Root Canal Controversy

When the nerve of a tooth dies, there is no longer adequate blood supply coming into the tooth and it becomes infected with bacteria. This can happen due to decay, a crack , trauma or previous dental treatment. If the infected tooth is left untreated, pain, swelling, bone loss, and in extreme cases death can occur.  A dead tooth can remain “asymptomatic” for a period of time or the infection can drain creating an abscess.  Even though there is no pain in this circumstance, bone loss, systemic circulation of bacterial toxins and a drain on the immune system ensues.  There are two treatment options for a dead or dying tooth:

Root Canal Therapy (RCT): involves removing the nerve, blood vessels, and lymph tissue from within the tooth and then sealing the empty chamber with a filling substance called gutta percha (may contain cadmium and mercury salts). Because the integrity of the tooth structure is usually compromised with RCT, a crown is typically placed over the remaining tooth structure.

Tooth Extraction: The infected tooth is removed and the site is allowed to heal for several weeks.  Once the extraction site is healed, tooth replacement (removable partial denture, bridge, dental implant) can begin.

Root Canal Therapy is Safe
Root Canal Therapy (RCT) is the conventional standard of care for a dead or dying tooth.  RCT has been practiced for almost a century and the American Dental Association has recognized endodontics (RCT) as a specialty within the field of dentistry.   It is estimated that 14 million root canals are performed every year by general dentists and endodontic specialists.  More detailed information can be found on the American Dental Association website.

Root Canal Toxicity = Unsafe
If you have a healthy diet and lifestyle and a strong immune system, you may be able to tolerate keeping a root canalled tooth in your body. However, a root canal treated tooth that is currently being tolerated may become intolerable in the future due to age, illness, or breakdown of the root canal materials.

In a root canal treated tooth, most of the nerve is removed. However, countless minute tubules leading from the central nerve canal remain untreated. The average tooth contains over three miles of these tubules making it physically impossible to clean them all and sterilize the tooth. Debris collects, tissue putrefies and becomes infected, and bacteria flourish. The resultant production of toxic gases and solutions from these chronic infections challenge the immune system and can lead to illness.

A holistic approach to dentistry avoids root canals whenever possible. They represent a stress on the immune system that can manifest in many ways throughout the body.

In the past few months we have received several questions about ozone therapy for dental problems.  While I can't speak of ozone in other medical fields, ozone therapy in dentistry is coming of age.  It is used to disinfect teeth with disease, such as cavities, periodontal disease (gum/bone infection) and disinfect the root oprior to putting a filing in it.  While there is promising research to suggest it works, the difficult question is how long will the tooth or root canal stay disinfected?

Ozone treatment for cavities: There are currently three ozone machines that can disinfect tooth decay beneath the enamel.  Certain protocols call for two or three one minute applications to kill the bacteria.  Heavy remineralization therapy is also recommended.

Ozone treatment for root canal therapy and disinfection:  The same ozone machines are being used to disinfect roots after cleaning out the nerves and blood vessels.  There's a problem with this scenario.  Root canal therapy is like putting a cork on an infection.  Many bacteria are persistent and can flourish in the harshest conditions, including a root canal..

Dentin in teeth are made of tubes called dentinal tubules. If you line up the tubules end to end for the average tooth, it would extend 3 miles. What that means is that we expect a disinfection procedure during root canal therapy to clean 3 miles of tubes that may contain bacteria. Studies have shown that ozone (and laser therapy in dentistry) can disinfect canals and keep them clean for about a year. But after that first year, bacteria finds a way back into the tubes. These bacteria can change from aerobic to anaerobic bacteria. Since there’s no blood flow after filling the root canal space, there’s no way for the body to fight these bacteria. They produce toxins and can release these toxins out of the root (although not through the root canal).

Also, after you fill the root canal with gutta percha or even biocalex or endocal, there’s no way of going back in to re-disinfect the tooth without “opening the tooth” once again. Who would want to have this procedure — root canal therapy — done every year?

You also have to consider what’s happening to the bacteria surrounding the tooth root and in the bone. People, including dentists, forget about the tissues surrounding the tooth, instead focusing on what they can see, the teeth. These infections are sometimes more harmful than the bugs in the dentinal tubes. The abscess or infection in the bone can get into the bloodstream and travel elsewhere. It can also cause disturbances in the meridians (causing problems in distant organs).

Ozone and laser therapy do little to help with these infections (cavitations).

The only incidence where holistic denist routinely use ozone or lasers for root canal therapy is when the immune system is working 100% efficiently, the tooth can’t easily be replaced, there’s no infections around the root or if it is a front tooth (central incisor). 

In summary, ozone and lasers would be good for beneath the surface cavity and periodontal disease disinfections, but not for long term root canal disinfections. The technology is promising but if overall health is your primary goal, the avoidance of root canal therapy through prevention is the key.