The term raises such apprehension and so many questions: What is a root canal? Is the tooth dead? Are root canals bad for you? Can they be avoided? What are my options?
A root canal, or endodontic treatment, is a dental procedure designed to save or preserve a badly infected, broken, or decayed tooth. The nerve, or pulp, of the tooth dies, so it is removed from the canal area and then filled with a rubber substance (gutta-percha). Then, the tooth is eventually covered with a crown to protect or “strengthen” the remaining tooth structure.
When the nerve of a tooth has irreversible damage, such as in an infection or a fracture, you essentially have two options to treat it: remove the tooth and replace it if desired, or have a root canal treatment.
Root canals have been in practice since the mid-1800s when dentists and patients wanted an alternative to having a tooth pulled. Needless to say, the techniques and materials used have evolved greatly. Today’s root canal specialists (endodontists) use microscopes, lasers, frequency treatments, and even ozone for disinfection.
Is the Tooth Dead?
Once a tooth receives a root canal, it is technically no longer alive—so the tooth, without the nerve, is retained in the jawbone so that esthetics and/or chewing functions are preserved. Most dentists are quite successful at cleaning out the dead tissue in the main canal area and disinfecting it. And even when there’s infection in the bone, most cases heal, and new bone will grow—the body is amazing!
The problem with a root canal treatment is a little more complicated, so let’s look at a little tooth anatomy first.
A tooth has three main parts:
- Enamel: The hardest substance of the tooth, it covers the crown.
- Dentin: Found under the enamel and covering the root, the dentin is the highway system of miles of small tubules filled with lymph-like fluid. Each tubule opens to the central nerve chamber of the tooth (pulp).
- Periodontal ligament (PDL): This ligament anchors the root of the tooth to its socket. Nutrients flow into the dentin and pulp/nerve, and the live tooth cleans/filters from inside.
Once the bacteria enter the tubules (dentin), it infects the tooth and, if left unattended, will reach the nerve and infect it as well. The medications used to clean out the main canal area are very effective, but not the microscopic tubule. Once the dentist seals the main canal, the fluid that fills those tubules can house bacteria for years. Antibiotics and our immune system are unable to flush them out. Why? Because the main flushing system has been filled with the gutta-percha.
Have you ever wondered why your teeth feel so nice and smooth when you brush them before bedtime, but then the next morning, there’s a film and no smooth feeling? Your teeth have a way of cleaning themselves when they are healthy. Surprised? We were, too! We did not learn this in dental school!
Now that bacteria in the small tubules adapt to living with no oxygen – anaerobic bacteria (AKA the bad guys) create endotoxins. These endotoxins will reach the bone (and the rest of the body), and here is when problems arise.
The truth is that some patients have very robust immune systems and will never notice a problem, while others have chronic conditions or their immune system is taxed, so symptoms become obvious.
Root Canals Aren’t Perfect
No, they’re not…but neither is modern medicine. Our patients are always given all the options. Each patient makes an informed decision on his own health. So why are biological dentists not fans of root canal treatments? Because dead things do not belong in the body. If another part of the body dies, we take it out. Gangrenous limb? Cut it off. Burst appendix? Take it out. Ruptured spleen? Out it comes. But for some reason, conventional dentistry has led us to believe it’s OK to taxidermy and leave a dead tooth in the body.
Our bodies are bioelectric! We conduct bioelectric energy. But when something dead is in the way, it blocks the bioelectric impulses. Plenty of patients are not emotionally prepared to lose a tooth, and we are firm believers in medical freedom of choice. Because of that, we believe everyone has the right to make their own choices…even if we ultimately do not love their decision.
You will NEVER hear, “You need a root canal.”
You WILL hear something along these lines: “Your tooth is infected/fractured; here is your X-ray and the 3-D image of it; here are your options for treatment A, B, or C.”
In my opinion, the odds are stacked against long-term success with a root canal, but patients make their own decisions.
Any good biological dentist will explain your options and design a treatment plan specific to your needs, desires, and recommendations for a holistic, biological, integrative, functional, and biomimetic approach.
The new frontier in regenerative dentistry includes regenerating pulpal (nerve) cells, TMD (temporomandibular disorders), and even ONJ (osteonecrosis of the jaws). Although there are no systemic reviews on the use of PRF in these cases, there are many case reports and studies showing promising outcomes.
At Pure Dental Naples, we have had success avoiding root canals in certain teeth. While we obviously cannot bring back to life a tooth (nerve) that is dead, there is a sensitive protocol that
needs to be followed, and the outcomes have been excellent.
If you already have a root-canaled tooth, make sure you have a CBCT or 3D cone beam to evaluate any changes in the bone around the root-canaled tooth. Just because it “doesn’t hurt” does not mean it’s fine. I always advocate for being proactive rather than reactive.
Dr. Josephine Perez, DMD, has been practicing dentistry for nearly thirty years. She is a graduate of Tufts University School of Dentistry in Boston and interned at New Orleans Coast Guard/Navy Base. Her holistic approach to dentistry encompasses each person’s unique and entire (or whole—holistic) state of physical and emotional well-being. The ability to maintain health through preventive measures and treatments of oral disease is her priority. Dr. Perez focuses on the underlying condition rather than only treating the symptoms. She tests for biocompatibility to find pathways to reduce inflammation and apply biocompatible and biomimetic materials, supplements, and essential oils to restore and strengthen the oral cavity and, ultimately, the whole body. After decades of restoring and transforming smiles, Dr. Perez has integrated total wellness into her oral health enhancement practice—a revolutionary style of dentistry.
Visit Pure Dental in Naples at 4444 Tamiami Trail N, Ste. 6–7, call 239.692.9623 or go to: www.puredentalnaples.com.
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