By Dr. Jacques Doueck
YOU KNOW THE OLD SAYING, “I’D RATHER HAVE A ROOT CANAL!” FOR YEARS, COMEDIANS HAVE JOKED ABOUT THE PROCEDURE, AND JUST THE THOUGHT OF HAVING ONE HAS BEEN ENOUGH TO MAKE PEOPLE NERVOUS. BUT DENTISTRY HAS COME A LONG WAY. TODAY, A ROOT CANAL CAN BE A COMFORTABLE PROCEDURE. STILL, IF THERE’S A WAY TO AVOID ONE ALTOGETHER, WHY WOULDN’T YOU?
There is no question that, when needed, root canal therapy saves teeth that would have been lost. A root canal is one of the most common dental procedures performed. The American Association of Endodontists estimates that 24 million root canals are performed each year and this number is expected to double within the next few years. This simple treatment can save your teeth and prevent the need for dental implants or bridges.
WHY AVOID ROOT CANALS? ARE THEY RISKY?
Because of the complex anatomy of the root canal system, it is a recognized fact that it is impossible to completely eliminate all bacteria. Root canal therapy, therefore, cannot be guaranteed 100% and carries a 10 to 15% failure rate. Statistically, the failure rate for root canals is much lower for endodontists (5%) than general dentists (10 to 15%). Besides failures due to unresolved infection, root-canaltreated teeth are also dead and weaker than living teeth and carry the additional recognized risk of fracturing under pressure. Even those root-canal-treated teeth that are reinforced with posts to support either crowns or bridges, carry this risk of fracture.
MAIN CAUSES OF ROOT CANAL COMPLICATIONS AND FAILURES
Missed root canals occur when a tooth has more root canals than are normally anticipated, allowing the infected pulp in it to recontaminate the tooth. In some cases, even if the branch is noticed by the dentist, it may be in a position difficult to reach, with the endodontist leaving infected tissue behind. Sooner or later, this will result in a new tooth abscess.
Vertical root fracture is another potential problem. When the nerve (pulp) dies, teeth tend to become brittle. A serious risk during root canal treatment is the fracture of the root of the tooth during the filing procedure. This may require the tooth to be lost. Dr. Gus Livaditis is the developer of Vital Pulp Therapy. Vital Pulp Therapy works because we control the bleeding, control the bacteria and place a durable filling on the tooth.
Root perforation can occur when an endodontic instrument accidentally perforates the root. If the opening is not sealed, it will be a gate for bacteria to re-enter the tooth.
Broken instruments present another risk. One root canal complication is the accidental breaking, inside the canal, of the endodontic files which are used to clean and shape it.
No cap or onlay can also lead to problems. Even if the root canal was perfectly done, if you do not seal and protect the tooth with a cap or onlay, bacteria can re-enter and cause a new root canal infection.
IS THERE AN ALTERNATIVE TO THE EXPENSE AND
RISK OF ROOT CANAL TREATMENT?
Today we have an easy and comfortable procedure called Vital Pulp Therapy. After treating the exposed nerve we use state-of-the-art bonding material to restore your tooth. All in one visit. This is a safe, effective alternative to root canal therapy with a high success rate. Using stateof-the-art technology and procedures, a safe, precise and effective result can be achieved. According to Dr. George Bogen, endodontist, “Vital Pulp Therapy has emerged as a predictable treatment option.”
HOW TO AVOID ROOT CANALS
Dr. Sam Masyr, an endodontist and root canal specialist, once joked, “Why would a root canal specialist tell you how to avoid a root canal?” He continued, “I would encourage patients to go for regular checkups. A great percentage of root canals is caused by active decay.”
For dentists, every time we treat a tooth, it irritates the nerve and uses up some of the healing capacity. We have no way of knowing how much it can handle. Therefore, taking care of problems early reduces the need for repeated assaults on the nerve.
If someone is more prone to cavities, they would benefit from prescription strength, CariFree™ toothpaste, which strengthens and rebuilds the enamel and prescription strength OraCare™ rinse, which has been shown to effectively reduce bacteria and in addition improve periodontal gum health. We need to keep in mind, are you prone to cavities? Do you clench or grind your teeth? You need to take it all into consideration.”
Dr. Jacques Doueck has practiced restorative dentistry in the community since 1977 and has taken thousands of hours of advanced training. He is a clinical consultant for the Dental Advisor, a monthly publication.
