it's not just happening in the States. Now, do you think there are any particular countries that are leading the way in advancing biocompatible dentistry? And if so, what will it take for this movement to be more readily accepted as the approach to clinical care globally?
Dr. To: Oh, great. This is so deep. It's so deep with what I'm thinking and seeing every day. Number one, you know, as an American dentist, I have to say, we are the leader. So many countries in the world want to say that, hey, we banned amalgam in 2007. You know what? But the world is watching us, Asia’s watching us, Europe’s watching us, South America’s watching us. We are the biggest market for all technology and materials. So if America adopts something, the world will follow.
And so I think that not just for our patients, but for the world, we have a bigger responsibility. And this movement is going to start with us. Because we have a huge number of dentists compared to the whole continent in Europe, Asia, and so many places. It's on us; if we adopt this movement by being open-minded and learning more about what our medical colleagues and patients are looking for, I think the biggest reward is that we will learn so much about our body that we get healthier. And you'll be like, oh, I started this journey just wanting to learn more for my patients, but I realize that my team now knows more, I know more, and so now everyone benefits from it.
I think this movement is unstoppable; the world is already heading in this direction. You probably noticed that for Black Friday, everything is wellness-themed, like the cold plunge, the sauna, the treadmill, the bike, etc. I mean, everything is about not just living longer but living healthier. So, in our practice, we always talk about confidence and smiling for a healthy life. You can't smile unless you're healthy. And you cannot have a healthy body unless you have a healthy mouth. So, you know what, dentists, we are so important in that role. And if we don't start this movement, who will?
Dr. Ardalan: That is awesome. Katie, if people want to learn more about this and learn more about you, what's the best way for them to follow your journey?
Dr. To: I love to connect with people on DM via Instagram. DM me, connect with me; @DrKatieTo is my handle, and my website is katietodds.com.
Dr. Ardalan: Yeah, and I'll say this as somebody who follows you, the stories are great, and you're very true to your word. It is very educational. Like when we hopped on before we recorded, we were talking about vacation, I only knew about that because I saw it on social media. So I was like, how was the concert? How was this? So, I 100% would recommend everybody to follow Katie. While you're at it, make sure you follow Dental Slang Podcast, and also give me a follow while you're at it at @Dr.RezaArdalan. Katie, thank you so much for taking the time to join us on the Dental Slang Podcast. We appreciate you so much.
Dr. To: Thank you. I love all your questions. Thank you so much for having me.
