It is estimated that in conventional dentistry, 75% of root canal procedures are performed even if they are not the best option, either because the tooth is still alive, or the area around the root is so infected, that the procedure is simply locking anaerobic bacteria into the bone, which might cause chronic inflammation and possible long-term systemic medical damage.
A root canal embalms a 'dead tooth', destroying the normal neurological and arterial anatomy , but still maintaining the tooth.
A tooth may die from internal or external trauma causing an irreversible pulpitis (inflammation of the pulp or nerve). The bacterial invasion from a cavity might extend into the nerve and in the microscopic tubules. The living pulp that nourishes each tooth decomposes, creating facial pain, swelling and abscess.
Endodontists (root canal specialist) will try to remove all the bacteria from an infected tooth irrigating with bleach, yet all they actually can treat is the main chamber of the tooth. If you put that tooth under a microscope, there are thousands of horizontal micro-tubules where bacteria and spirochetes survive for years without oxygen. Although these bacteria multiply slowly, they are the most virulent of organisms and their exudates have been linked to heart disease. The body will try to wall off the bacteria, creating a cyst at the end of the root which appears dark on x-ray. A digital x-ray or CAT scan is the best diagnostic tooth for locating the disease.
Not all root canal teeth are infected, it depends on the sterility of the technique and the status of the tooth when the service was first performed. An infected root canal is often painless, but you might notice a small swelling around the root, bleeding in the gum or a draining fistula (pimple). The tooth might feel different on biting. Root canal re-treatment (doing a failed root canal treatment again) is rarely successful and an apisectomy (surgically removing the cyst) does not address the bacteria living in the micro-tubules.
If a patient has a healthy immune system an infected tooth can always be extracted later, but our bodies are besieged by environmental challenges everyday and if you choose to avoid adding insult to injury, you should extract the tooth sooner rather than later and the Biological Dentist will perform a cavitation of the socket with ozone irrigation.
Avoiding the need for root canal treatment is of course the best solution; treat decay in early stages, replace leaking fillings and poorly fitting crowns. If the tooth is alive it will be sensitive to cold and sweet, but the condition is still reversible if the decay is carefully removed and any offending irritants such as poor fitting filling or crown are replaced. Food and periodontal traps must be eliminated and hyper-occlusion adjusted. Adjacent wisdom teeth may be extracted.
Hot sensitivity is an indication of change but the tooth may still be saved in some cases. The best alternative at this point is to use a Biological Dentist whose “intentions” are to keep tooth alive using a biocompatible 'sedative' filling. Many traditional dentists simply view an x-ray of a deep cavity as being irreversible without making any attempt to save the pulp.
If the pulp can not be saved and the anatomy of the root is favourable, a root canal can still be a valid option, if done under the right conditions (complete isolation of the tooth with dental-dam, using ozone gas and ozonated water to disinfect the pulp chambers, using bio-compatible cement to close the canal(s) and a good fitting bio-compatible restoration or crown to repair the tooth). If these conditions can’t be met the safest option is the removal of the tooth and considering some kind of tooth replacement, for example a (zirconium) dental implant or a full ceramic bridge.
At Anne Swart Clinic we will use the best possible treatment for your teeth using the latest technology and biological treatment options.