On The Cusp: How safe is root canal therapy?

We have discussed, in previous columns, what root canals are and what the benefits of this treatment are. Recently, there has appeared on the internet, and particularly on Facebook, information alleging that this very useful treatment might be responsible for various maladies and in particular cancer. We will address these allegations, and perhaps gain a little more insight into the strengths and weaknesses of root canal therapy, in today’s column.

Root canal therapy consists mainly of the removal of dead and diseased nerve tissue from within the tooth’s root canal system, followed by disinfection of the canals and sealing them, most commonly,with a natural latex material called gutta percha. While the ultimate goal of all root canal treatments is complete removal of all bacteria from the canals, it is quite a difficult goal to achieve. The little nooks and crannies lining the walls of the root canals make ideal places for bacteria to hide where they are more difficult to get at with our cleaning efforts. This in turn makes complete disinfection challenging but not impossible. In the end, any missed bacteria are rendered harmless by sealing them inside a chunk of gutta percha within the canal. Sealed up in this manner, away from their food supply and other bacteria, they are no longer able to affect the areas around the teeth to cause problems.

The American Association of Endodontists (Specialists in root canal therapy) estimates that over 25 million root canal treatments are performed every year. With numbers this high there would most certainly be studies supporting the Facebook factoid that “97% of all cancer victims have had root canal therapy” yet there are none. The most recent research, done last year by head and neck surgeons and published in the ‘Journal of the American Medical Association’, found that patients with multiple endodontic (root canal) treatments were 45% less likely to get certain types of head and neck cancers than those with no root canal treatments.

So what is the root (pun intended) of this misinformation…. where did it come from? It’s on Facebook and they check all posts for truthfulness, don’t they? While the American Dental Association and The AAE have not been able to determine a source for this disinformation it seems likely that it is a resurrection of an old theory, known as The Focal Infection Theory, which drew interest from the profession in the early 1900’s. It claimed that teeth that were infected or had been infected and subsequently treated with root canal therapy would act as ‘seeds’ for spreading this infection throughout the body and affecting virtually every other part of the body. This theory claimed that almost any disease could be brought about by these bacteria hidden within these dangerous teeth….arthritis, kidney disease, heart disease and yes, cancer. This theory was supported almost entirely by the efforts and research of one man: Dr. Weston Price. Dr. Price’s research methods were soon proven unsound and the results shown to be invalid. This school of thought has persisted, not among the medical/dental community where it might be evaluated with an eye toward the scientific validity of the theory but among our patients from whom it emerges periodically by various means –usually spread by someone with an agenda known only to them. This time the very effective means was the internet- more specifically Facebook. 

While, in recent years, dental implants have become a very successful means of replacing missing teeth they still are subject to problems of their own. Implants are very good at replacing missing teeth but the conventional treatment of root canal therapy followed by restoration with a crown (cap) is generally less expensive and involves less time and fewer procedures to complete. These factors, along with the high success rates of this treatment, make it more desirable to most patients. Root canal therapy also enjoys, at the current time, more widespread coverage by dental insurance than do implant procedures.

Anyone familiar with the internet and the various social websites realizes that any information found there is at least somewhat likely to be a misrepresentation or distortion of the truth and should be examined critically before judging it truth or fiction. While I am convinced that this information is a hoax I would urge you to visit the website of The American Association of Endodontists (www.aae.org) or that of the American Dental Association (www.ada.org) for information to aid you in deciding for yourself. This valuable dental treatment should not be abandoned just because you saw it on Facebook.

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