Root Canals Reconstructing for Healthy Smiles
Tooth death and infection is a situation that most adults face during their lifetime. Sometimes, it occurs without a patient even knowing it, while other times, a patient can experience debilitating pain. In either situation, the infected nerve must be removed, and the only way to do this is to extract the tooth or perform a root canal. Root canal treatment is a conservative measure that can preserve your tooth and prevent the need for a prosthetic replacement. At Imagine Smiles, Dr. Green performs comfortable root canals to alleviate pain, remove infection, and revitalize oral health. He uses advanced tools, proven techniques, and biocompatible materials.
Why a root canal?
When teeth die, it is most often the result of tooth trauma from an injury, a deep crack within the tooth, or a deep cavity that has gone untreated. This allows bacteria to penetrate the protective layers of a tooth and invade the nerve tissue inside. Although not painful at first, this infection will eventually lead to pressure, swelling, fever, and extreme discomfort around the area. We can remove the infected nerve tissue, allowing to tooth to recover and become pain free and functional again in most situations.
What steps are involved in a root canal?
Before performing your root canal, Dr. Green will explain the process. A root canal typically consists of:
- Accessing and removing the infect nerve tissue within the tooth
- Cleaning out and smoothing the nerve canals
- Filling the canals with a biocompatible sealer
- Applying a custom-made restoration to restore shape and function
You’ll care for your restored tooth as you do your natural ones, with twice daily brushing, daily flossing, and six-month checkups and hygiene visits at Imagine Smiles.
The Root Canal Controversy
Over the past decade, there have been many debates about the safety and efficacy of the root canal procedure. the directive of root canal treatment is to remove the infected nerve tissue from within the tooth. This is accomplished through a series of files and rinses that are designed to both kill and/or remove bacteria during the clean out process. As a rule, though, the practitioner will NEVER remove all the tissue from within a tooth. As a result, there is at least a 50:50 chance that a tooth will continue to be infected long after a root canal is performed. This causes many patients to avoid root canal treatment altogether and choose to remove the tooth and consider another restorative option, such as a removable partial, bridge, or dental implants.
The potential for root canal failure is high, and because of this, we choose to do root canals a bit differently in this office. Research has shown that the traditional rinses and medicaments are not very effective at removing infected tissue, so we utilize ozone heavily during the root canal procedure in an effort to more thoroughly disinfect a tooth. By using both ozonated water and direct ozone gas, we can better penetrate the internal dentinal tubules where we cannot mechanically remove infected tissue. This technique has dramatically improved the clinical healing around the teeth that we have treated thus far, so using ozone has become a standard of care in our office when performing root canals, as well as numerous other dental procedures.
Dr. Green's Position on Root Canal Treatment
As a dentist, I have personally struggled with the ethical position on whether or not I should stop performing root canals on patients. I have a moral obligation to provide healing treatments for my patients and root canal treatment, in my mind, does not do this. We do not have the physical ability to remove ALL of the infected tissue from a tooth. Any doctor that claims they can is lying, and if you look at the EM tooth scan on this page, you can easily understand why. There is simply no physical way to adapt our current instruments so that we can remove all of the tissue from within a tooth.
The mere concept of doing another root canal wasn't even a thought when I first learned about focal infection theory. I was about ready to stop offering them as a treatment option altogether, but this is when I started to learn about ozone and its abilities to kill germs. I invested time and money into talking to the people who were doing these treatments (and I'm sorry to say that, once again, we lag 15-20 years behind the Europeans on the use of this technology) and these people were getting positive results with the use of ozone instead of traditional rinses. Because of this fact, and when considering that the only alternative is to remove the tooth, I chose to continue to do root canals under the strict requirement that ozone would be used as a treatment standard.
Therefore, we do continue to offer root canal therapy as a treatment modality for our patients, but we do so by fully educating our patients about what might happen. Even though ozone is a powerful adjunct to this procedure, it's still not a guarantee that the tooth will not ultimately fail. There are many other factors that may contribute to this beyond simple tooth infection. We can't see or control many of these factors, and therefore, it's important to me that our patients know about the potential for failure. It's about options for me. Natural teeth are still the toughest structure in the human body, and if I can save them, I will. Ultimately, the patient must decide which direction they want to go. My job as their doctor is to educate and provide guidance based on all the factors involved to try and find a reliable, long term solution.
The Future of Root Canal Treatment
Effectively cleaning out an infected tooth has been the quintessential dilemma dentists and endodontic specialists face. Luckily, there is new technology on the horizon that may solve this problem. The GentleWave system has shown promise in FDA testing. If it lives up to its claims, we may soon have a more reliable and effective way to clean out an infected tooth. Check out the link for more information on this exciting new technology.