Are Root Canals Beneficial or Harmful?
Root canal therapy is a controversial treatment. While a root canal can theoretically allow a tooth to be retained, a poorly disinfected root canal has the potential to cause toxicity. Conventional methods have been shown to be ineffective in disinfecting the microtubules present inside the porous surfaces inside the canals, thus leaving the tooth susceptible to recurring infection which can be painful and expensive to treat as well as potentially harmful. Due to ethical concerns about root canal failure, Dr. Ulm has eliminated root canal therapy from his practice. In most cases, we recommend removing the tooth to prevent future reinfection and chronic inflammation, but if a patient chooses to pursue root canal therapy, we will refer them to a local endodontist for treatment, followed by restorative work on the tooth here by Dr. Ulm.
What if I Already Have a Root Canal?
Existing root canals are closely monitored at the initial new patient exam, and every year thereafter in hopes of catching reinfection early. In our opinion, one of the greatest risks of root canal failure is that it happens silently, due to the nerve and vascular structures being removed from the tooth during the initial root canal therapy, “killing” the tooth and the body’s ability to communicate with it. When reinfection occurs, bacteria leaks out the apex, or tip, of the root inside the jaw bone, where capillaries in the bone send white blood cells to fight the infection. This inflammation becomes chronic, as the source of the infection is inside the tooth where it cannot be accessed by the body, and over time, bone resorption occurs around the root. It is this loss of bone density around the tip of the root which is detectable by x-ray. A standard 2-dimensional x-ray may show an abscess forming, but a 3-dimensional x-ray, or cone beam, is an incredibly useful tool Dr. Ulm uses to more closely evaluate the bone around a root canal tooth. (Read more about Cone Beams, or CBCT imaging, here.) When a root canal failure is diagnosed, our recommended treatment is extraction, and in some cases, replacement with a ceramic zirconia implant. A patient may also elect to seek treatment by an endodontist to attempt retreatment of the root canal. See our Extraction and Implant pages for more information on how Dr. Ulm performs these treatments from a Biological Dentistry perspective.