Root Canals

Root canal treatment – two sides of the story?

When a tooth becomes infected or painful one of the options recommended by a dentist may be a root canal treatment.  This procedure may be performed by either a general dentist or an endodontist (a dentist who specializes in doing only root canal treatments).

The treatment consists of making an opening into the pulp chamber in the center of the tooth, which contains the nerve, and then using small files to clean and enlarge the space, called the root canal.   This space goes from the center of the tooth to the tip of the root and can have many side branches.   Usually the root canal is irrigated with bleach or other chemicals which help to clean and disinfect (but not sterilize) the tooth.  The canal is then filled by cementing in a rubbery-type of filling material, called gutta- percha, with a eugenol containing cement.  Eugenol acts as a long-term natural anti-biotic helping to control the infection.

For detailed and illustrated description of root canal treatment procedure see:     Root Canal Procedure (from Crest)

The American Dental Association advocates utilization of root canal treatments.     http://www.ada.org/2890.aspx

However, some other professional organizations urge caution in prescribing root canal therapy:

IAOMT – International Academy of Oral Medicine and Toxicology, http://IAOMT.org,  – Status Report on Endodontic Therapy –              Therefore, the IAOMT cannot take the position that all non-vital teeth [root canal treated] must be extracted.  On the other hand, it is clear that non-vital teeth – with or without endodontic therapy – can present a systemic health risk to some patients.  Each patient must be evaluated on an individual basis, considering the medical status and other factors.” 

http://www.iaomt.org/articles/files/files170/Status%20Report%20on%20Endodontic%20Therapy.pdf


IABDM -International Academy of Biological Dentistry and Medicine –April 2008.                                                                                                                                                
A tooth without blood vessels and nerves is dead – keeping that tooth in the body will always be a burden with which that body must deal.  Controversy over “compatible” root canal filing materials, use of laser light energy to “sterilize” canals, and the relative effectiveness of varying irrigants is interesting and perhaps even hopeful. But these concerns remain subsidiary to the primary issue, namely that “The tooth is dead and will remain a burden.” Practitioners –and ultimately each patient for him or herself – face the quandary of understanding to what degree good health might be sacrificed by keeping dead teeth in the mouth. In many cases, the choice can have overwhelming consequences, especially for those with chronic, debilitating diseases so common in our society today .”

Dr Mercola video –                                                                                                                “97% of Terminal Cancer Patients Previously Had This Dental Procedure…”

“ Why You Should Avoid Root Canals” – Dr. Joseph Mercola,D.O.

 http://www.youtube.com/watch?v=a8EjEOqYEYs&feature=related

On-going concern regarding the overall health effects of root canal treated teeth:                                                                                                                                          While generally accepted as one standard of care (others being extraction and replacement with an implant, a cemented bridge or a removable partial denture) there is on-going concern regarding the overall health effects of root canal treated teeth.  This concern was highlighted in the 1920s with the research of Dr. Weston Price, which he performed as Research Director of the National Dental Association (forerunner to the American Dental Association),  and continues today with the current recognition of the relationship between dental disease and systemic illness

Today Dr. Price’s concerns are expressed  by experts like Dr. George Meinig, D.D.S., a founding member of the American Association of Endodontists.   Dr. Joseph Mercola, D.O., discusses the dangers of root canal treatments in this interview with Dr. Meinig:

http://www.mercola.com/article/dental/rootcanal/root_canals.htm

“Please don’t let your dentist mislead you that a root canal is your only option, or that it is entirely safe.

Teeth are similar to other organ systems in your body in that they also require a blood supply, lymphatic and venous drainage, and nervous innervations. Root canals, however, are dead teeth, and these dead teeth typically become one of, if not the worst, sources of chronic bacterial toxicity in your body.

If your kidney, liver or any other organ in your body dies, it will have to be removed so that bacteria and necrosis will not set in and kill you … but teeth are commonly left dead in your body.

Teeth have roots with main canals and thousands of side canals, and contained in those side canals are miles of nerves. When dentists perform a root canal, they remove the nerve from the main canals; however they do not have access to the microscopic side canals, which have dead nerves left behind in those spaces.

Anaerobic bacteria, which do not require oxygen to survive, thrive in these side canals and excrete toxicity from digesting necrotic tissue that leads to chronic infection. Blood supply and lymphatics that surround those dead teeth drains this toxicity and allows it to spread throughout your body. This toxicity will invade all organ systems and can lead to a plethora of diseases such as autoimmune diseases, cancers, musculoskeletal diseases, irritable bowel diseases, and depression to name just a few.

Even antibiotics won’t help in these cases, because the bacteria are protected inside of your dead tooth.

It appears that the longer root canal-treated teeth stay in your body, the more your immune system becomes compromised.”

Dr. George Meinig has written a book, “Root Canal Cover-up” exposing what he considers are the dangers of root canal treated teeth- Editorial Reviews:

“Bacteria trapped inside the structure of teeth migrate throughout the body. They may infect any organ, gland, or tissue and can damage the heart, kidneys, joints, eyes, brain, and endanger pregnant women. Learn how these infections were discovered by Weston A. Price, DDS in a 25 year Root Canal Research Program which was carried out under the auspices of the American Dental Association, and were subsequently covered-up.” 

About the Author:

Doctor Meinig received his Doctor of Dental Surgery degree in 1937.  Early in his practice, at a time when few dentists treated root canal infections and only a handful of dental schools gave instructions about the subject, Dr. Meinig practiced root canal therapy and taught the subject at dental association sessions around the Middle West. These professional activities led to his being one of the founding members who started the American Association of Endodontists (root canal therapists).

Because of his background in root canal therapy and his holistic and nutritional approach to practice, Dr. Meinig was selected to manage the Twentieth Century Fox Studio dental office after World War II service in the Air Corps.   Learning about the meticulous 25-year root canal research of Dr. Weston A. Price, DDS and the serious side effects that result, Dr. Meinig, in consideration of his own opportune, well-suited background, found he was anxious for this information to be made public. The thought of millions of chronic disease sufferers who could be helped was a powerful motivating force.
http://www.amazon.com/Root-Canal-Cover-Up-George-Meinig/dp/0945196199

Illustrations:

Tooth decay progressing into the pulp and nerve and the formation of an infection in the jaw bone:
Tooth decay progressing into the pulp chamber, which becomes the “root canal”. The root canal contains the tooth’s nerve and blood vessels through which bacteria can pass and form an infection (abscess) in the jaw bone.  

 

Root canal anatomy is often presented as a single canal inside the tooth:

Root canal anatomy is often presented as a single canal inside the tooth through which the pulp passes.

However, the central blood vessel has numerous side-branches, each of which may further branch off.
However, the central blood vessel has numerous side-branches, each of which may further branch off.

 

In addition, each blood vessel connects with small dentinal tubules that course throughout the tooth making it “porous” and inhabitable for bacteria throughout:
Finally, each blood vessel connects with miles of small dentinal tubules that course throughout the tooth making it “porous” and inhabitable for bacteria throughout.

The question is, how can this tooth be mechanically cleaned and sterilized?

The answer is, it can’t.

The population of microorganisms in an infected root canal may be reduced significantly by reaming, filing and irrigating. However, some microorganisms lodged in the root dentinal tubules may not be removed by instrumentation and irrigation

The persistence of bacteria in the root canal system often leads to the failure of treatment. Microorganisms can colonize spaces that are not accessible to instruments and irrigation. There are few reports on the efficacy of root canal medicaments against infected tubules under controlled conditions.”  http://www.forp.usp.br/bdj/t0182.html

An In Vitro Test Model for Investigation of Disinfection of Dentinal Tubules Infected with Enterococcus faecalis

Füsun TANRIVERDI ,  Timur ESENER,  Osman ERGANIS,  Sema BELLI

Department of Conservative Dentistry and Endodontics, Selçuk University,

Department of Microbiology, Selçuk University, Faculty of Veterinary Medicine,

Konya, Türkiye

 Braz Dent J (1997) 8(2): 67-72 ISSN 0103-6440

_____________________________________________________________________

Keywords:

  • Endodontics;
  • intra-canal medicaments;
  • single-visit;
  • multiple visits

The ultimate goals of endodontic treatment are complete removal of bacteria, their byproducts and pulpal remnants from infected root canals and the complete seal of disinfected root canals. Intracanal medicaments have been thought an essential step in killing the bacteria in root canals; however, in modern endodontics, shaping and cleaning may be assuming greater importance than intracanal medicaments as a means of disinfecting root canals. Until recently, formocresol and its relatives were frequently used as intracanal medicaments, but it was pointed out that such bactericidal chemicals dressed in the canal distributed to the whole body from the root apex and so might induce various harmful effects including allergies. Furthermore, as these medicaments are potent carcinogenic agents, there is no indication for these chemicals in modern endodontic treatment.

[If root canal medicaments (herein carcinogenic) can distribute to the whole body, what precludes bacterial toxins from the same  distribution?]

http://onlinelibrary.wiley.com/doi/10.1922/IDJ_2060Kawashima07/abstract

Root canal medicaments

  1. Nobuyuki Kawashima1,*,
  2. Reiko Wadachi1,
  3. Hideaki Suda1,
  4. Thai Yeng2,
  5. Peter Parashos2

Article first published online: 8 APR 2011

DOI: 10.1922/IDJ_2060Kawashima07

____________________________________________________________________

“Bacterial invasion of dentinal tubules and the clinical consequences have been recognized for over a century. However, while many components of the infected dentinal tubule microflora have been identified, it is likely that there are etiological agents involved in endodontic infections that have not yet been recognized. Bacterial invasion of coronal dentinal tubules occurs when the dentine is exposed to the oral environment and of radicular dentinal tubules subsequent to infection of the root canal system or as a consequence of periodontal disease. The content and architecture of a dentinal tubule can influence bacterial invasion, with tubule patency being important. This can account for regional variations in bacterial invasion and is particularly seen with dentinal sclerosis, where more advanced sclerotic changes in apical radicular tubules, especially in elderly individuals, limit bacterial invasion in this area. While several hundred bacterial species are known to inhabit the oral cavity, a relatively small and select group of bacteria are involved in invasion of dentinal tubules. Gram-positive organisms dominate the tubule microflora in both carious and non-carious dentine. The relatively high numbers of obligate anaerobes present, such    as Eubacterium spp., Propionibacterium spp., Bifidobacterium spp., Peptostreptococcus micros, and Veillonella spp., suggests that the environment favors the growth of these bacteria. Gram-negative obligate anaerobic rods, e.g. Porphyromonas spp., are less frequently recovered; however, with time, fastidious obligately anaerobic bacteria become established as principal components of the microflora and can be found within the deep dentine layers. In the early stages of infection, Gram-positive bacteria dominate the microflora. The identification of adhesins that mediate these initial interactions of bacteria with dentine is important for understanding the development of tubule infection and in designing adhesion-blocking compounds. Recent evidence suggests that streptococci and enterococci may recognize components present within dentinal tubules, such as collagen type I, which stimulate bacterial adhesion and intra-tubular growth. Specific interactions of other oral bacteria with invading streptococci may then facilitate invasion of dentine by select bacteria. It is important therefore that the mechanisms of invasion and inter-bacterial adhesion are understood to assist development of novel control strategies.”     http://onlinelibrary.wiley.com/doi/10.1111/j.16011546.2004.00078.x/abstract

Robert M. Love,  Article first published online: 19 APR 2005,  DOI: 10.1111/j.1601-1546.2004.00078.x

________________________________________________________________

“A critical review of the literature suggests that the microenvironment of dentinal tubules appears to favour the selection of relatively few bacterial types irrespective of the aetiology of the infection process; coronal dental caries or pulpar necrosis. These bacteria may constitute an important reservoir from which root canal infection and re-infection may occur following pulp necrosis or during and after endodontic treatment.”  http://www.ncbi.nlm.nih.gov/pubmed/7814132

Int Endod J. 1994 Jul;27(4):218-22.   Dentine tubule infection and endodontic therapy implications.  Oguntebi BR.  Source :Department of Endodontics, University of Florida, College of Dentistry, Gainesville 32610-0436.

Leave a Reply

Your email address will not be published. Required fields are marked *