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.”
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 bad 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 bad 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:
1. Schellenberg et al Journal Endo 18:3 1992