-To ask your dentist
When your dentist tells you that you ‘need’ a root canal treatment, you will need some information with which to make an informed decision. The following questions should be directed to your dentist, and you should feel comfortable in the replies.
Consider printing this page and taking it with you on your next dental visit. The answers supplied here are all verifiable with published references.
Read The Garbage Collector to become fully informed. You could also read the Root Canal Procedures page to get a quick overview of the main issues.
How do you plan to remove all the dead tissue from my tooth?
It is not possible to remove tissue from the dentine tubules or the accessory canals. [1],[2],[3] It is not even possible to remove all tissue from the inside of the main canal. Anywhere from 35 – 50% of the inside of the main canal will remain untouched. [4] There is more tissue in the dentine tubules than in the main canals of a tooth. Thus, infected gangrenous tissue will always remain in the tooth, the breakdown products of which have potentially serious consequences. Reamers & files, Ozone, Laser or any other technique will not remove all the dead tissue.
Why do I need antibiotics?
Unless the infection has spread from the tooth to the surrounding tissue or systemically throughout the body, there is no relevance in the use of antibiotics. If the blood supply to the tooth does not exist (either because the tooth is dead or because it has been removed during the root canal procedure), it is not possible for antibiotics to be transported into the tooth. Antibiotics cannot affect the organisms in the tooth. 6
Antibiotics are often placed inside the tooth to try to kill the bacteria. Unfortunately, they reach the bacteria in extremely low levels levels and instead of killing the bacteria, promote antibiotic resistance in these organisms. Dentistry is thus a cause of a great medical problem facing humanity at present. 7
Are the materials used, toxic in any way? Will they remain in my tooth or spread through my body?
All materials used to sterilize a tooth are toxic. Some are Neurotoxic and effect nerve tissue. They interfere or stop nerve transmission, in some cases irreversibly. [5],[6] Some are mutagenic and carcinogenic. [7],[8],[9],[10],[11] All can, and do leak out of the tooth. There is direct blood and neural transport of all materials from the tooth to the brain. “Virtually any irritation of the dental pulp or amputation stump has the potential of transporting alergesic toxins throughout the Trigeminal system whether they be of chemical or bacterial origin” [12],[13],[14],[15],[16],[17],[18],[19] Note that Gutta Percha points can have a devastating effect on people with latex allergies.
Get a list of materials that the dentist wants to put into your tooth and then check the MSDS for that material.
How do you plan to sterilize the tooth?
As long ago as 1923, Dr Weston price demonstrated the inability of dentistry to sterilize teeth. Note that materials used today are the same or similar to those used for the last 100 years. Current research supports these findings. [20],[21] Current publications from the Australian Dental Association also support these findings. [22] Dentistry still cannot sterilize a tooth and thus it will remain infected, principally with anaerobic organisms. Thus, you will most likely hear that the tooth is taken to a point of physiological balance.
Physiologic Balance
This term has been created by the dental profession as a way of side stepping the fact that a tooth is impossible to sterilize. It is a non-sense term. Try getting answers to the following:
1 please give a definition of physiologic balance.
2 please let me know how you decide that you have arrived at this state.
3 once having arrived at this state of physiologic balance, please tell me what happens to the bacteria in the tooth a year down the track.
What happens to the bacteria, which remain alive in the tooth?
Most organisms isolated from dead teeth are anaerobic. [23] They live quite happily in an oxygen-depleted environment such as a tooth. These anaerobes will quite happily multiply and continue to produce serious toxins, which will leach out of the tooth. The bacteria themselves can easily spread from the tooth and infect other organs and tissues. This is called Focal Infection.
Can the toxins from these organisms affect my health?
The dental profession at large claims that Focal Infection from dental causes does not exist, except in the case of patients with heart problems. This attitude flies in the face of the volumes of published research, which considers dental infections as a major source of focal infection throughout the body. [24] Organisms and their toxins do escape from the tooth and may cause infections and disease processes in remote parts of the body as well as causing a more generalized allergic response. [25] If your dentist claims that Focal Infection Theory has been disproved for many years, ask for references to support their position. Dental association statements are NOT references!
How do you know that the tooth is sterile before you fill it?
Very occasionally you may find a dentist or endodontist who will take a culture swab from the inside of a tooth and test for the growth of organisms. Even if this is done, they are only testing for aerobic organisms. Culturing anaerobes (the most common organisms in a dead tooth) is so difficult that it is only done for research purposes. Even if these approaches were routinely done, they would still give false results, as they would only be taking a swab from the canal surface, which is doused with sodium hypochlorite or equivalent disinfectant, and not from the depths of the dentinal tubules where most of the organisms reside.
It is IMPOSSIBLE to sterilize a tooth unless it is boiled for 30 minutes or autoclaved!
Lasers and Ozone do NOT sterilize a tooth!
Most often the dentist will take a guess that the tooth is clean. There is no other scientific test available.
What materials will be used to fill my tooth?
Get a list of materials that the dentist wants to put into your tooth and then check the MSDS for that material.
Usually, the root filling material used by most dentists is Gutta Percha and some form of thin cement to ‘lock’ the points in place and fill the gaps between them. Note that all materials used as root fillings (including Gutta Percha) are cytotoxic. Some contain formaldehyde and other toxic materials, and some break down to formaldehyde or ammonia or other dangerous substances. These are carcinogenic! Be aware that whatever is placed inside the tooth will be transported throughout your body within a matter of minutes. [26],[27],[28],[29],[30],[31], [32],[33],[34]
Do the materials you plan to use either contain or breakdown to Formaldehyde?
Formaldehyde is cytotoxic, mutagenic, carcinogenic, embryotoxic, and teratogenic. It is often used in children’s teeth. NEVER allow this material to be placed in your body or that of your children. Formaldehyde is distributed throughout the body from a tooth within minutes. [35],[36],[37],[38],[39],[40]
Formaldehyde is found in some root filling cements (N2) and others such as AH26 will produce formaldehyde as part of their breakdown process.
Can you guarantee to completely seal the canal?
There is not one root filling technique, which will completely seal a root canal. [41],[42],[43],[44],[45],[46],[47] The blind faith demonstrated by the dental profession is sadly lacking scientific support.
How do you measure the success of a Root Canal Therapy?
Lack of pain and supposed resolution of a dental abscess is not a guarantee that serious systemic consequences will not occur. Dentists do not include systemic diseases as a consequence of dead teeth. They will tell you that if it stops hurting or if the x-ray looks OK than they have done a good job. Local reactions of pain and the way the x-ray looks are not signs of success, nor are they a sign that no systemic condition will arise from this procedure.
Weston Price says that the belief that comfort is a sign of successful treatment
“…constitutes one of the greatest paradoxes and one of the costliest diagnostic mistakes through injury to health.”
What happens if the Root canal procedure ‘Fails’?
You will usually be recommended to re-do the treatment and/or to have a procedure called an Apicectomy. This involves a surgical approach to cut off the end of the root and physically clean out the abscess. The whole procedure is untenable as it ignores the fact that the tooth is the source of the infection, which will of course remain. The bone is not the source of the infection.
This procedure will often incorporate placing a filling material at the end of the root (Retrograde Root Filling) in an attempt to seal the canal further. All Retrograde fillings leak. The worst is amalgam. [48],[49],[50],[51],[52],[53] Never allow amalgam to be implanted into your bone at the end of the root. This is literally an implant of mercury directly into the brain. See the Contraindications from a manufacturer, Caulk Co.
The alternative of Pro Root MTA is not much better. It is a form of Portland Cement which is usually contaminated with Arsenic. “Exposure to moisture will produce caustic calcium Hydroxide“.
Can you supply me with references to support the claims of safety of Root Canal Therapy?
Just as there is no reason to believe what is written here, there is also no reason to trust the opposing views, if they cannot be substantiated with peer reviewed scientific papers. You do have a right to information, which can be verified. The fact that millions of root canal procedures are done every year is not a claim to safety. Millions of cancers are also created every year.
References
[1] Samulson H., Sieraski S “diseases of the dental histopathology and pulp” ed/ Franklin S weine endodontic therapy 1989
[2] U. Schellenberg et al J. Endo 18:3 1992
[3] Stanley H “Pulpal responses to ionomer cements” JADA 1990
[4] E. Mandel Scanning Electron Microscope Observation of Canal Cleanliness. J. Endo. 16:6 1990
[5] Brodin P Roed A Aars H Orstavik D Neurotoxic effects of root filling materials on rat phrenic nerve in vitro. J Dent Res (1982 Aug) 61(8):1020-3
[6] Serper A Ucer O Onur R Etikan I Comparative neurotoxic effects of root canal filling materials on rat sciatic nerve. J Endod (1998 Sep) 24(9):592-4
[7] Arenholt-Bindslev D Horsted-Bindslev P A simple model for evaluating relative toxicity of root filling materials in cultures of human oral fibroblasts. Endod Dent Traumatol (1989 Oct) 5(5):219-26
[8] Geurtsen W Leyhausen G Biological aspects of root canal filling materials– histocompatibility,cytotoxicity, and mutagenicity. Clin Oral Investig (1997 Feb) 1(1):5-11
[9] R. Gerosa et al J. Endo 21:9 1995
[10] Chong BS Owadally ID Pitt Ford TR Wilson RF Cytotoxicity of potential retrograde root-filling materials. Endod Dent Traumatol (1994 Jun) 10(3):129-33
[11] Peltola M Salo T Oikarinen K Toxic effects of various retrograde root filling materials on gingival fibroblasts and rat sarcoma cells. Endod Dent Traumatol (1992 Jun) 8(3):120-4
[12] Price DL., Griffin J., Neurons and ensheathing cells as targets of disease processes.
[13] Ed. P.S. Spencer. Experimental and Clinical Neurotoxicology (Schaumburg: Wilkens and Wilkens 1980
[14] Ed. P.S. Spencer. Experimental and Clinical Neurotoxicology (Schaumburg: Wilkens and Wilkens 1980
[15] Stortebecker. Mercury Poisoning from Dental Amalgam 1985 p38
[16] Patrick Stortebecker – Dental Caries as a cause of nervous disorders.
[17] Arvidson J. Gobel S. An HRP study of the Central Projections of Primary Trigeminal Neurons which innovate tooth pulps in the cat. Brain Res. 210 (1981) 1-16
[18] Marfurt C. Turner D Uptake and transneuronal transport of Horseradish Peroxidase – Wheat Germ aglutinin by Tooth Pulp Primary Afferent Neurons Brain Res. 452(1988) 381-387
[19] Capra N. Andersopn KV. Pride JB. Jones TE simultaneous Demonstration of Neuronal Somata that innovate the tooth pulp and adjacent periodontal tissues using two retrogradely transported anatomic markers. Exp. Neurol 86(1984) 165-170
[20] E. Berutti et al J. Endo 23:12 1997
[21] Philip Delivanis Oral Surgery 1981 Vol 52 No 4
[22] ‘Journal of the Australian Dental Association Endodontic Supplement’ Vol 52 No 1 March 2007
[23] Wu, Moorer, Wesselink. Capacity of anaerobic bacteria enclosed in a simulated root canal to induce inflammation. Int. Endodontic Journal (1989) 22, 269-277
[24] http:www.bcd.com.au Lists over 300 references
[25] Mechanism of Focal Infection J Am Dent Assoc Vol 42 June 1951(619-633)
[26] B. Briseno J. Endo. 16:8 1990
[27] N. Economedes et al J. Endo 21:3 1995
[28] R. Gerosa et al J. Endo 21:9 1995
[29] Pascon EA Spangberg LS In vitro cytotoxicity of root canal filling materials: 1. Gutta- percha. J Endod (1990 Sep) 16(9):429-33
[30] Chong BS Pitt Ford TR Kariyawasam SP Short-term tissue response to potential root-end filling materials in infected root canals. Int Endod J (1997 Jul) 30(4):240-9
[31] Chong BS Ford TR Kariyawasam SP Tissue response to potential root-end filling materials in infected root canals. Int Endod J (1997 Mar) 30(2):102-14
[32] Peltola M Salo T Oikarinen K Toxic effects of various retrograde root filling materials on gingival fibroblasts and rat sarcoma cells. Endod Dent Traumatol (1992 Jun) 8(3):120-4
[33] Geurtsen W Leyhausen G Biological aspects of root canal filling materials– histocompatibility,cytotoxicity, and mutagenicity. Clin Oral Investig (1997 Feb) 1(1):5-11
[34] Material Safety Data Sheets on each material. Available from suppliers.
[35] Capra N. Andersopn KV. Pride JB. Jones TE simultaneous Demonstration of Neuronal Somata that innovate the tooth pulp and adjacent periodontal tissues using two retrogradely transported anatomic markers. Exp. Neurol 86(1984) 165-170
[36] Marfurt C. Turner D Uptake and transneuronal transport of Horseradish Peroxidase – Wheat Germ aglutinin by Tooth Pulp Primary Afferent Neurons Brain Res. 452(1988) 381-387
[37] Arvidson J. Gobel S. An HRP study of the Central Projections of Primary Trigeminal Neurons which innovate tooth pulps in the cat. Brain Res. 210 (1981) 1-16
[38] Marfurt C. Turner D The central Projections of tooth pulp afferent neurons in the rat as determined by the Transganglionic transport of Horseradish Peroxidase” J. of Comp.Neuro 223 (1984) 535-547.
[39] Lewis BB Chestner SB Formaldehyde In Dentistry: A Review Of Mutagenic And Carcinogenic Potential J Am Dent Assoc (1981) 103(3):429-434
[40] Hata G. et al. “Systemic distribution of 14 c-labelled Formaldehyde applied in the root Canal following pulpectomy” J. of Endo 15 No11 1989 539-543
[41] J. Simons et al J. Endo 17:3 1991
[42] M. Magura J. Endo 17:7 1991
[43] F. Goldberg et al J. Endo 21:1 1995
[44] lChong BS Pitt Ford TR Watson TF Wilson RF Sealing ability of potential retrograde root filling materials. Endod Dent Traumatol (1995 Dec) 11(6):264-9
[45] C. Budd J.Endo 17:6 1991
[46] Adamo HL Buruiana R Schertzer L Boylan RJ A comparison of MTA, Super-EBA, composite and amalgam as root-end filling materials using a bacterial microleakage model. Int Endod J (1999 May) 32(3):197-203
[47] Peters LB Harrison JW A comparison of leakage of filling materials in demineralized and non- demineralized resected root ends under vacuum and non-vacuum conditions. Int Endod J (1992 Nov) 25(6):273-8
[48] K. King Et Al J. Endo 16:7 1990
[49] S. Dorn J. Endo 16:8 1990
[50] C. Lee et al J. Endo 23:4 1997
[51] F Gerhards et al J. Endo 22:9 1996
[52] C. Lee et al J. Endo 23:4 1997
[53] AK Olson J. Endo 16:8 1990