Hi! I’m Dr. Paige Woods, and I’m a dentist that wants to explain the ins and outs of dentistry to people who perhaps do not have a dentist who talks them through their diagnosis and treatments. This blog post is about root canals, and the surprising controversy that has followed them.
The History Of The Root Canal
Believe it or not, root canal treatments are controversial, even from the first century AD which is the earliest evidence that we have that teeth were drained. This was painful, and continued to be painful right up to 1756, when Philip Pfaff started to fill in root canals – with gold!
By the 1900s, root canal treatments looked a lot more like they do now, and by the 1960s, dentist were achieving an 80% success rate when they used them. However, it was only in 1963 that endodontics, which is the study and practice of root canals, was officially seen as a new branch of dentistry.
Advantages & Disadvantages
One of the best things about root canal treatment is that it can stop acute pain, and keeps your tooth instead of replacing it. This keeps the integrity of the arch in place, helping to keep your other teeth in place in your mouth.
However, there are disadvantages to root canal treatment. The blood supply to the inside of the tooth is irrevocably damaged and stopped, which can make your tooth more likely to be infected, and the tooth becomes more brittle, often needing a crown to stay together. For immune-compromised patients, root canal treatments are just not an option.
Root Canal Alternatives
So what alternative do you have? Well, I always think it really depends on the patient, and exactly what sort of general health and immune system they are enjoying. If you don’t have any systemic problems, and you’re healthy, then a root canal is actually the best decision – and if you are not generally healthy and you have immune problems, then a root canal is best avoided.
The other option is often the removal of the tooth completely, to prevent it from getting infected or collapsing, but there are consequences to this treatment option too. If there is already some infection here, a large amount of cleaning will need to be carried out after the extraction, and then something will need to be done with the gap that has been left in your mouth. For some people, after a root canal extraction they do not want anything else – but in most cases, to maintain the structural integrity of your mouth, you’ll need a replacement.
Fixed Bridge vs Root Canal
An alternative to root canal treatment is a fixed bridge, comprised of two crowns and false tooth in the middle where the gap is. These bridges can be made out of non-metallic materials to make it even safer for you. The only downside is that fixed bridges only work if you have two strong teeth either side of the gap – if either of them may need work or have crowns or fillings already, that won’t work.
Maryland Bridge vs Root Canal
If most of your teeth are pretty healthy, then you do not have to damage the tooth structure in order to receive treatment for root canal problems – and the Maryland bridge is a great example of this. This non-invasive treatment involves reducing the tooth on one side, and popping in the bridge. Most of my patients who have Maryland bridges tell me how much they love them, and they only need re-cementing in very rarely.
Implant vs Root Canal
Another root canal treatment option is to replace the tooth completely with a new implant tooth, that is made to look exactly look your other teeth. If made with zirconium, it will be completely metal free, but this is a very large implant option, and will often need rather aggressive bone removal in order to fit the implant into your mouth properly. This increases the amount of surgery that you need to have. Titanium implants, on the other hand, do not need such drastic measures to be taken. Titanium implants are only made out of one piece, unlike the two pieces of the zirconium, and so also take up less room and require less change within your mouth.
Some grinding will be necessary in order to make sure that there is room for your new implant, but it is very little compared to what you could need. The implants that I always use are called Bircons and are titanium, but are actually half the size of other titanium implants so that your mouth has a really easy time of accepting them. They are completely biocompatible, so unless you specifically have a reaction to titanium itself, your body will not reject them.
Removal Bridge vs Root Canal
Last but by no means least, you can have a removal bridge instead of root canal treatment. Although this is easily the cheapest option out of them all, that is mainly because it does not have a good quality of life opportunity for you, especially as you will need to remove it frequently, putting pressure on your teeth and gums when you do.
The Biocompatible Root Canal
Traditional root canal treatments that are given by other dentists have lots of issues, and they are primarily based around the way that they were placed into the mouth of the patient. For example, traditional root canal treatments were usually filled up with something called guttapercha, which is actually a type of rubber. Some sealant would be added to the traditional root canal treatments as well, which is rather toxic – and because they were hydrophobic, which means they moved away from water, they would actually withdraw and get smaller, breaking the seal around the traditional root canal treatment. Infections would get in, and the treatment would fail, allowing bacteria to grow in the tooth.
New technologies and new materials for traditional root canal treatments mean that a new sealant is used, called calcium hydroxide-based osteogenic. This actually promotes the growth of the bone around your tooth, which naturally closes up and becomes a sealant itself, swelling to protect the root from infection and bacteria, keeping your tooth nice and healthy. I use Bee Sealer in my dentist practice, mainly because it has a pH of 12.8, and partly because it does not solidify for up to two days after being put into the mouth – which means that it can be sterilising for all of that time. The American Society of Microbiology has shown that the most bacteriais killed when at a pH off 12 – the exact pH level of the Bee Sealer.
To find out more about which option might be best for you, call (619) 359-6569 for a free consultation with Dr. Woods.