Wouldn’t you agree that we are only as informed as the questions we know to ask?
In other words, the way we learn new information that is outside our realm of current knowledge is to form questions of something unknown and get those questions answered.
The problem is, unless we know what questions to ask, we won’t get the answers we need to make an informed decision, right?
So when we turn our attention toward the serious consideration of whether or not to get a root canal, we must gather all the information possible in order to make the wisest, most informed decision we can for our long term health. We hope this article helps you have some questions to ask your dentist regarding their understanding of root canal therapy.
Just in case you are joining us new in this discussion, this article is the next ‘piece to the puzzle’ regarding the hotly debated subject of the safety of root canal therapy. While you can read this article as a stand alone article, reading the other posts in this series will give you a more fleshed out understanding of the relative risks and safety of root canals.
In the first article, titled ‘Understanding the issues with root canals’, we discuss the broad historical concerns regarding this common dental procedure. In article two in this series, I have a root canal, what are my options?, we explore the options a person has if they have an existing root canal.
In the third article, ‘Options if you have a missing tooth‘, we uncover the various options a person has if they have had a root canal tooth removed. And our most recent article dives into the question ‘My dentist says I need a root canal. What are my options?’
Continuing on from that point, in this article, we want to offer you some rather pointed questions to ask a dentist who is proposing that you need a root canal.
Our intent here is to ‘arm’ you in a sense with questions that will help you determine if the dentist is ideally trained and uses the optimal protocols available if you decide to move forward with this procedure.
(Note: Much of this information comes from a wonderfully brave dentist, Dr. Robert Gammal, who has invested many years into researching and categorizing the data behind root canal therapy. Many of you may recall our interview with Dr. Gammal during our Healthy Mouth World Summit.)
1. How do you plan to remove all the living tissue from the tooth?
The issue here is that within dental journals, it’s recognized that it’s not possible to remove all the living tissue from within the tubules of the tooth, or even to completely clean out the main canal of the tooth. That’s a problem as any living tissue that has its blood flow cut off will die. Dead tissue becomes gangrenous and can cause all sorts of problems for the living host (that’s us!). [1,2]
2. How do you plan to sterilize the tooth once you drill it out?
If you recall our previous article discussing Weston Price’s research on root canals, you’ll recall that Dr. Price found the only way to sterilize the tooth was to boil it for 30 minutes. At the risk of trying to bring some levity to an otherwise rather sober subject, it’s pretty hard to boil the tooth while it’s still in the mouth!
Recent developments in the use of ozone gas to sterilize the root canal can improve the level of sterility obtained substantially. So, a critically important question to ask your dentist is whether they use ozone gas during the procedure. Here’s an article we wrote to you help find a dentist who may be more qualified to assist you along your path to optimal oral health.
Also, feel free to download our FREE Guide to Safe Dentistry, which explains what questions to ask to find a dental team who will work with you on your journey to greater oral health.
3. Will the sealant materials stay within the tooth?
I’d like to quote an essay on this very subject here. This quote also rather nonchalantly states the above, that there is no way to completely remove all the dead tissue from the tooth. Don’t let the scientific wording throw you. Emphasis is ours for readability. A partial title of this document is ‘Microbial leakage of… root canal filling material‘.
“Successful endodontic (root canal) treatment depends upon three-dimensional obturation (completely filling the canal) of the root canal system to the end of the canal. Since it is virtually impossible to completely eliminate bacteria from the canal system, the obturation must provide a hermetic seal at the apex in order to prevent reinfection of periapical tissue. Thus, the main objective of root canal filling is the entombment of most surviving bacteria and the creation of a barrier to stop periapical tissue fluids from reaching them. Gutta-percha (the main ‘filler used in root canals) associated with a sealer has, from its introduction into clinical practice in 1848 until the present time, been the most widely used root canal obturation material; still today it is considered the ‘standard of care’ in endodontic therapy.”[3]
Ok, so what did we get from this quote?
1. It’s ‘virtually impossible’ to get the canal clean
2. So the game is the ‘entombment’ of the surviving bacteria inside the tooth
3. The compound ‘gutta-percha’ began being used in 1848 and is still the ‘standard of care’
Here’s the rub. The ‘entombed’ bacteria are anaerobic (low oxygen loving) bugs, so they grow very well in this entombed space. And…
They can and do leak.
Yeah, complete sealing of the root canal is the goal but not always achieved. So, that means that the thug bugs that have been entombed have a chance of creeping into the rest of the body. Thus, the analogy we have used before of ‘an enemy inside the gates’ applies here again. If you don’t see the problem with this leakage, we encourage you to go back and read about the research of Dr. Boyd Haley here, as the toxins these thug bugs produce are among the most potent toxins known to humans.
Now, this throws the idea of a root canal under the bus pretty hard. And frankly, rightfully so. However, this is still not a ‘black and white’ issue for us because having a tooth removed is also a permanent action and there is no suitable substitute we currently have access to that will function like a tooth rooted to our jaw bone. (Yes, we do have hope for stem cell research and the ability to regrow a replacement tooth.)
So, IF you have chosen to move forward with the root canal, the game is to find a dentist who:
1. Uses ozone gas to help sterilize the canals of the tooth
2. Uses fillers and sealants that have a better track record than compounds dentistry began using in 1848.
3. Will take as much time to get the job done as well as possible.
There are many other questions you could ask a prospective dentist regarding their protocols for root canals. We hope this gets you heading in the right direction.
There are also other issues with root canal therapy we haven’t discussed here (out of brevity) including the toxic risks of the filler and sealants used as well as the problem with putting low dose antibiotics in the canal and the relative risks of developing antibiotic resistant bacteria. Perhaps this will be another article someday if you all want to hear more on this ‘not very fun’ topic! 🙂
Whew, that’s a heavy subject! Thanks for wading through it with us!
As always, please share this article with your loved ones who may benefit from this information.
Other related articles on root canals:
Understanding the issues with root canals, part one
“I have a root canal. What are my options?”
Options if you have a missing tooth
“My dentist says I need a root canal. What are my options?”
References:
1. Schellenberg et al Journal Endo 18:3 1992
2. http://www.ncbi.nlm.nih.gov/pubmed/2074426
3. https://hal.archives-ouvertes.fr/hal-00570780/document
I’m reading about gentle wave treatments as an alternative to root canals. Do you guys have any insight on this? Thanks!
Aloha Rachel,
Thanks for stopping by. 🙂
We’re not familiar with Gentle Wave technology, but we just did a quick Google search on it and at first glance, it sounds intriguing.
You may have already discovered that we’re not generally fans of root canal therapy (RCT). We don’t know if Gentle Wave technology would really address some of the more concerning components of RCT, but it definitely seems less invasive. If you go this route of using Gentle Wave tech, PLEASE keep us posted of how it goes so we can learn from your experience. Also, we would certainly encourage you to find a dentist who does this AND uses ozone gas as part of their protocol.
It’s our understanding that a big issue with root canals is that some dentists leave decaying tissue or don’t use proper techniques to kill off the bacteria before sealing the root canal. This decayed tissue and/or bacteria left under the root canal filling then has the perfect environment to continue to decay the rest of the tooth and create infections that can go undetected for a long time, since there is no longer a nerve in the tooth to provide pain as a signal that something is wrong and needs attention.
Ideally, if we get any dental work done (filling, crown, root canal, tooth extraction, etc.), we try to find a dentist who uses ozone in their daily practice, as ozone gas provides a much greater capacity to thoroughly cleanse the tooth than strictly liquid-based cleansing solutions. So, ozone gas can really help to ensure that there are no lurking pathogens that might be trapped in the area. Our blog entries, “3 reasons why you want your dentist to use ozone in their practice” and “I Have a Root Canal – What Are My Options?” explain more on this.
In the meantime, here are our other resources on root canals, in case you’d like to check them out:
Understanding the issues with root canals
“My dentist says I need a root canal. What are my options?”
Is Thermal Imaging the Solution to Screen for Problem Root Canals?
Finally, a good dentist is a dream for answering questions on stuff like this. Here’s an article that explains how to find a dentist: Helpful Resources to Find a Qualified Dentist to Assist You
I hope that helps! Aloha 🙂
Hi, do you have more info now on Gentle Wave? My dentist recommended it to me at the endodontists across from her.
Aloha Tommy,
Thank you for your comment!
Please check your email for a message to get the conversation going! : )
Aloha!
I loved this website thx a lot
It’s nice of you that you have shared the questions one must ask their dentist when it comes to getting a root canal treatment. Keep sharing such kind of stuff!
As I was reading your article, you state that one of the safest ways in moving forward with a root canal is to find a dentist who will take the time to get the job done correctly. My husband has a tooth that is continuously aching, and we are hoping that he doesn’t need a root canal. Thank you for writing such an informative article about questions to ask a dentist about root canal therapy.
Have you researched the new Gentle Wave technology? My dentist referred me to an endodontist who uses that for root canals. I was leaning toward just having the tooth pulled, but after reading your options for replacing teeth, that doesn’t seem like a great option either!
Did you have this done and how did it go? I am also considering Gentle Wave.
I just had a root canal done by an endodonist for a painful tooth. He cleared up the pain. The specialist was recommended by a dentist. I just went back to that dentist for a temp crown. I heard the dentist tell his technician, why did the endodonist send his back to me without cleaning out the debris? I did not ask the dentist what that meant. I should have. Do you have any idea what that means?
Aloha Al,
Thank you for reaching out to us.
I’m sorry to hear about your experience. We wish that all dentists would remember that they have feeling human beings in their chairs when they make off hand comments like that to their staff. While we don’t know what the dentist was saying, it sounds to me like he was saying that the root canal wasn’t sufficiently cleaned out by the endodontist. This is concerning to me as it’s very important that the canal be very well cleaned out prior to capping it off with a crown. If I were in your shoes, I would go back to the dentist and ask and probably go back to the endo (or another one that’s going to do a more thorough job than the first) and get that procedure completed.
There’s my two cents Al. I hope it helps.
My nightmare experience of a root canal and it’s effects on the rest of my body started with a tooth that needed a crown. The crown was sensitive from the start and I was told I needed a root canal. I waited about 3 years and just lived with the sensitivity. The actual root canal procedure was not pleasant but it was the DEAD feeling in the tooth afterwards that bothered me. For 5 years it felt strange. I developed arthritis in my hands to the point that turning a key in the door was painful and I could barely hold a coffee cup. I read medical articles saying there was a connection between arthritis and the toxins released from a root canal and decided to have the tooth pulled. Within a 3 month period the pain in my hands disappeared and has not returned in 10 years. That convinced me it was indeed due to the root canal leaking toxins. As usual most dentists didn’t acknowledge the connection so I kept looking for a dentist who was informed and had read some of the current research articles. Everyone reacts differently to metals and toxins in their body but based on my experience I will never have another root canal. I probably had 8 years of toxins circulating in my body and once that tooth was removed it was a dramatic improvement. For the same reasons I have not replaced that tooth with an implant. There is some bone loss in the area but chewing is fine and no shifting of teeth noticeable in the last 10 years.
Aloha Kay,
Thank you so much for sharing your story with us.
While I’m sorry you went through such challenge for those 10 years, what a relief to have it in the past and to know that for you the cause came from the root canal.
When you step back and look at it, this connection between oral health, particularly root canals, and whole body dysfunction really makes sense. Like we have said for years now, the mouth is the ‘headwaters’ to the whole body. As such, anything ‘downstream’ is either going to benefit or suffer for what’s going on in the mouth.
Thank you again Kay! I hope that others looking for answers to their issues will read your story. I’m confident your sharing here will help others!
Speaking from experience my son had 7 root canals by 17 years of age by 23 he had Osteoblastoma. The underlying infection in his jaw had practically dissolved all his lower mandible and was pulling nutrients out of his long bones. Dentists don’t want to know and practically push you out the door if I share his story.
It is good to know that one can ask their dentist how he plans on sterilizing a tooth once it is drilled out when it comes to getting a root canal. I did not know that boiling a tooth for 30 minutes could be an effective method. It would also be helpful to find how long the entire root canal process will take to plan your life accordingly.
Thank you so much for your information & resources. Wish I knew these facts 10 years ago but grateful to be better informed now. I actually had a bad root canal tooth & dentist wanted to re-do it. As it was one of my molars I chose to have it pulled rather than go through another root canal. After reading several of your articles on root canals, bridges & implants I feel I made the right decision.
Thanks again, JudyAnne
Well, given the facts brought up by that journal article excerpt, this doesn’t seem like a rational approach. If it’s necessary to sterilize the tooth in order to deal with infection, it seems like sterilization is what they ought to be focusing on in the first place. Why is no one looking for a less damaging alternative?
Thanks for stopping by to add your thoughts Rachel.
We agree on both your points. If conventional dentistry would simply embrace the use of ozone gas, the factor of sterlization would be effectively addressed.
For a less damaging alternative to come forward, dentistry would have to embrace the holistic health model. We’re not holding our breath on this one. It’s going to take at least 10 years for convention to catch up with research I’m afraid.
Thanks for sharing. I’ve been told to undergo a root canal treatment in a dental clinic at Burlington. I was not that aware on the root canal treatment ( http://www.aldershotdentist.com/root_canal.html ) is actually going to be. This blog has given a scenario where i can understand what root canal treatment is ?
I have only gone through a few root canals so far in my life. While they definitely aren’t a walk in the park, they aren’t as scary as I had previously thought. I’ll have to ask my dentists some of these questions the next time I go in, just because I’m curious about the answers.
I’m reading all these articles referring to Root Canals and to remove or not remove, etc….what about Wisdom Teeth or other teeth you may have had removed for braces, etc. when you were younger? The same principals have to exist with the removal of those, right? Practically everyone gets wisdom teeth removed out of necessity and I know 8 year olds that are getting multiple teeth pulled for orthodontic reasons. There is not much more I can do for my removed wisdom teeth other than maintain my health, but I would love to know as my children are coming up on the age where we have to start thinking about all that.
Aloha Michelle,
Great questions! I wish I had all the answers to every question we are asked on the blog! 🙂
I would be much, much more inclined to look into alternative orthodontics for children where the dentist expands the palate of the child in order to receive all the teeth God has given that child than have a dentist pull teeth to fit into the palate.
This is a serious problem for many people due to multiple generations of people eating processed foods. It’s essentially nutritional decline over generations which causes a collapse of the palate.
So, the solution is to make the necessary changes to our diets today so we can begin to stop the downward spiral while we research for solutions to help this current generation have the space necessary to receive the teeth. There are dentists who practice palate expansion. I’ll look to write on this soon.
Thanks again for coming to ask such a great question! I’m sorry my reply is so late to you!