Root Canal Therapy

The Actual Root Canal

Root Canal: The Holistic Approach

There’s a serious controversy involving whether a root canal procedure is a good idea or not, and I hope to help you clear up some confusion about it now. This is not an easy topic to explore, but it helps to look at the history of root canal treatment before coming to the present and then reaching a sensible conclusion.

Surgeons began draining painful teeth in the first century. The first true root canal, however was performed by Philip Pfaff in 1756. He filled tooth canals with gold. In the 1950s and 1960s, root canals reached a success rate of about 80 percent and a successful root canal procedure could prolong the life of a tooth by many years. Endodontics developed in 1963, and this branch of dentistry deals with root canal therapy today.

The Pros And Cons

Root canal has the advantage of relieving acute pain while allowing you to keep your tooth. It also allows you to maintain arch integrity so your teeth don’t widen apart to fill in the space left from an extracted tooth.

There are disadvantages, however. Because it eliminates the internal blood supply of the tooth, the tooth can become infected. The tooth can also become brittle, requiring a crown to hold it together. There are also other overall health issues involved in doing root canal therapy on immune-compromised patients.

Alternatives To A Root Canal Procedure

To decide if it makes more sense to get a root canal or have a tooth removed, you need to take your overall health into consideration. If you have no systemic health concerns and a strong immune system, root canal treatment might be okay for you. It makes sense to choose a biocompatible root canal, however.

If a tooth must be removed, it’s necessary to maintain arch integrity. However, not all teeth need to be replaced. A second molar, for example, with no opposing teeth doesn’t create an arch integrity issue if removed. But most teeth do need replacing.

One alternative to a root canal is a fixed bridge. A fixed bridge combines crowns on the teeth to each side of a missing tooth with a false tooth that bridges the gap. Today, nonmetallic bridges are possible, but assessing the teeth on each side of the missing tooth is necessary. If these already have crowns, a fixed bridge is sensible. If they are healthy and don’t need treatment, there’s another alternative. A Maryland Bridge involves very little loss to the teeth on each side of the root canal, but they don’t always hold as well as they should and sometimes have to be re-cemented occasionally over time.

An implant is also a sensible root canal alternative. Zirconia implants contain no metal, but they require a lot of bone removal and sometime other surgeries when they are close to the sinus cavity. They also integrate a bit less well than titanium, the other popular choice and the one I use.

The least expensive option is the removable bridge, but this bridge must be frequently taken in and out.

Biocompatible Root Canal Therapy

Traditional root canals are problematic in a number of ways. Perhaps the worst problem is that they are usually filled with something called gutta percha, a rubber sealer. This sealer is toxic and can react with moisture from the canal, causing the seal to break at the bottom of the canal — and that can allow root canal infection to develop there. Accessory canals inside the tooth that aren’t properly filled can be a problem too.

New materials for root canal treatment include a calcium hydroxide sealer that actually stimulates the formation of bone material. That’s obviously better than the problematic old rubber sealant. This new sealer also swells with moisture rather than pulling away so it seals off the main canal and accessory canals better than ever before.

The brand we use is called Bee Sealer, and another advantage is that it has a pH value of 12.8 and doesn’t completely solidify for a day or two. That means that the material continues to sterilize the canal even after the procedure is complete. As it turns out, materials with a pH of 12 or above do a great job of destroying pathogenic bacteria, according to a study published by the American Society of Microbiology.

The Final Word

So is a biocompatible root canal always a good idea? No. You have to take into consideration your overall health — just like with a traditional procedure. If you have a serious systemic disease or are immunocompromised in any way, it may be best to avoid root canals altogether. If you’re otherwise healthy, it may be okay. It’s a decision that you and your holistic dentist must make together.

Before you make a decision, however, you must consider your post-extraction options as well, and consider whether one of those would be suitable for you.

There is a right decision for you, and you and your dentist will come to a good conclusion. The important thing is to consider root canals carefully and take the decision to have one — or not — very seriously.