Root canal decisions: A whole body perspective (Part 1)

I had my first root canal done at age 17, and I will never forget the throbbing, terrifying and debilitating pain so deep inside my head that I didn't even recognize it as toothache.  A friend drove me to the Otago Dental School where they couldn't see a cavity to blame for the pain. After a consultation involving a crowd of students, the supervising dentist advised drilling a hole in the back of my right lateral incisor. An overpoweringly shameful smell of rotten meat seemed to flood the huge teaching clinic, confirming that they had pinpointed the infected tooth.

These days the root canal is much more controversial dental procedure. Books like The Toxic Tooth by Robert Kulacz and Root Canal Cover-Up by Dr George Meinig have raised public awareness that a 'high percentage of chronic degenerative disease can originate from root filled teeth' (Meinig). However, most dentists continue to recommend and perform root canals without hesitation while most holistic dentists believe all teeth with root canals should be removed. 

When professionals are so divided it can be hard to make a decision for your own teeth, especially if you are in pain. I believe that because everyone is unique, with different combinations of genetics, lifestyle, dental history, family histories, personal health, budgets and priorities there can be no simple answer to the question 'should I get a root canal?'.

That's why I've developed a list of questions designed to help tease out the aspects of each unique situation that may have a bearing on a root canal decision.  The majority of questions to be considered are actually the same for either getting or removing a root canal. However, your answers may lead you to a different conclusion, depending on whether you are getting new root canal or having an old one removed.  This article is split into two parts, Part 1 (this post) is for people who are considering a new root canal. Part 2 will be for people who have a root canal already and who are considering its removal.

Disclaimer: Please be aware that I am not a dental professional and I am offering information for educational purposes only. If you are thinking about acting on the basis of any information in this article, I encourage you to do your own additional research, use your own common sense and take responsibility for your own health choices. However, do not delay in addressing any infection in your mouth, because if left untreated, there can be serious, long-term health consequences, up to, and including, death.

What is a root canal?

The root canal procedure involves the removal of the pulp (nerve, blood and lymphatic tissue) from within the hollow roots (canals) of the tooth.  The canal is sterilized and then packed with a material that seals off the canal. The idea is to quarantine the sterilized canal to keep it free from further infection.  Once the root is packed and sealed, a crown or filling is built up to recreate the original shape of the tooth and provide a biting surface (this is often done at a second appointment, with a temporary filling in place for a few weeks between).

To understand why so many people consider root canals to be a health risk, you need to know the anatomy inside your teeth. Enamel is the outside covering of the tooth, dentin is the material under the enamel and pulp fills the canal at the center of the tooth, extending down into the roots.  The dentin is made of millions of tiny tubes whose job is to transport nutrients and oxygen from the pulp out to the enamel, which like dentin, is made up of microscopic tubes. These tubes in the dentin and the enamel can also carry fluids from the saliva into the enamel and through the dentin down into pulp and eventually via the bloodstream to the rest of your body.

The tubes are so tiny, and so numerous that if the tubes from just one tooth were laid end to end they would be three miles long! Mark A Briener, dentist and author of Whole Body Dentistry declares 'it is absurd to believe all those millions of tiny tubules could possibly be "sterilized" during the process of performing a root canal.'  After the procedure, any bacteria unavoidably left behind in the sealed tubes begins to metabolise anaerobically and give off toxins that can enter the bloodstream. and attack the parts of your body that are genetically weak or under stress.

That's why before you decide to get a root canal, its probably a good idea to assess how much you are at risk. To help you to make a personal risk assessment quickly and comprehensively, I've summarized the 10 questions below into a downloadable checklist.   Print or save the The Root Canal Decision Checklist and use it to help make a decision about treatment quickly, even if your thoughts are fogged with pain or drugs.

Some of the questions are for yourself and your family to answer. Some your dentist or doctor or other health professionals may be able to answer based on an examination or interview. You may also choose to get some tests to get more certainty. 

Questions to ask before getting a root canal

  1. How strong is my immune system?  A strong immune system may be able to tolerate a root canal. 
  2. How good is my overall health?  If you are chronically or acutely ill, you may not be able to tolerate a root canal. 
  3. Is there a family history of degenerative diseases? For example (but not limited to) arthritis, heart valve problems, breast cancer, gall bladder disease, eczema, cystitis, colitis, migraines, sinusitis, hypertension, coronary artery disease and thyroid disease. A root canal can trigger the onset of these diseases in a previously healthy patient. 
  4. What other body parts does this tooth relate to and how resilient are they?  Each tooth sits on a meridian that relates it to different parts of the body. For example, the lower left back molar is on the lung and large intestine meridians, which also relates to connective tissue, elbow, shoulder and bronchus and is associated with lumbago and rheumatism.  A root canal gone bad is likely to cause problems with the associated body parts, even if there are no symptoms in the mouth.  Weakness in those body parts can also contribute to problems in that tooth.  Meridian charts can be found here
  5. Am I willing to risk bacterial infection? Even if your overall health is good, your immune system is strong, and your family history is free from degenerative diseases, you may not want to risk bacterial infection. However, a healthy system may be able to quarantine off the toxins from the rest of the body. For example, a drain may open through the gum called a fistula, that usually causes no danger or pain. I have a fistula which drains near the site of a double root canal/extraction. I experience it as an occasional raised blister on the side of my gum which causes me no discomfort but which I take as a sign that I need to be looking after my general health better. 
  6. Is a root canal being recommended for a cavity that has already exposed the root?   If there is a cavity through the enamel that has already exposed the root, then extraction, root canal, or laser treatment are probably the only options.  However, if the root canal is being recommended because the cavity is getting large and coming close to the root, you might try to use holistic strategies to halt the decay and begin building up the enamel across the hole.
  7. Do we know for sure exactly which tooth is causing the problem? If the problem is below the surface and there is no visible cavity, your dentist may not be able to accurately identify which tooth has the root problems. It is not uncommon for two root canals to be put in side by side because 'the wrong tooth' was root canaled first (this problem accounts for three of my root canals in two molars, now extracted). In this situation you might try to heal the infection and inflammation around the roots with holistic strategies (and/or antibiotics) before deciding what, if any, procedure is needed.
  8. Is laser sterilization an option? Some dentists offer this technique which can sometimes be used instead of a root canal or extraction. 
  9. Could I live without this tooth for chewing or looks? If the tooth cannot be saved without the root canal, the only real alternative is an extraction. Once its removed you may choose to live with the gap, invest in an implant (which have their own controversial issues), install a bridge (only available if there are teeth either side of the gap) or a removable partial appliance (a false tooth). 
  10. What is my budget? What are the costs of the root canal, alternatives or possible follow up procedures? A root canal is more expensive than an extraction. An implant is more expensive than a bridge or partial. If a root canal fails, or causes problems you may end up paying for a repeat of the procedure, and then for an extraction and an implant or partial anyway.  It is also a good idea to budget for an adjustment from an cranial oesteopath after any drilling or an extraction. Many holistic teeth healing strategies are low cost, but the most effective teeth healing diet is usually more expensive than regular food. However it will save on future dental costs as well as saving your teeth and gums for life!

I hope these questions help you to make the best decision about whether or not to get a new root canal. If you already have a root canal, and are considering having it removed, make sure to join the Holistic Tooth Fairy Circle (below) so that you get notified when Part 2 of this article is published. The Circle receive semi-weekly emails with updates from the blog as well as extra tips and holistic strategies to help you keep strong teeth and healthy gums for life.  

Further Reading