Q In your Dental Handbook, you mention that root canal work is dangerous, but don't spell out the dangers. Could you elaborate them for us?-MN, Brighton.
A Recently, panel member and dentist Hal Huggins, who has written extensively about the dangers of root canals, has done some further research in this area. According to Dr Huggins, a successful root canal needs to have a fully sterilised canal, to have all canals adequately filled and to make sure the tooth is solid and pain-free. However, in some cases, root-canal teeth don t measure up to these standards, according to the American Endodontic Society.
Writing in the Townsend Letter for Doctors & Patients (July 1997), Dr Huggins says that some recent research has examined the difference between root-canal teeth and healthy teeth. The researchers compared teeth with abscesses or root canals to recently removed healthy third molars which had had no fillings, cavities or infection.
The researchers found that although the extracted third molars had no proteins or toxic chemicals around them, unless the tooth had had a periodontal infection at the time of extraction, more than half of the periodontal ligaments of abscessed or root-filled teeth contained unhealthy chemicals. Once they were isolated with a special procedure called gel electrophoresis, the researchers found certain protein patterns which seemed to correlate with the diseases the patients had symptoms of. Upon further investigation into these chemicals, the researchers discovered that these chemicals were exotoxins from the bacteria trapped in the dentinal tubules of the root-filled teeth, and that the exotoxins somehow had migrated to the periodontal ligament, usually from the lateral canals of the tooth. From there, the infection can travel into the surrounding bony socket of the jaw, into the blood supply and then all over the body.
In the studies examined by Huggins, once abscessed or root-filled teeth were removed, the patients experienced improvements in health - so long as the periodontal ligaments were surgically removed from the tooth socket after it was extracted. However, once the tooth is removed, the problem may not end there.
'Chemicals, of course, are not subject to control by antibiotics,' Huggins points out. 'If these chemicals are not physically removed, the top of the socket heals over with 2 to 3 mm of bone, and the root space remains somewhat intact in form, but lined with the chemicals and bacteria that produce them.'
In the study, 95 per cent of these air pockets within bone, called cavitations, were found to contain unhealthy chemicals.
Researchers have also taken extracts of these chemicals and introduced them to several of the important enzymes of the body. The study found that more than one chemical was involved and that they could destroy essential enzymes, leading eventually to a breakdown in some function of the body and, eventually, disease, if the person's genetic constitution isn't strong enough to withstand the assault.
Some of the most common problems from infected root canals include aching joints and muscles, rheumatoid problems like arthritis, and even chronic fatigue syndrome, according to Dr George Meinig, dentist and author of Root Canal Coverup. Dr Meinig has discovered that root-canal materials shrink by as much as 2 per cent, which means that space is then left for bacteria to get in and multiply. Meinig also finds that many lateral canals - that is, the small canals that lead out from the root of the tooth, and not right at the end - are those that carry the infection throughout the body.
Dr Jerry Eboco, head of oral pathology at the University of West Virginia who has been researching this for several years, has formed a research group called the North America NICO (Neuralgia Inducing Cavitational Osteonecrosis) Research Group. Dr Eboco's research has made the connection between such problems as trigeminal neuralgia, atypical fascial pain, chronic migraine headaches and the presence of cavitations.
Astonishing as it may seem, Dr Meinig says that most patients improve within a day or two once the cavitations are cleaned out, even those suffering with illnesses like arthritis. 'I've had them call and tell me that they can now do their mile jogging and walking that they couldn't do yesterday when they had that tooth in their mouth,' he says. In Dr Eboco's studies, some 70 per cent of people with trigeminal neuralgia had their pain entirely disappear once the cavitations were removed.
Because the relief is so dramatic, many dentists like Dr Meinig believe that something more is involved other than simple infection - an electrical transference problem through, say, the acupuncture meridians of the body.
In their research, NICO has discovered evidence of 'fibrin sludging' - a blood clot formed from blood which was there when the tooth was pulled, blocking circulation and eventually causing progressive bone death in the jaw - or as Dr Michael LaMarche, a Washington dentist and one of 30 dentists in the US, Canada and Europe selected to participate in NICO, puts it, 'bone death, cell by cell'.
Of 150 root-canal teeth that have been extracted, NICO has documented ischaemic osteonecrosis (bone death from reduced blood flow) around the tooth. However, since a third to a half of the bone must be destroyed before it shows up on X-ray, diagnosis by X-ray is very difficult.
Dr LaMarche finds that patients with multiple sclerosis have a high level of antibodies to the myelin sheath, or the nerve wiring's 'insulation'. The enzymes, which begin breaking down bone in cavitations, begin to dissolve the myelin sheath, eventually causing the body to begin developing antibodies to it, as though mounting a defence to a foreign invader. Although there is no evidence of this as a cause of MS, he believes there may be in the near future.
If you do need to have a root-canal tooth extracted, it's vital to follow a certain protocol to reduce the possibility that the extraction site becomes a cavitation. In America, the Price-Pottenger Foundation has a list of dentists who follow the root-canal extraction protocol.
After the tooth is extracted, this includes having the dentist use a slow-moving drill to remove the periodontal membrane and about 1 mm of the bony socket in order to prevent infection in the bone, according to Dr LaMarche. This procedure is recommended even when healthy wisdom teeth are extracted since even they can develop cavitations.
To remove cavitations, a dentist opens the skin from the healed site of an extracted tooth, drills out the necrotic bone, has it biopsied to confirm the presence of dead bone and bacteria, and allows it to heal over. Without the presence of bacteria, the bone will fill in naturally without pockets of infection.
Many root canals are unnecessary, says Dr LaMarche. In many cases, people complain of pain in the jaw in the area of a tooth that sits in front of a missing tooth. Although it was recommended that they have a root canal in that tooth, Dr La Marche's tests show that the tooth is healthy and that the pain is actually coming from the bone and extraction site of the former tooth.
This is because the jawbone, the only bone in the body with sensory nerve endings, contains some 12,000 to 15,000 nerve fibres per tooth. When osteonecrosis occurs, the enzymes breaking down the bone increase the pressure within the bone by four times that of normal teeth, says Dr LaMarche. This is why patients so often have immediate relief from pain after a cavitation is cleaned out and this pressure lifted.
Dr Huggins says that there are blood and other tests now available to find out whether these chemicals are present in the periodontal ligament or the tooth while it is still in your mouth.
This means that we may able to determine which root-canal teeth are safe to remain in and which are doing us harm. Important clues can come from general blood tests to measure the bands, or immature lymphocytes, or white blood cells in the body. These are in high supply in people who have a major, ongoing infection in the body because the body is attempting to release lymphocytes in the body too quickly in an attempt to counteract the infection. In LaMarche's experience, patients with 3-5 per cent of lymphocytes as bands have problems with cavitation. Once the cavitations are removed, this high percentage of bands disappears.
WDDTY panel member Jack Levenson emphasises that, if you have root canals, you shouldn't rush to get them removed, unless you are experiencing major health problems. If you do wish to investigate, you can find out about the appropriate tests from the British Society for Mercury-free Dentistry. BSMD will also provide a list of UK dentists who follow the correct root-canal extraction protocol. (Write to BSMD, 225 Brompton Rd, London SW5 OEA, enclosing SAE and two first-class stamps.) For a list of US dentists, write to PO Box 3010, Bellevue, WA 98009, USA.