Do You REALLY Need a Root Canal? Dentist Reveals the Truth

Why Root Canals Are Done 0:00

What is a root canal and why are they performed inside of dentistry? 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. But before we get to those, let's actually talk about why are they done and is there a positive reason for this? The answer is yes. Root canals are done to save a tooth. 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.

Really, the problem inside of a tooth is that there is a nerve chamber that houses the nerve, the blood vessels. It's called the pulp of the tooth. 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, that nerve and blood vessel tissue, it can lead to it dying. Now, if you've ever had a toothache, you know what it feels like. It feels terrible, right? People tell me that tooth pain is the worst pain they've ever experienced.

So this pain is really intense. It can hurt all the way up and down. It can shoot everywhere. It can keep you up at night. It can hurt with hot and cold. It can cause a lot of swelling. and just inflammation, it could even kill you. There have been studies that have shown that abscessed teeth have led to heart failure, heart problems, heart attacks, even abscesses that have extended into people's brains or extended down here into their breathing area and cut off their breathing. So, abscessed teeth are nothing to mess around with, right?

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 in that spot, and then fills it back up with a rubber-like material called gutta percha. This is standard treatment protocol in dentistry worldwide. That nerve tissue is removed, disinfected inside of there and then filled up with a material. There's the gutter percher, there's also something called sealer that helps to kind of seal that plastic-like material in place.

Seal the end of the root and then after this is done, typically a crown is put on top of the tooth. Why? Well, the crown is put there because usually if the tooth has been compromised so much from the cavity, from the fracture, from whatever it might be, there might not be a lot of good, healthy, strong tooth structure left. So a crown is put over top to support it all. This all sounds great. And in reality, the concept is great. You're able to continue chewing and using this tooth. Unfortunately, there are a lot of things that can go wrong inside of root canals.

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 and deals with them on a daily basis. 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. 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. So the first one is disinfection. What does this mean?

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 have to be killed. 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 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 it sits there for a long time.

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. That's where the tooth can let minerals come from the inside of your body all the way to the enamel on the outside. That's how you feel things. 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. 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.

And bleach will eat away the tissue inside of there if it's left long enough. 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 4:10

Typically, we're not letting it sit that long because you don't want to let it sit that long. You don't want to sit there with your mouth open that long. And we need to get the procedure completed. So it's not sitting long enough to really kill and eat away all the dead tissue in there. So there's always going to be dead tissue left behind. That's really the issue. And we're going to get to that at the end. There's dead tissue left behind. So even if all of the bugs are killed, that dead tissue is going to attract bugs eventually.

But sometimes you don't even get all of the dead tissue out. Even in the main nerve channels, there's so much that goes on inside of a tooth. There's so much complicated anatomy. Look it up on Google. 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, but there's all sorts of funky little canals going off of everywhere. And our instruments are tiny little straight instruments. They do bend, but there's no way they can get into little curves and channels off to the side.

So we're really relying on that bleach to do the job. Like I said, it doesn't always do the job completely. So that's one thing. Missing canals. Sometimes we'll find three or four or even five canals, but there's more that we don't know about. We can't see. It's unusual anatomies that throw us off. Sometimes we're missing canals. And this is fairly frequent that that happens. Reinfection. Now, why does reinfection occur? Because there's still dead tissue inside of the tooth. So, reinfection, that dead tissue, will attract bacteria.

New bacteria will come and build up around the outside of the tooth root. This happens fairly frequently. The next one is filling quality. So, once everything's been cleaned out, now we need to fill it up with that gutta-percha material. well, it will get soft with heat. So typically we will heat it up in one way or another. There's a lot of different filling materials and ways to do it. 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 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 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 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 pushes out the end of the root as well.

Sometimes it'll push that gut aperture, that rubbery material out. Sometimes it will push the sealer out, which is like cement. It's our glue that you've kind of put into glued in place. Sometimes it will push that out. Well, there was a joke in dental school. The filling material is called gutta-purcha, and they taught us gutta-purcha won't hurt ya. That was what they told us. Basically what it meant is even if it squirts out all over the place, the body doesn't care. 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 around these extra squirts of gutta percha and sealer.

The body doesn't really like them out there. So I disagree with that. Procedural errors, what is this? Well, root canals are hard. They're hard to perform. There are these little teeny tiny spaces that don't always let your instruments go down in there. And sometimes it's hard to find all the canals. It's actually a really complex procedure. So what can happen during that procedure? 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. 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.

That's called a perforation. Typically when a perforation occurs, the lifespan of that tooth is going to diminish pretty significantly. Sometimes the instruments that we use themselves will break. They're little, they're tiny, they're fragile. You have to use them in a specific way. And sometimes even with the best of intentions, one of those instruments breaks. I've had instruments break myself when I was doing root canals years ago. They break inside of the tooth and they're very hard to retrieve them.

So oftentimes those broken instruments stay inside of the tooth. These are things that we don't talk about a lot. The next thing is undetected canals, complex structures. We've already talked some about that. Sometimes there's just canals we just don't see. We can't tell they're there. X-rays don't show them. We are simply not cleaning them.

Failure Rates and Risks 8:40

The last thing is a tooth fracture itself. 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 root is a lot more fragile. 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, put a crown on top. They use something called a post. To do a post, you use a drill that goes down inside of the root structure and makes a space.

And then you cement a post inside. The post is kind of like rebar and concrete. So the post comes up out of the canal and you put filling material around that and it holds everything together. The problem is, is the posts are oftentimes bigger than the canal itself. 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. I find so many of these. Let's talk about percentages. We're just talking traditional dentistry right now. We're not even talking anything about the health-based dentistry that I talk about.

This is just regular old run-of-the-mill dentistry and endodontics. In these incidences, in failed root canals, 36% of the time, it was because of an inadequate filling material. 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. 14% of the time, they missed a canal. So something was there that was a little different than usual, just didn't even know it was there to clean it. 12% of the time, it was because that filling material squirted out the end of the root.

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. 8% of the time it was an instrument problem so probably one of those files broke off inside of the root. 2% of the time it was from an endodontic access, which basically is getting to the roots itself. Something happened, broke the tooth, perforated out the side, whatever it might be. So again, like I said, this is just traditional dental research. This is the amount of things that can go wrong in a root canal.

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, 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. So many different things that can go wrong with root canals. Now are they great? They are if they could save your chewing and your smiling, all of those things. But is the risk worth it? That's really the thing that we are constantly weighing here at our dental practice is saying, is the risk worth it?

Because when all of these failures occur, You usually can't feel them.

Alternatives to Root Canals 11:20

You don't know. But it's leading to infection in your body, in your system that's spreading and potentially leading to chronic disease in you. That's my concern. So thank goodness we have alternatives now. We can remove the tooth instead of doing the root canal. We can remove the tooth and replace it with a ceramic dental implant. We can also save a tooth if it's not dead yet. 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.

There are options. I just want you as a consumer to understand, what are you choosing when you're choosing a root canal? 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. So make sure that you are informed as a consumer. 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. So hopefully this has been helpful for you and like I said I have been trained as a traditional dentist for years.

I practiced that way for 15 years before I changed what I did. 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. nor really recommend them. Legally, I have to tell you it's an option, but I don't recommend it to very many patients. So make sure you're choosing what is best for you. If you would like more information, make sure to subscribe below. I'm always talking about root canals. Learn what you want for your own body and how you can care for it so that you can really be well.

And if you want more information about our office here, please click the link below as well. We'll tell you all about total care dental and how we take care of things here to avoid root canals.