Root Canals, Root Canals, and Root Canals! Oh My!
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In this episode Holistic Dentist Dr. Marvin bring’s his incredible insight on Root Canals and combines it with his Holistic approach to dentistry to answer some of the questions you need to be answering for your own symptoms. Lets dive into Root Canal Therapy and give you the answers you need to make better, more informed decisions. So with that, lets get going on this week’s episode of Let’s Talk Dentistry!
— Transcript Below —
Good morning, this is Dr. Marvin. You’re listening to let’s talk dentistry. We’re live here in San Diego, La Jolla, to be specific. We’re here to talk dentistry. For the next 25 minutes, we’re going to talk about dentistry. If you have questions, you can call in and ask me. I’ll give you comments, advice, and everything you need. The number you want to call is 866-577-2473, or 866-KPRAISE. If this is your first time listening, thank you for tuning in. You’re in for a great show. I’m going to call it the root canal show. We’re going to talk about root canals. What a wonderful topic!
I’m a licensed dentist; I’ve been practicing for quite a few years. I’m ready to talk to about dentistry, but a more holistic or natural approach, a unique approach, and hopefully an approach that you agree with. What our approach deals with is dentistry that’s good for your overall health. It’s not just about saving teeth and teaching you to use the right toothbrush. We’re all about working with you as an individual. If you like this approach, then this is the type of dentistry for you. I have a dental clinic here in San Diego. It’s in Encinitas. That telephone number is 760-536-1199. If you’re not a patient of ours, then I encourage you to come with us. Schedule a visit. Come with Dr. Godes, she’s the other doctor in our office, or my self. We’ll give you an evaluation based on health, not just based on teeth.
It’s very different from regular dentistry. Hopefully you’ll appreciate it when we sit down with you and evaluate you as a person and figure out what the root cause of problems are, as opposed to just eliminating symptoms. If you have a headache, you can always go to a doctor and they can tell you to take a tylenol, asprin, advil or ibuprophen and it will go away. Did they ever really get to the root cause of your headache? If you don’t get to the root cause of your headache, then it could come back worse and be a bigger problem. Then are they just going to recommend more medications? Getting to the root cause is the most important part, because if you get rid of the symptom it does not necessarily mean it went away.
Let me give you an example: I had a patient come in this week whose tooth has been bothering her for two years. She hasn’t been going to the dentist, because she doesn’t want to get a root canal. She doesn’t like the idea of getting a root canal, because she’s gotten root canals in the past and they haven’t worked. She’s been avoiding things and taking different medications, even natural herbs and homeopathic medications to help get rid of it, but it’s not getting rid of the pain. The pain was so excruciating this weekend that she had to come in to get that done.
We deal with the root cause of problems, not just symptoms. If this kind of philosophy works well with you, then you should be going to a dentist that also believes in this kind of philosophy. If you want to visit us online, you can do that too. That web address is trynaturaldentistry.com. You’ll find a lot of great information on our website about a lot of the topics that we talk about on this show.
Let’s go ahead and get started. I have a lot to go through. Actually, I’m going to break this up in to a couple of different shows, because there is just so much information about root canals. Everyone’s getting root canals. Everyone’s being recommended root canals, and everyone’s having problems with root canals. Once you realize what our view is on root canals, you’ll be more empowered to do what’s best for you. Again, the phone lines are open. If you don’t call in and ask a question, then you’re going to hear my voice for these next 20 minutes. Call right now. I don’t want to cut you off short if you call in later.
Let’s go ahead, let’s move forward. This show is about root canals. What is a root canal? You need to know what a root canal is. The name is incorrect, it’s actually root canal therapy, because in every single tooth there is a root canal. A root canal is an anatomical structure. It’s the canal inside the root. That canal includes your nerve, your artery, vein, connective tissue, lymphatic tissue. It has a lot of stuff in it. That’s what communicates inside the tooth, just like a kidney has an artery, a vein, a nerve, and a lot of connections to it, just like the liver and heart. There are so many things in your body that have an artery, nerve, vein, and connective tissue. Your body connects to your teeth like it does to any other part of your body. Because it connects to your teeth, it is like a living organ. It has an ability to heal and to protect itself. Dentists know this, because in the tooth you have the outer shell, which is the enamel, and just underneath the enamel you have the dentin, and just underneath the dentin is the nerve, or the pulp chamber, or the root canal. It’s this root canal that provides the nutrients to help build up defenses. Whenever you have a cavity or tooth decay and it gets really close to the nerve, your body will tell you it’s painful. Your body has defense mechanisms to put up repairative or secondary dentin to build up an extra layer of protection against the cavity. It’s amazing, our teeth can heal themselves, and they do this all the time. If you look at an x-ray of a person’s tooth that is 50 years old versus a person’s tooth that is 20 years old, the root canal is different, because your body has made changes to all the different changes as your life gets older. That’s what a root canal is. It’s an anatomical spot for a tooth that is vital. It builds up defenses, it supplies nutrients to the tooth, so any thing that you eat goes through the tooth and into your tooth and really helps it survive.
Dr. Marvin: Hello, this is Dr. Marvin, you’re on Let’s Talk Dentistry. How can I help you?
Caller: I wanted to talk to you about an implant that I had put in about three or four years ago. Now it’s infected; I have pus coming out of it. I want to know what my options are. Does it have to be taken out? Then am I without a tooth, or where do we go from here?
Dr. Marvin: Is it in the front of your mouth or the back of your mouth?
Caller: It’s a molar.
Dr. Marvin: What were the incidents before you had an implant? You had a missing tooth, obviously.
Caller: It was pulled out, because it had gotten decayed to the point that it couldn’t be saved any more.
Dr. Marvin: Did you have a root canal on that tooth?
Dr. Marvin: Is it a lower tooth or an upper tooth?
Dr. Marvin: And it’s a big tooth?
Dr. Marvin: I can’t really give you a definitive answer without actually looking at it, but I’ll give you some ideas. If you have puss coming out of the implant or around the implant, you definitely have an infection. The question is, how big of an infection, how is it affecting your body, and is the implant still usable? You need to figure those things out.
Caller: How do I know if it’s still usable?
Dr. Marvin: Evaluation. You have to figure out how many teeth you have in that area, how much bone supports the implant, and whether it can be repaired or just cleaned out. Have you been to a dentist already for this?
Caller: No, I haven’t. I don’t have insurance for three more weeks.
Dr. Marvin: Be careful, because you have an infection in your body. We talk about how infections in your mouth can infect your whole body, and cause a more serious issue than just a tooth issue. You have to figure out what the cause of the infection is. If you don’t figure out the cause, the problem could come back, even if you do treat it.
Most dentists will just start you on antibiotics. Antibiotics may help a little bit, but it’s not getting to the root cause, and it will probably come back. It will give you a false sense of security, thinking you’re curing the infection.
I would evaluate it, and then I would figure out how much bone is connected to the implant. Then I’d determine if you’re compatible with the implant. Whenever I do implants, I have to make sure that the implant is compatible. Do you know what that means?
Caller: Yes I do, and I have a concern about that.
Dr. Marvin: If you’re not compatible with it, you’re more likely to have an infection, because whenever you insert a foreign body into your body, your body has a natural ability to try to reject it. If it’s not tested before doing it, your body will reject it more. Part of the rejection process is inflammation and infection. That might be one of the reasons why your body didn’t accept it. It was just lack of understanding by the person that does it. 99% of dentists don’t understand that.
Caller: I made sure there wasn’t any nickle in there, because I have a nickle allergy.
Dr. Marvin: Nickle is not the only one. A lot of people know about nickle. A lot of times titanium implants don’t have nickle in them. The screws might have nickle on them, the abutments might have nickle in them, but it’s a really small amount of nickle, if it is nickle. These titanium implants have a bunch of alloys, which is a combination of metals. You may be sensitive to titanium. If you ask any dentist if titanium is OK, they’ll all say it is. If you talk to people who do hip implants, they started doing titanium implants, and there have been studies to show traces of titanium oxides in the body when you have titanium hip implants. That’s why they’re going to ceramic implants for hips. There are a lot of people that are sensitive to titanium. If you are, that could be the reason why you have an infection.
The other reason you have an infection could be the same reason why you have infection on other teeth. If you have gum disease on other teeth, you could have gum disease around an implant. The gums don’t attach to an implant like they do to a natural tooth. Since they don’t attach the same way, it’s harder to clean, and you get more bacteria and inflammation. That’s one of the reasons I don’t like implants. Some people are not willing to make the extra effort to keep them clean. You pay once, then you just leave it alone. That’s not how these work. You pay once and then you end up spending more time trying to keep it clean. That could be the problem.
The other issue that kind of goes along with our issue today, which is root canals, is infections to begin with. You have an infection in your bone where they put the implant in, then you just open up a can of worms. You’ve just placed an implant into an infection, which is going to make that infection bigger and will cause the implant to fail. As you have experienced, you’ve had this implant for three or four years. A lot of dentists love to quote statistics. They say implants have a 95% success rate. It’s baloney, because implants haven’t been around long enough. They don’t report failures, they’re just using these studies that are done in the laboratory. They don’t know that a lot of these implants are starting to fail, and that the success rate isn’t as high. They use those statistics in order to sell you on these implants.
There could have been an infection before the implant, you could have been incompatible with the implant, or they could have placed an implant in a place where there’s not enough bone, but they tried to force the issue. When you force the issue and place the implant in not much bone, the amount of biting forces on the implant are just too much. You can have biting forces that could ruin a tooth. You can have biting forces ruin an implant and keep it from working. If your implant gets loose and mobile, then it can also form gum disease, and an infection there. No one talked to you about this before, because they didn’t know. It’s not because they’re bad people, it’s just that they don’t know what they don’t know. The reality is that you have a problem now. You’re going to have to fix it, and you’re going to have to pay in order to get it fixed. What’s going to happen? You’re going to be toothless. It’s very frustrating. A lot of energy has been spent, a lot of money, and a lot more is going to be spent, all because they tried to get you to do implants.
You need to go to the dentists that understand the big picture. The big picture is that you have to look at all variables in order to have good information, so that you give consent to get the right treatment done. In my practice, I try to give all the information. It’s a lot of information. It’s sometimes more difficult to make a decision because you have so much information. However, I believe that’s the better way to do things, instead of just jumping in to something with the possibility of a lot of failures.
Caller: Is this something that could be done in a day or two if I came in from out of state?
Dr. Marvin: Yes and no. It all depends. If you had a house and you called someone to clean your house, it’s hard for them to know if it’s going to take 30 minutes to clean it, or 12 hours. It’s going to be hard for us to determine how long. If you are dead set on making sure you get the implant out, we could probably book a little more time in order to do that. We generally don’t do it because of that reason. We don’t like to prebook a lot of appointments, because things change, people cancel last second because of flight or something like that, and then it leaves us stuck with empty seats. Give us a call, tell us what your situation is, we’ll get that scheduled and we’ll give you the right information up front so that you can make better decisions.
Caller: I appreciate it.
Dr. Marvin: You’re welcome. Thanks for the call; great question.
Getting back to the root canal issues, this is the root canal show. That’s what the root canal is. It’s basic anatomy where every single tooth has a root canal. When they say you need to have a root canal, it means that the root canal chamber is going to be removed. That means the whole contents is going to be removed. I’m not going to get in to why it needs to be removed, I’m just going to tell you that the way they do a root canal is typically to make a whole at the top of the tooth, and they get access to the root canal, then they clean out all the contents. They usually do this with different instruments. Some of them could be on a drill, some of them could be on hand instruments. They use a little wristwatch movement and they kind of pull everything out. They use different irrigants to go in and clean things out. They try to clean it out all the way to the end of the tooth. At the end of the root canal, there’s a little hole where everything comes out. They call it a constriction. It’s about a milimeter long and about .1 milimeter wide. The diameter is really small. They try to clean all the way to that end, shape the canal, disinfect the root canal, and then they put a rubbery substance and a sealer that goes all the way down and to the sides in order to seal the inside of the tooth. There are dentinal tubials and accessory canals that come out from the main root canal. All of these are supposed to be sealed with this sealer and this rubbery substance.
Once the root canal is done, you typically go to a restorative dentist, and they’re going to put a post inside 3/4 of the root canal, or they’re going to do a build up, which goes down the root canal a little bit in order to build the tooth back up, so that you get a crown. Does every single root canal need a crown? About 80 – 90% of them do. The reason why, is because the tooth is now really brittle. You’ve taken away the moisture from the inside of the tooth. You’ve hollowed out the tooth, and it’s naturally brittle. If you bite down on this brittle, dehydrated tooth, the tooth is going to crumble. A crown is recommended to go on to a post or build up in order to protect the tooth from shattering. Most of the time it’s done in the back of the mouth. In the front of the mouth, they’re going to recommend a crown. Almost all teeth that have root canals need a crown.
What are the costs? A root canal can be done by a general dentist or an endodontist. Endodontist go to school for after dental school for about 2 -3 years afterward, in order to get extra training to be considered a specialist. Most of the time, they do root canals. They evaluate the pain, they have special microscopes and x-rays, and they do root canals all the time, so they’re the experts in root canal therapy. They do the best dentistry possible in order to save the tooth. Saving a tooth is very emotional, because no one wants to walk around with a missing tooth. If you walk around with missing tooth, it’s bad emotionally, and you can’t function or bite on anything there, so saving the tooth is a very noble thing. That’s what endodontists do; they try to save the tooth at all costs.
As you know, Dr. Marvin is different. Here on Let’s Talk Dentistry we talk about saving your health as opposed to saving the tooth. So next week I’m going to get more involved with this root canal issue and tell you what the problems are with root canals and the alternatives to root canals. We’re going to get to some success stories of root canals, and what to do if you already have a root canalled tooth. Do you extract it or retreat it? Also, if you extract the tooth, what do you do with it? Lots and lots of questions.
I’m running out of time here today. This is Dr. Marvin on Let’s Talk Dentistry. I’m here every week, same time, same place. Go to our website, trynaturaldentistry.com. 760-536-1199. If you’ve been told you have a root canal, I want you to give me a call right now. For the first three callers, I’ll give you a free consult. I’ll see you next week, same time, same place. I’m out.