Root Canals

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Root Canals

At Meetinghouse Dental Care, advances in dental diagnostic technology and a preventive orientation that includes remineralization, ozone therapy, and promotion of healthful pH-balancing nutrition can often avoid the infection that precipitates performance of a root canal.  Root canals are overprescribed and sometimes prophylactically completed when dentists do not embrace the potential gravity of the procedure’s acute and long-term systemic effects. Unfortunately, there are times when a tooth is not salvageable. Once a tooth reaches this crossroad, the only options are root canal therapy or extraction.  If a patient chooses a root canal, s/he should do so with a full understanding that it is a “get you by” procedure.  It will alleviate pain and temporarily address the abscess, but about 70% of root canals, even those done by the best endodontic specialists in the world, will eventually fail.  

How Do I Know If My Tooth Nerve Is Inflamed/Infected?

The tooth may be infected if you experience one or more of the following symptoms:

• Pain stimulated by warm foods or liquids
• Pain that throbs/pulses like a heartbeat 
• Pain that radiates into other teeth or other areas of the jaw, TM joint, head, or neck
• Pain on biting (inflammation can jut the tooth out of occlusion, making it hit too hard)
• Pain that occurs spontaneously (with no stimulus like biting) and may come and go
• Small pimple looking bubble low on the gum near the base of the painful tooth 
• Pain that wakes and/or keeps you up at night

Why Is My Tooth Nerve Inflamed/Infected?

A primary reason for nerve inflammation/infection is unchecked tooth decay.  When bacteria remain on teeth for too long, they slowly eat through enamel (hard outside layer of the tooth).  Once inside the enamel layer, bacteria rapidly burrow through dentin (softer inside-portion of the tooth) and enter the nerve chamber.  They feast on the nerve.  The nerve becomes inflamed and begins to die.

Another possible cause of nerve inflammation/pain is trauma.  Facial impact during a car accident or sports injury can cause inflammation and eventual death of the nerve.  Accidental trauma is especially common with front teeth.  The nerve may die immediately after trauma, or it can infect years later.  Inflammation and nerve damage can even be precipitated by the trauma of routine dental work, especially in the case of a previously compromised tooth.

What Happens When The Nerve Is Inflamed/Infected? 

Once the nerve becomes irreversibly inflamed, it swells and dies.  Dead nerve tissue is a source of nutrients for bacteria, and the warm, moist nerve canal provides an ideal breeding ground.  The canal can harbor not only bacteria, but viruses and fungi as well.  Eventually the bacteria/viruses/fungi can emerge through the end of the root, and an abscess appears as a black circle on a dental x-ray.  Your body’s immune system will try to fight the infection, and laser treatment and herbals/homeopathics can provide significant support; ozone injections can address infected bone, and antibiotics can tamp down symptoms (although they wreak havoc on your gut and immune system).  The source of the infection, however, is inaccessible, buried in the tooth canal. 

Viable options to treat an infected nerve are limited to root canal or extraction. 

We repeat: at this time there is no known cure for an infected nerve.  Treatments like antibiotics, ozone, and laser can mitigate discomfort and prepare the site for extraction, but they cannot cure the infected nerve.  If infected, we recommend extraction under biologic protocol.

What Is Root Canal Treatment?

The dentist opens the tooth to expose the canal that contains the dying/dead nerve.  The nerve tissue is removed, and the canal is cleaned as thoroughly as possible, given the potentially complicating factors of root curvature, calcification, and/or hidden canals.  The tip of the root is sealed with a small amount of cement, and the canal is filled with a material called gutta-percha.  (Guttapercha contains cadmium, but the more biologically compatible material, Endocal, is rarely used now because of unpredictable expansion properties.)  The top of the tooth is restored with a ceramic onlay or crown to give the tooth strength. 
(*NEVER place a porcelain-fused-to-metal crown on a root canalled tooth.  See page on galvanic current.)

Possible Root Canal Complications

A healthy tooth consists of a hard outer layer called enamel.  Enamel protects the softer, living dentin.  At the center of the dentin is the pulp chamber, the home for the blood vessels and nerves.  Each tooth has one to four major canals.  However, coming off the main canals are literally miles of microscopic accessory canals.

Accessory canals cannot be cleaned and filled with guttapercha as described above.  Even the best endodontist can not clean microscopic accessory canals.  Bacteria now trapped outside the main nerve chamber settle into accessory canals, virtually safe from the body’s immune system (as well as from traditional antibiotics).  Ozone or laser used during root canal treatment can provide cleaner accessory canals, although neither ozone nor laser can guarantee permanent neutrality. 

Bacteria in root canalled teeth can stay subclinical (you experience no symptoms) for years or even decades.  As long as your immune system remains strong, bacteria that stray from the infected tooth are handled. 

Health Risks

Bacteria in a root canalled tooth and their waste toxins do not stay local.  They can travel through the lymphatic system and to surrounding tissues/bone as well as through the blood stream, reaching any organ, gland, or tissue.  Nearly every chronic degenerative disease has been linked (not necessarily caused by, but certainly linked) to root canalled teeth: heart disease, kidney disease, arthritis/joint/rheumatic diseases, neurological diseases (including ALS, MS, Alzheimer’s), autoimmune diseases (Lupus and more), breast and prostate cancer. 

It is not possible to predict how long a root canalled tooth, which is a dead organ (no blood flow), will remain neutral.  Status is affected by such factors as oral and systemic pH, stress level, nutrition, fatigue, illness, trauma, oxidative stress, oral galvanic levels, etc.  Even if a tooth does not clinically re-infect, bacteria in accessory canals can cause systemic issues, immediately or eventually.  Re-infection can be silent and undetectable on a 2-D radiograph.

So Now What?

Provided you do not have a condition listed above, you might view a root canal as a “get-you-by” procedure . . . maybe you are not emotionally ready to lose a tooth, or maybe the tooth provides an anchor for a bridge you are not ready to sacrifice; maybe you are mid orthodontic treatment, or maybe current replacement options for a front tooth are unacceptable, etc.  Confer with your healthcare provider.  Patients who choose a root canal usually do so as a temporary measure, with the expectation that dentistry will progress.  If you do choose a root canal, ask your healthcare provider to check the status of the tooth periodically.  Ozone treatment may assist in neutral root canal maintenance as can regular oil pulling (see page on oil pulling).  Again, consult your healthcare provider.