I’m often asked, ‘Is there a way to prevent a root canal without actually killing the tooth?’ Another way of asking this is, ‘Is there a way to reverse a root canal after it’s been diagnosed?
What’s the truth, doc? Is there a way to avoid root canals?
Yes and no. First, not all painful teeth need root canals. Other things that cause pain are cracks, decay, grinding your teeth, a high bite from recent dental work, dental work that is not properly sealed and trauma to your teeth. ‘That’s a lot of potential causes, doc.’ Yes it is. However, just because your teeth hurt or are sensitive doesn’t mean that your tooth automatically needs a root canal. Think about it. The reason you can feel your tooth or have tooth pain is because your tooth is still alive. So pain does not automatically mean root canal. In fact if you remove the cause of the pain often the tooth makes a full recovery and does not need a root canal at all. Sometimes these things cause root canals, however many times the tooth can recover and heal short of a root canal just by addressing the cause. As an example, I cannot tell you the number of times a root canal was diagnosed and all the tooth needed was the bite adjusted or a crack sealed and repaired. In my eyes, root canals are a last resort, to be done when all other problems have been fixed. It is unfortunate when I see a patient for a second opinion for a root canal that’s been diagnosed, and I find no need for one! This happens more often than I care to admit.
Are there any other ways to avoid root canals?
Another scenario where root canals can be avoided is when there is deep decay. Often dentists will see deep decay on an Xray and recommend that a root canal be done, assuming that it is already into the nerve area and it is only a ‘matter of time’ before the whole tooth becomes infected and pain results. However, this is not necessarily true. Dentists base their recommendations on past results and experience, and when a fair amount of teeth with decay end up needing root canals, they start recommending them more and more to avoid teeth getting infected after they work on them. This is especially true when dentists do crowns as a fair number of them end up needing root canals anyway. Many patients come into my practice thinking that all teeth that need crowns also need root canals, because that’s been their experience and what they have been told by their dentist.
Do all teeth that need crowns automatically need root canals?
Absolutely not. Truth be told, in my experience very few teeth that need crowns also need root canals. In fact I can count on one hand the times that I remember this happening. The reason for this are two fold:
- When I do dental work I go a little slower and use copious amount of water spray to cool the tooth as I drill. This is of paramount importance with any dental work done on your teeth. Drilling causes heat through friction that the delicate tissues on the inside of your tooth can feel. If there is too much pressure used, the tooth heats up and essentially burns the nerve of the tooth. This can result in necrosis of the soft tissue of the pulp. If the damage is enough, the tooth may not be able to recover and heal. This is a common way that root canals occur during dental work.
- Fighting decay with ozone. Deep decay or cavities are the most common way that root canals occur. This is because cavities contain bacteria and once this bacteria reaches the inside tissue of the tooth, it very quickly becomes infected resulting in pain and swelling. I regularly use ozone when working on teeth. Ozone is simply concentrated oxygen that kills harmful bacteria and supports healing, and when applied to a tooth it kills bacteria on the surface of the tooth and in cavities.
Normally, during dental work all the decay and cavity needs to be removed before restoring the tooth. This is because if all the decay is not removed then bacteria can still leak into the pulp and infect the tooth over time resulting in a root canal. This often results in trauma to the nerve directly as you get too close to it during decay removal, or directly exposing the nerve and allowing the bacteria more access to the pulp.
So, how does ozone prevent root canals?
After applying ozone to the tooth, all the tooth eating bacteria is killed and the tooth is sanitized. This allows minerals from the blood vessels in the tooth to remineralize the tooth and harden it to produce healthy tooth again. The way this prevents root canals is four fold:
- Ozone eliminates bacteria leaking into the pulp that eventually infects it.
- It removes the necessity of removing all of the cavity thereby eliminating the risk of a direct exposure of the nerve
- It lowers the trauma and stress exerted on the pulp during the dental work
- It supports the healing potential of the tooth by lowering inflammation and increasing blood flow.
I can’t tell you how many root canals I have avoided by using ozone in my practice on teeth with cavities and deep decay. Some day I will do a study on this but suffice it to say that in the vast majority of the time when I use ozone the tooth does not need a root canal. This is due to the fact that ozone kills all the bacteria in the cavity and allows it to remineralize and heal naturally. Essentially we are creating new tooth to cover and protect the nerve.
How is ozone applied to the tooth?
There have been many times that I have been able to prevent a root canal by treating the decay and restoring the tooth as follows. Although I have had a lot of success preventing root canals, this is not to say that other dentists would be able to reproduce my results. So here is the protocol I use to heal the tooth when there is a deep cavity in order to prevent a root canal from being needed:
1. Carefully remove the decay with a slow speed drill and then a hand instrument at the very end. The regular hand piece that dentists use is very aggressive and creates a lot of heat. It is hard to control, and when it gets deep into the tooth close to the nerve, it can damage and even burn the tissue that needs to be protected. This damage and trauma can create breakdown of the delicate nerve tissue and cause a root canal just by itself.
2. Do not remove all of the decay. This sounds counter intuitive but there is a very important reason why this is done. By carefully removing all of the soft tooth, the infected tooth structure is gone. At this point the tooth remaining is fairly hard. It is important to stop here rather than continue to drill on the tooth. One would think that it is better to be sure that all the bacteria is removed by ensuring you are down to good tooth and there is no possible decay left. The only problem with this is that you are risking injuring or exposing the nerve to more bacteria or trauma in the process. Essentially by being thorough you might cause the very root canal you are trying to avoid.
3. Treat the mostly hard tooth to kill the remaining bacteria and encourage the tooth to remineralize. In my practice I do this with concentrated oxygen, or ozone, as the bacteria that causes decay cannot live long in this environment. What happens when the bacteria is killed is the tooth hardens and you end up with hard, healthy tooth again. You end up with more healthy tooth structure covering and protecting the nerve tissue underneath.
4. I then seal the tooth so that it can heal properly from within. I can’t tell you how many root canals I have prevented by using this technique. In my opinion vital teeth are to be maintained at all costs as it means that the tooth is alive, viable and can continue to maintain itself without aggressive root canals.
Why aren’t more dentists doing this?
First of all you would have to believe that root canals should be avoided at all costs vs encouraged as a preventative measure. Second of all, you would have to know about this protocol and have the experience to use it. It takes special training from people that specialize in ozone and oxygen therapies. In dentistry there are only a few people who are really qualified to teach these therapies and most dentists don’t know about them. Third you would have to not believe the negative press about ozone. There is virtually no danger in the use of ozone, except to the delicate tissues of your lungs and eyes. In other words you absolutely should not breathe it in. The good news is that in my dental office this is strictly controlled through intraoral suction and two external suction units. In this way you are protected from any negative effects, while getting all the positive oxidative effects of ozone on your tooth in order to prevent root canals. To learn more about root canals, please check out the other articles I have written on the subject on this blog.