References

Here is a quick hit list of questions you should ask and feel good about the answers.  The answers supplied here are all verifiable with published references. 

Consider printing this page and taking it with you on your next dental visit.

How do you plan to remove all of the dead tissue from my tooth?

It is not possible to remove tissue from the dentine tubules or the accessory canals.[i],[ii],[iii]  It is not even possible to remove all tissue from the inside of the canal.[iv]  Thus infected gangrenous tissue will always remain in the tooth, the breakdown products of which have potentially serious consequences.

How do you plan to sterilize the tooth? 

As long ago as 1925, 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.[v],[vi]

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 treatment procedure), it is not possible for antibiotics to reach the depth of the tooth.  Antibiotics cannot affect the organisms in the tooth.[vii]

Are the materials you will use in any way toxic?  Will they remain in the tooth?

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.[viii],[ix] Some are mutagenic and carcinogenic.[x],[xi],[xii],[xiii],[xiv] All can, and usually do leak out of the tooth.  There is direct blood and neural transport of all materials form the tooth to the brain. "Virtually any irritation of the dental pulp or ‘amputation stump’ has the potential of transporting alegesic toxins throughout the Trigeminal system whether they be of chemical or bacterial origin"

   [xv],[xvi], [xvii], 

[xviii],[xix],[xx],[xxi],[xxii]

What happens to the bacteria, which remain alive in the tooth?

Most organisms isolated from dead teeth are anaerobic.[xxiii]  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.

Can the toxins from these organisms affect my health?

The dental profession at large claim that Focal Infection form 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 processes throughout the body.[xxiv]  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.[xxv]

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 usually 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. 

Most often the dentist will take a guess that the tooth is sterile.  There is no other scientific test available.

What materials will be used to fill my tooth?

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. Be aware that whatever is placed inside the tooth will be transported throughout your body within a matter of minutes.  [xxvi],[xxvii],[xxviii],[xxix],[xxx],[xxxi],[xxxii],[xxxiii],[xxxiv],[xxxv]  

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.[xxxvi],[xxxvii],[xxxviii],[xxxix],[xl],[xli]

Can you guarantee to completely occlude the canal?

There is not one root filling technique, which will completely seal a root canal.[xlii],[xliii],[xliv],[xlv],[xlvi],[xlvii],[xlviii] The blind faith demonstrated by the dental profession is sadly lacking in 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.  These parameters are far too limited to really assess the success of a root therapy.

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 Therapy 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 that the tooth is the source of the infection, which will of course remain.  It is NOT the bone.    

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.[xlix],[l],[li],[lii],[liii],[liv],[lv],[lvi],[lvii],[lviii] 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.

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.

References 

[i] U. Schellenberg et al J. Endo 18:3  1992

[ii] Samulson H., Sieraski S "diseases of the dental histopathology and pulp" ed/ Franklin S weine endodontic therapy 1989

[iii] Stanley H  "Pulpal responses to ionomer cements"  JADA 1990

[iv] E. Mandel Scanning Electron Microscope Observation of Canal Cleanliness. J. Endo. 16:6 1990

[v] Philip Delivanis  Oral Surgery 1981 Vol 52 No 4

[vi] E. Berutti et al J. Endo  23:12  1997

[vii] Philip Delivanis  Oral Surgery 1981 Vol 52 No 4

[viii] [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

[ix] 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

[x] R. Gerosa et al J. Endo 21:9 1995

[xi] Geurtsen W  Leyhausen G   Biological aspects of root canal filling materials--   histocompatibility,cytotoxicity, and mutagenicity.  Clin Oral Investig (1997 Feb) 1(1):5-11

[xii] 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

[xiii] 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

[xiv] 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

[xv] Price DL., Griffin J.,  Neurons and ensheathing cells as targets of disease processes.  

[xvi] Ed. P.S. Spencer.  Experimental and Clinical Neurotoxicology  (Schaumburg: Wilkens and Wilkens 1980

[xvii] Kristensson K., Olssan Y., Diffusion Pathways and Retrograde Transport in Peripheral nerves"  Prog. In Neurobio. 1 (1973)

[xviii] Stortebecker.   Mercury Poisoning from Dental Amalgam 1985 p38

[xix] Patrick Stortebecker - Dental Caries as a cause of nervous disorders. 

[xx] nArvidson 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

[xxi] 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

[xxii] 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

[xxiii] Wu, Moorer, Wesselink.   Capacity of anaerobic bacteria enclosed in a simulated root canal to induce inflammation. Int. Endodontic Journal (1989)  22, 269-277

[xxiv] http:www.bcd.com.au  Lists over 300 references

[xxv] Mechanism of Focal Infection     J Am Dent Assoc  Vol 42 June 1951(619-633)

[xxvi] Material Safety Data Sheets on each material.  Available from suppliers.

[xxvii] B. Briseno J. Endo. 16:8 1990

[xxviii] N. Economedes et al J. Endo 21:3 1995

[xxix] R. Gerosa et al J. Endo 21:9 1995

[xxx] Ersev H  Schmalz G  Bayirli G     Schweikl H   Cytotoxic and mutagenic potencies of various root canal filling   materials in eukaryotic and prokaryotic cells in vitro.  J Endod (1999 May) 25(5):359-63 

[xxxi] [Pascon EA  Spangberg LS   In vitro cytotoxicity of root canal filling materials: 1. Gutta-   percha.  J Endod (1990 Sep) 16(9):429-33

[xxxii] [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

[xxxiii] [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

[xxxiv] [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

[xxxv] Geurtsen W  Leyhausen G   Biological aspects of root canal filling materials--   histocompatibility,cytotoxicity, and mutagenicity.  Clin Oral Investig (1997 Feb) 1(1):5-11

[xxxvi] 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

[xxxvii]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 

[xxxviii] 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

[xxxix] 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

[xl] nMarfurt 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.

[xli] [Lewis BB  Chestner SB   Formaldehyde In Dentistry: A Review Of Mutagenic And Carcinogenic   Potential       J Am Dent Assoc (1981) 103(3):429-434

[xlii] C. Budd J.Endo 17:6  1991

[xliii] F.  Goldberg et al J. Endo 21:1   1995

[xliv] M. Magura  J. Endo 17:7    1991

[xlv] J. Simons et al J. Endo  17:3  1991

[xlvi] 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

[xlvii] lAdamo 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

[xlviii] lPeters 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

[xlix] AK Olson J. Endo 16:8 1990

[l] K. King Et Al J. Endo 16:7 1990

[li] S. Dorn J. Endo 16:8 1990

[lii] F Gerhards et al J. Endo 22:9  1996

[liii] C. Lee et al J. Endo 23:4   1997

[liv] J. Welch et al J. Endo 22:11 1996

[lv] F. Goldberg et al  J. Endo 21:10  1995

[lvi] J. Smith et al J. Endo 18:4 1992

[lvii] M. Torabinejad et al J. Endo 21:3 1995

[lviii] D. Smith et al J. Endo 18:1  1992