Full Transcript Why Root Canals Are Done 0:00 What is a root canal and why are they performed inside of dentistry? 0:04 You know, I myself have done hundreds of root canals before I really took a deep dive into the pitfalls and the problems that can come from them. 0:12 But before we get to those, let's actually talk about why are they done and is there a positive reason for this? 0:18 The answer is yes. 0:19 Root canals are done to save a tooth. 0:21 so that you can have a tooth stay in your mouth for chewing reasons, for smiling reasons, so that you can continue to use that tooth. 0:30 Really, the problem inside of a tooth is that there is a nerve chamber that houses the nerve, the blood vessels. 0:36 It's called the pulp of the tooth. 0:38 And if there's decay or a cavity that gets near that pulp, or if there's been a fracture that gets near that pulp, it can lead to that pulp, 0:46 that nerve and blood vessel tissue, it can lead to it dying. 0:50 Now, if you've ever had a toothache, you know what it feels like. 0:53 It feels terrible, right? 0:55 People tell me that tooth pain is the worst pain they've ever experienced. 0:59 So this pain is really intense. 1:02 It can hurt all the way up and down. 1:04 It can shoot everywhere. 1:05 It can keep you up at night. 1:06 It can hurt with hot and cold. 1:08 It can cause a lot of swelling. 1:11 and just inflammation, it could even kill you. 1:14 There have been studies that have shown that abscessed teeth have led to heart failure, heart problems, heart attacks, even abscesses that have extended 1:23 into people's brains or extended down here into their breathing area and cut off their breathing. 1:28 So, abscessed teeth are nothing to mess around with, right? 1:32 We want to make sure that they're taken care of properly.
How a Root Canal Is Performed 1:35 What a root canal does is it removes that nerve and blood vessel tissue inside of the tooth, disinfects it, so cleans any bacteria that have been living 1:42 in that spot, and then fills it back up with a rubber-like material called gutta percha. 1:47 This is standard treatment protocol in dentistry worldwide. 1:52 That nerve tissue is removed, disinfected inside of there and then filled up with a material. 1:57 There's the gutter percher, there's also something called sealer that helps to kind of seal that plastic-like material in place. 2:03 Seal the end of the root and then after this is done, typically a crown is put on top of the tooth. 2:09 Why? 2:10 Well, the crown is put there because usually if the tooth has been compromised so much from the cavity, from the fracture, 2:17 from whatever it might be, there might not be a lot of good, healthy, strong tooth structure left. 2:22 So a crown is put over top to support it all. 2:26 This all sounds great. 2:27 And in reality, the concept is great. 2:31 You're able to continue chewing and using this tooth. 2:34 Unfortunately, there are a lot of things that can go wrong inside of root canals. 2:39 And we're going to talk about even just traditional dentistry and all the things that can go wrong there first, because every dentist knows these things 2:46 and deals with them on a daily basis. 2:48 I'm going to be reading a little bit of this just because I don't want to skip any of them, but I'm going to describe what they are. 2:53 And then we're going to go to a research today that shows what percentage of time does root canal failure actually relate to these problems. 3:00 So the first one is disinfection. 3:02 What does this mean? 3:03 Well, really all of that nerve and blood vessel tissue has to be removed and all of the bacteria that are already inside of that root surface root structure 3:13 have to be killed. 3:15 this is where the problem really comes because first of all the typical disinfectant used in a root canal procedure is bleach which is kind of a broad 3:24 spectrum you know antimicrobial it kills a lot of bugs but it doesn't necessarily kill everything it also can't get deep into some of these tubes unless 3:33 it sits there for a long time. 3:35 Inside of that tooth structure, there is the main root canal, but there's little tubes called dentinal tubules that go off of the main canal system. 3:43 That's where the tooth can let minerals come from the inside of your body all the way to the enamel on the outside. 3:49 That's how you feel things. 3:50 That's how you can tap on your tooth and feel it because there's little nerve extensions that go all the way through those little tubules. 3:55 Well, that bleach can get to the main nerve canal that's been cleaned out, but it's difficult to get it all the way into those little tubules. 4:02 And bleach will eat away the tissue inside of there if it's left long enough. 4:06 But even we as dentists know that it has to sit there for 15 to 30 minutes to really do a lot of that eating away.
Common Root Canal Problems 4:14 Typically, we're not letting it sit that long because you don't want to let it sit that long. 4:17 You don't want to sit there with your mouth open that long. 4:20 And we need to get the procedure completed. 4:22 So it's not sitting long enough to really kill and eat away all the dead tissue in there. 4:27 So there's always going to be dead tissue left behind. 4:30 That's really the issue. 4:31 And we're going to get to that at the end. 4:33 There's dead tissue left behind. 4:35 So even if all of the bugs are killed, that dead tissue is going to attract bugs eventually. 4:40 But sometimes you don't even get all of the dead tissue out. 4:44 Even in the main nerve channels, there's so much that goes on inside of a tooth. 4:49 There's so much complicated anatomy. 4:52 Look it up on Google. 4:53 You can find if you put, you know, the anatomy inside of a root canal tooth, you'll see that there's the main nerve channels, 4:59 but there's all sorts of funky little canals going off of everywhere. 5:02 And our instruments are tiny little straight instruments. 5:06 They do bend, but there's no way they can get into little curves and channels off to the side. 5:11 So we're really relying on that bleach to do the job. 5:14 Like I said, it doesn't always do the job completely. 5:17 So that's one thing. 5:18 Missing canals. 5:20 Sometimes we'll find three or four or even five canals, but there's more that we don't know about. 5:25 We can't see. 5:26 It's unusual anatomies that throw us off. 5:28 Sometimes we're missing canals. 5:30 And this is fairly frequent that that happens. 5:33 Reinfection. 5:34 Now, why does reinfection occur? 5:36 Because there's still dead tissue inside of the tooth. 5:38 So, reinfection, that dead tissue, will attract bacteria. 5:42 New bacteria will come and build up around the outside of the tooth root. 5:45 This happens fairly frequently. 5:48 The next one is filling quality. 5:49 So, once everything's been cleaned out, now we need to fill it up with that gutta-percha material. 5:54 well, it will get soft with heat. 5:57 So typically we will heat it up in one way or another. 5:59 There's a lot of different filling materials and ways to do it. 6:02 There's new ways that are called kind of a flow material where you use this heated, flowable, rubbery material and flow it into these canals it is even 6:12 more effective so this is getting better and better but we don't always fill up all of the little nooks and crannies in the tooth so that's the next thing 6:21 sometimes we overfill it so once we're cleaning out we clean all the way down to the end of the root but that end of the root is actually has a hole that's 6:30 where the nerve and blood vessels exit So sometimes with the force and pressure or heat, whatever it might be that we're filling this up with a little 6:39 pushes out the end of the root as well. 6:42 Sometimes it'll push that gut aperture, that rubbery material out. 6:45 Sometimes it will push the sealer out, which is like cement. 6:49 It's our glue that you've kind of put into glued in place. 6:51 Sometimes it will push that out. 6:53 Well, there was a joke in dental school. 6:55 The filling material is called gutta-purcha, and they taught us gutta-purcha won't hurt ya. 7:01 That was what they told us. 7:03 Basically what it meant is even if it squirts out all over the place, the body doesn't care. 7:09 I actually disagree because I see a lot of issues on cone beam CT scans where there's big kind of abscesses areas of the bone that have been eaten away 7:18 around these extra squirts of gutta percha and sealer. 7:20 The body doesn't really like them out there. 7:23 So I disagree with that. 7:24 Procedural errors, what is this? 7:27 Well, root canals are hard. 7:28 They're hard to perform. 7:30 There are these little teeny tiny spaces that don't always let your instruments go down in there. 7:35 And sometimes it's hard to find all the canals. 7:37 It's actually a really complex procedure. 7:41 So what can happen during that procedure? 7:42 Well, first of all, we're trying to find the tops of those canals so that we can clean them out and fill them up. 7:50 Sometimes in trying to find the tops of the canals, The drill that we're using goes out the side of the root or goes out the side of the tooth. 7:56 That's called a perforation. 7:58 Typically when a perforation occurs, the lifespan of that tooth is going to diminish pretty significantly. 8:04 Sometimes the instruments that we use themselves will break. 8:07 They're little, they're tiny, they're fragile. 8:10 You have to use them in a specific way. 8:12 And sometimes even with the best of intentions, one of those instruments breaks. 8:17 I've had instruments break myself when I was doing root canals years ago. 8:20 They break inside of the tooth and they're very hard to retrieve them. 8:24 So oftentimes those broken instruments stay inside of the tooth. 8:27 These are things that we don't talk about a lot. 8:29 The next thing is undetected canals, complex structures. 8:32 We've already talked some about that. 8:33 Sometimes there's just canals we just don't see. 8:35 We can't tell they're there. 8:37 X-rays don't show them. 8:38 We are simply not cleaning them.
Failure Rates and Risks 8:40 The last thing is a tooth fracture itself. 8:43 This happens fairly frequently and I find it's because usually when we're cleaning out inside of those canals, it's hollowing the root out and that hollowed 8:53 root is a lot more fragile. 8:54 So I see a lot of root fractures on cone beam CT scans as well, particularly when The dentist is attempting again to build the tooth back up, 9:03 put a crown on top. 9:04 They use something called a post. 9:06 To do a post, you use a drill that goes down inside of the root structure and makes a space. 9:11 And then you cement a post inside. 9:13 The post is kind of like rebar and concrete. 9:15 So the post comes up out of the canal and you put filling material around that and it holds everything together. 9:22 The problem is, is the posts are oftentimes bigger than the canal itself. 9:27 So in drilling the whole space, the post space, it creates cracks in the roots, and it's not visible on a regular x-ray. 9:35 I find so many of these. 9:37 Let's talk about percentages. 9:39 We're just talking traditional dentistry right now. 9:41 We're not even talking anything about the health-based dentistry that I talk about. 9:45 This is just regular old run-of-the-mill dentistry and endodontics. 9:50 In these incidences, in failed root canals, 36% of the time, it was because of an inadequate filling material. 9:57 Basically, there were you know, little canals that didn't get filled, things just didn't get sealed up, and there was still dead tissue. 10:04 14% of the time, they missed a canal. 10:07 So something was there that was a little different than usual, just didn't even know it was there to clean it. 10:11 12% of the time, it was because that filling material squirted out the end of the root. 10:16 9% of the time was from a perforation that was where they drill out the side of the root or drill out the side of the tooth. 10:23 8% of the time it was an instrument problem so probably one of those files broke off inside of the root. 10:29 2% of the time it was from an endodontic access, which basically is getting to the roots itself. 10:36 Something happened, broke the tooth, perforated out the side, whatever it might be. 10:41 So again, like I said, this is just traditional dental research. 10:45 This is the amount of things that can go wrong in a root canal. 10:49 We haven't even dived into the things that I talk about, where when there's dead tissue in the tooth, bacteria find it, it compromises your immune system, 10:58 and it grows and builds and destroys bone around the tooth, and you don't even know what's happening because the nerve's gone. 11:03 So many different things that can go wrong with root canals. 11:07 Now are they great? 11:08 They are if they could save your chewing and your smiling, all of those things. 11:12 But is the risk worth it? 11:13 That's really the thing that we are constantly weighing here at our dental practice is saying, is the risk worth it? 11:19 Because when all of these failures occur, You usually can't feel them.
Alternatives to Root Canals 11:23 You don't know. 11:24 But it's leading to infection in your body, in your system that's spreading and potentially leading to chronic disease in you. 11:31 That's my concern. 11:33 So thank goodness we have alternatives now. 11:35 We can remove the tooth instead of doing the root canal. 11:38 We can remove the tooth and replace it with a ceramic dental implant. 11:41 We can also save a tooth if it's not dead yet. 11:44 we can actually save it by cleaning out to the deepest level of decay, ozoning it right there, and filling up and keeping the tooth alive. 11:53 There are options. 11:54 I just want you as a consumer to understand, what are you choosing when you're choosing a root canal? 12:00 You're choosing to potentially have any of these complications happen, and you don't necessarily know that they've happened until years down the road. 12:08 So make sure that you are informed as a consumer. 12:12 You know what you're choosing when you're saying yes to something and you're looking at all of your options before you do say yes. 12:18 So hopefully this has been helpful for you and like I said I have been trained as a traditional dentist for years. 12:23 I practiced that way for 15 years before I changed what I did. 12:27 So I really know both sides of things and I know the reasons the root canals are done but I also know the reasons that I don't do them anymore. 12:35 nor really recommend them. 12:37 Legally, I have to tell you it's an option, but I don't recommend it to very many patients. 12:41 So make sure you're choosing what is best for you. 12:43 If you would like more information, make sure to subscribe below. 12:46 I'm always talking about root canals. 12:48 Learn what you want for your own body and how you can care for it so that you can really be well. 12:53 And if you want more information about our office here, please click the link below as well. 12:57 We'll tell you all about total care dental and how we take care of things here to avoid root canals.
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