BIOLOGIC ROOT CANALS
Root canal (endodontic) therapy is undertaken when a bacterial infection or trauma causes the tissue/pulp (nerve and blood vessels) within a tooth to die. This can result in extreme pain, although, sometimes there is no pain at all. There are a variety of ways that an acute (painful) or chronic (not painful) infection is diagnosed. These include:
- History of symptoms (hot/cold sensitivity, spontaneous pain, percussion sensitivity)
- Radiographs (x-rays)
- Pulp vitality testing
What Treatment Looks Like
Tissue within a “dead” tooth will not heal, even with antibiotics (which can alleviate the pain from a swollen infected tooth for a short time). Treatment options for an infected tooth are limited to extraction or root canal therapy. Studies indicate that somewhere between 85%-95% of endodontically treated teeth are successful. It should also be noted that a crown is highly recommended for all back teeth after root canal therapy.
The major reason that some root canals fail is because teeth are composed of millions of crystalline tubes, radiating outward from the pulp. Once dead tissue, bacteria and toxins are embedded within these tubules, they must be thoroughly cleaned or the tooth will not fully heal. In fact, the tooth may even become re-infected.
Many biological dentists claim that any infected tooth, even those with a successful root canal treatment, should be removed. They base this recommendation on two claims. First, they feel that the tubules cannot be cleaned out no matter how thoroughly they are instrumented. Thus, any root canal treated tooth results in chronic infection and worse yet, is the cause of other deadly diseases. Second, they are concerned that dead teeth impact the body systemically and should always be removed to properly allow healing.
At the Van Hala Dental Group, we routinely present root canal therapy as an option for our patients. One reason we feel comfortable with this therapy is we do not feel the evidence supports the claims that root canals cause disease. Another reason is that many patients in our practice have had root canal therapy, and they are healthy, even after many years.
As for the claims that root canal systems cannot be decontaminated, we feel that to properly disinfect root canal systems, the use of 3D, CBCT imaging (which assists us in the identification of all the major canals within a tooth) is crucial. As for the many tubules, studies have shown that use of extremely basic materials, such as calcium hydroxide, left in the canal for several weeks (prior to obturation or the final fill), can migrate all the way to the outside of the tooth, resulting in the bacteria to be expelled and killed.
As for claims about whether root canal therapy interrupts body systems, we feel that each person must take careful consideration. We have not seen conclusive data that supports this belief. Again, if any of our patients are absolutely against root canal therapy, we completely respect that and are happy to present them with other options such as implants or other removable solutions.