The Tribune

THE medical health writer Dr Joseph Mercola publishes articles on root canal therapy several times a year. In his articles, he advises all his readers never to have a root canal therapy performed.

Dr Mercola, however, has never suggested to his readers any alternative treatments if they were advised by their dentists of the need to have a root canal therapy performed.

It is my professional opinion that Dr Mercola and others who make this suggestion live in a utopia and not the real world where people have real dental problems that need to be solved.

In fairness to Dr Mercola, however, his suggestion can work in a world where there are no mouth accidents, and where people are so dentally vigilant that dental decay is under complete control.

What is root canal therapy?

Root canal therapy is dental treatment that removes the nerves from the inside of a tooth.

What does the dentist do in the treatment?

Simply put, the dentist seeks to remove all the nerve tissue from the tooth and occlude the empty nerve channel with a biocompatible material.

When is root canal therapy necessary?

Root canal therapy is necessary when there is irreversible damage to the nerves of a tooth.

What are the situations that call for root canal therapy?

Nerve damage to a tooth usually occurs by four different routes:

1. A tooth with a large untreated carious lesion (cavity) is the main cause. The cavity can become sufficiently deep within the tooth that it invades the nerve chamber. The result of this is that the nerves of the tooth become exposed, and the tooth becomes very painful. This tooth requires root canal therapy to eliminate pain.

2. A traumatic blow to a tooth can fracture a perfectly healthy tooth (usually a front teeth) across the nerves within the crown of the tooth. This exposed nerve will be very painful and the damage is usually irreversible. This tooth requires root canal therapy to eliminate pain.

3. A traumatic blow can occur to a tooth (usually a front tooth) and not fracture the tooth. The tooth can appear usual in all ways following the blow. Later in the history of this tooth the enamel can appear to lose its whiteness and become a shade of grey. This is the signal that the blow actually killed the tooth at the time of the trauma. This tooth requires root canal therapy to remove the dead nerves.

4. A tooth, which required a large filling, may not have shown exposure of the nerves at the time of the filling procedure. Sometimes, weeks, months, or years later, such a tooth can show the symptoms (including pain) of irreversible nerve damage, and require root canal therapy.

Why is root canal therapy performed?

Because the person is desirous of retaining their natural tooth in the midst of one of the four situations mentioned above.

What is the alternative to root canal treatment?

The only viable alternative to root canal treatment is removing a tooth.

What is “failure” in root canal therapy? Failure means that a treated tooth is still symptomatic. Symptomatic here means that the tooth hurts, or shows signs of inflammation or infection.

What causes failure of root canal therapy?

1. Bacterial invasion of unfinished cases.

2. Bacterial invasion of finished unrestored cases.

Conclusion

Contrary to some beliefs, root canal therapy is a gift to patients. It is a final resort available that can retain a natural tooth, which has come under attack from trauma or disease.

Non-trauma induced root canal therapies can be greatly reduced with regular dental visits including X-Rays for early detection of dental caries.