Root Canals: Are They Safe?
Are Root Canals Safe? This is a loaded question with an even more complicated answer. In this chapter I’ll go into detail about when a root canal might be a good option and when you should avoid it.
What Are Root Canals?
Root canals are a dental treatment designed to remove bacteria from the infected root canal, prevent reinfection of the tooth, and save the natural tooth.
A better name for the procedure is a “root-filled tooth”. The nerve inside a tooth can get inflamed or infected from a very large cavity, or from trauma.
Option #1 – Pull the Tooth.
Option #2–Remove the nerve tissue in the center of the tooth and down the root, and fill the area with a material called gutta-percha (a rubber-like material from Malaysian trees).
The Origins of the Root Canal
In the 1800’s when modern dentistry was in its infancy, dentists and their patients were frustrated because so many teeth had to be pulled. They experimented with removing the infected and dead nerve tissue, rinsing and disinfecting the inside of the tooth, and filling it.
The techniques and materials have evolved, and today more than 22 million root canals are performed every year in the US alone.
Why is that?
To “save” teeth that have been neglected or damaged.
When a tooth receives a root canal the tooth is no longer technically alive…
…but the tooth (without the nerve) is retained in the jaw bone to continue functioning as a tooth.
The problem with root canals
Dentists are usually quite successful in cleaning out the main root canal area and disinfecting it. In fact, in most cases, even the infected bone at the end of the root will heal and new bone grows in its place after the procedure. If so, what is the problem with root canals?
In one word: the dentin. Think of dentin as the highway system of the tooth. It is made up of miles of tubules, all filled with a lymph-like fluid. Each of those tubules opens into the center nerve chamber in the tooth.
The bacteria that cause tooth decay travel through those dentin tubules to get from the outside to the inside of the tooth in order to infect the nerve.
The medications used to sterilize a tooth are very effective at cleaning the main root canal area, but not the tubules. There are simply too many of them. Once the root is filled, the fluid that fills those tubules and the bacteria they contain back up like a clogged sewer on a busy street.
The tubules are a nice place for the bacteria to hide, and your immune system or any antibiotic can’t get to them because the flushing system in the tooth has been removed.
Those trapped bacteria have to adapt to living with no oxygen, and these new “anaerobic” (without oxygen) bacteria create waste products called endotoxins. Endotoxins freely circulate in the bloodstream and around the end of the tooth, causing the bone around the tooth to become very unhealthy. Eventually, this even affects your jawbone and your body at large.
Why Dentists Don’t Know This
Any dental student or dentist with a traditional education can tell you where a root canal can go wrong. Every dentist is taught how to best avoid the problems…
…but most dentists don’t know why they are taught that.
It’s because there are SO MANY potential areas of failure in even the most “routine” root canal, making the idea of a ‘perfect’ procedure almost unobtainable.
Here are just a few of the potential areas of failure:
- Bacteria remaining in the root
- Leaking of the root canal filling material
- The filling material ending up too short or too long for the root
- Leaking fillings or crowns on top of the root canal tooth
- Instruments breaking inside the root during the procedure
- Completely missing one or more of the canals when cleaning out the root
Whew… that’s a lot of things to do perfectly every time, reducing the chance that every root canal will be perfect.
The odds are stacked against long term success with root canals, and indeed, studies are showing that failures do occur at some point in the life span of the root-filled teeth.
Can You Have a Successful Root Canal?
This is where things get sticky…
Traditional dentists will usually recommend a root canal for infected or dead teeth, and redo a surgical root canal (called an apicoectomy) if that root canal fails. I myself have performed hundreds of root canals in my career, but I no longer offer or perform the procedure.
Why the change?
I now use a specialized dental x-ray called a Cone Beam CT scan that shows the teeth and surrounding bone in 3D. I can see teeth and root canals and the bone surrounding the root canals in a way I never could before—and every day I see failed root canals…
In fact, nearly every new patient that I visit has at least one failed root canal!
I see so much infection and disease in my visits with new patients that I can no longer, in good conscience, offer that procedure myself.
I still tell my patients about the root canal option, as I am required to do so by law, but I prefer them to a root canal specialist (an endodontist) if they choose to have a root canal.
So, Do Successful Root Canals Ever Happen?
Let’s answer this with another question: What is the key to a successful root canal?
The health of the person getting the root canal!
People with strong immune systems and no strong genealogical history of chronic degenerative disease can possibly have and retain successful root canal fillings.
Here’s the catch twenty-two—When the immune system of even the healthiest person becomes overstressed, it will start to drop the ball on a few things…
…and those trapped bacteria around the end of the root may multiply and start causing problems.
A healthy person with a root canal may not stay healthy.
I was faced with this very personal situation a few years ago with my 11-year-old son. While warming up for an All-Stars baseball game, he got hit in the mouth with a baseball. He came around the corner spitting out teeth, and my heart just sank…
…I knew what he was in for.
One of his front teeth came out and was not salvageable, and the other front tooth was fractured 1/2 way down the root but didn’t come out.
My choice was:
- Do a root canal to save the tooth for now or…
- Take out both of my son’s permanent front teeth.
It makes me sick to my stomach to think about it even years later!
I chose to do a root canal. And in his situation, with a fractured root, I 100% knew his root canal will one day leak and fail.
Why did I make this choice?
He was very healthy, in the middle of a big growth spurt, and I could keep an eye on his health and the tooth.
His body should be able to handle the root canal for a few years until he has grown enough to permanently replace the tooth.
I view root canals as temporary solutions. They help retain the tooth in the mouth, keep the space, and buy time for the patient to stop growing or find a better solution.
Recommendations For Long-Term Health And Wellness
One Warning: Any good holistic dentist will let you know that the removal of a root canal tooth may not fully alleviate the illness you feel has been caused by that tooth. There are often multiple “foundational problems” that contribute to your illness or disease – the root canal being one.
If enough of these foundational problems are removed, the body is able to heal. Improving nutrition, correcting stomach acid, and rebuilding your energy systems are all important pieces that your holistic dentist should be keeping in mind as they consult you.
The best root canal is no root canal at all.
Except in trauma situations like my son’s, most root canals can be avoided with proper care and nutrition. Please read the chapters on Protecting Teeth Through Nutrition.
You don’t ever want to have to make the difficult decision to keep or remove a tooth.
If you do have a very deep cavity, make sure to read the chapter on Biomimetic and Tooth Preserving Dentistry before getting a root canal.
There are treatment options, including ozone, that can be used to seal and heal a tooth that may otherwise have required a root canal.
What can you do if you already have a root canal tooth?
No one likes this option. People don’t like going without teeth or paying to have them replaced, and dentists don’t like removing them! Root canal teeth have lost the ligament surrounding them and they are often “cemented” to the bone, making these teeth difficult to remove.
Despite this difficulty, I am recommending removing teeth on a greater number of patients than ever before. I used to recommend saving a tooth at any cost – now I recommend saving health at any cost, even if it means losing a tooth.
I know the patients who follow this advice will thank me later on down the road. Keep your long-term health in front-of-mind when making your decision.
There are two additional dental procedures you can choose from to prolong the life of the root canal tooth.
- Non-metal crown. This one is a little mad-scientist like. If you have a metal filling or crown or porcelain crown with a metal core, you have a small battery in your mouth (You can’t always see the metal core, and can check to see if there is one with a dental Xray).All fillings and metal-containing crowns are made out of an alloy, which is a combination of different metals. In saliva, those metals have a small electrical current running between them. You may have felt like “you are chewing on tin foil”…
…that’s the current I’m talking about. It’s called galvanism.
Bacteria love this small current and they flourish when it’s there. If you have a metal filling or crown on the tooth with a root canal, you’ve created the perfect storm.
The metals are attracting bacteria and the bacteria are re-infecting the root canal. Solution–have the metal replaced with porcelain.
- Good bugs. We all have millions of microbes in our mouths. Some are good and some are bad. If you have a root canal that you would like to keep healthy, give your mouth an extra boost by taking a special probiotic formulated for your mouths. There are many brands available online now, including Florassist by Life Extension, a lozenge shown through research to reduce infection in the mouth.
Interesting to note – just like you can pass on those flu bugs, you can pass on your cavity bugs too.
If you and your mom have bad teeth, it’s probably as much about a mom giving you her bad bugs as it is about genetics. A probiotic can turn this around for you and your family.
Now that we’ve discussed root canals in-depth I’d like to discuss a topic that you may not have heard about before . . . dental cavitations.
This is even MORE COMMON than failed root canals!
Click below to read more in Chapter 6
WORRIED ABOUT ONE OF YOUR TEETH?
If you think you may have an infected tooth or are worried that you have an existing root canal that is bothering you, we would love to help! Schedule a Complete Wellness Physical with Total Care Dental & Wellness and you can receive:
- A Cone Beam CT Scan to identify problems related to old root canals, extraction sites, or failed tooth fillings.
- An adrenal test, pH test, Heart Rate Variability test, blood pressure, microscope bacterial analysis, and a 40-point intraoral exam. (We make sure there is no stone uncovered when it comes to your health)
- Screenings for problems related to infection, toxic metals, airway problems, or sleep issues.