{"id":4226,"date":"2018-05-23T15:33:36","date_gmt":"2018-05-23T15:33:36","guid":{"rendered":"https:\/\/myholisticdentist.com\/?p=4226"},"modified":"2020-04-18T17:35:35","modified_gmt":"2020-04-18T17:35:35","slug":"how-to-resolve-a-root-canal-infection-a-pardigm-shift","status":"publish","type":"post","link":"https:\/\/myholisticdentist.com\/2018\/05\/23\/how-to-resolve-a-root-canal-infection-a-pardigm-shift\/","title":{"rendered":"How to Resolve a Root Canal Infection &#8211; A Pardigm Shift"},"content":{"rendered":"<p>[et_pb_section fb_built=&#8221;1&#8243; admin_label=&#8221;section&#8221; _builder_version=&#8221;3.22&#8243;][et_pb_row admin_label=&#8221;row&#8221; _builder_version=&#8221;3.25&#8243; background_size=&#8221;initial&#8221; background_position=&#8221;top_left&#8221; background_repeat=&#8221;repeat&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;3.25&#8243; custom_padding=&#8221;|||&#8221; custom_padding__hover=&#8221;|||&#8221;][et_pb_image src=&#8221;https:\/\/myholisticdentist.com\/wp-content\/uploads\/2018\/05\/LaserActivated-2.png&#8221; align=&#8221;center&#8221; force_fullwidth=&#8221;on&#8221; align_tablet=&#8221;center&#8221; align_phone=&#8221;&#8221; align_last_edited=&#8221;on|desktop&#8221; _builder_version=&#8221;3.23&#8243; box_shadow_style=&#8221;preset1&#8243;][\/et_pb_image][et_pb_text _builder_version=&#8221;4.4.2&#8243; background_size=&#8221;initial&#8221; background_position=&#8221;top_left&#8221; background_repeat=&#8221;repeat&#8221; hover_enabled=&#8221;0&#8243;]<\/p>\n<p>A lot of patients come to me seeking help in trying to resolve root canal infections.\u00a0 The problem is that the basic protocol for treating root canals hasn&#8217;t changed in the last 30 years, ever since I got out of dental school.\u00a0 There have been improvements and tweaks, but we are still using the same basic approach, strategies and tools.<\/p>\n<h2>What is a laser root canal and how is it done?<\/h2>\n<p>Here is a video explaining what is done during root canal therapy with the Fotana laser in SWEEPS mode:<\/p>\n<p><iframe loading=\"lazy\" width=\"1080\" height=\"608\" src=\"https:\/\/www.youtube.com\/embed\/_cjbmxAfJoU?feature=oembed\" frameborder=\"0\" allow=\"autoplay; encrypted-media\" allowfullscreen><\/iframe><\/p>\n<p>[\/et_pb_text][et_pb_text _builder_version=&#8221;3.27.4&#8243; background_size=&#8221;initial&#8221; background_position=&#8221;top_left&#8221; background_repeat=&#8221;repeat&#8221;]<\/p>\n<h2>What&#8217;s the problem in doing root canals?<\/h2>\n<p>Some problems that may arise in any root canal procedure are as follows:<\/p>\n<ol>\n<li>You remove the nerve and blood supply of the tooth, thereby removing the natural healing capability of your tooth.<\/li>\n<li>Too much tooth structure might be removed through over-instrumenting and using posts (See above video).<\/li>\n<li>Using the wrong rinses during the root canal procedure can cause denaturing, alteration and weakening of the remaining tooth structure.<\/li>\n<li>The sealers used to fill the canals and plug up the tooth are sometimes inflammatory to the bone surrounding the tooth.<\/li>\n<li>Bacteria is left behind that can eventually reinfect the tooth and bone around the tooth.<\/li>\n<\/ol>\n<p>Keep in mind that dentists are trying to save your tooth when they recommend a root canal to you, and it takes a lot of skill and training to do a root canal.\u00a0 A whole specialty called endodontics is dedicated to doing root canals using the best materials and procedures known, as evidenced by research.<\/p>\n<p>However, there are problems when you weaken the structure of the tooth and remove its nerve and blood supply.\u00a0 It&#8217;s not the practitioners&#8217; fault, as they are doing the best they can under very compromising circumstances.\u00a0 However, these problems still exist, as they are problems inherent in the procedure itself.\u00a0 This results in a lot of these teeth failing over time.<br \/>\n[\/et_pb_text][et_pb_text _builder_version=&#8221;3.27.4&#8243; background_size=&#8221;initial&#8221; background_position=&#8221;top_left&#8221; background_repeat=&#8221;repeat&#8221;]<\/p>\n<h2>Wait a minute, I thought root canal treatment lasted forever.<\/h2>\n<h2>Are you telling me it&#8217;s going to fail?<\/h2>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-4540 alignright\" style=\"caret-color: #000000; color: #000000; font-family: -webkit-standard; font-size: 16px;\" src=\"https:\/\/myholisticdentist.com\/wp-content\/uploads\/2018\/05\/Infection-draining-from-old-root-canal-tooth-300x300.jpg\" alt=\"Root Canal Infection\" width=\"300\" height=\"300\" srcset=\"https:\/\/myholisticdentist.com\/wp-content\/uploads\/2018\/05\/Infection-draining-from-old-root-canal-tooth-300x300.jpg 300w, https:\/\/myholisticdentist.com\/wp-content\/uploads\/2018\/05\/Infection-draining-from-old-root-canal-tooth-150x150.jpg 150w, https:\/\/myholisticdentist.com\/wp-content\/uploads\/2018\/05\/Infection-draining-from-old-root-canal-tooth-610x610.jpg 610w, https:\/\/myholisticdentist.com\/wp-content\/uploads\/2018\/05\/Infection-draining-from-old-root-canal-tooth.jpg 756w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/p>\n<p>In my practice I see many failing root canals due to infection. \u00a0<span style=\"font-size: 16px;\">After root canal therapy, the tooth no longer has a blood or lymph supply to bring immune cells into the tooth or carry waste out of the tooth. \u00a0<\/span><span style=\"font-size: 16px;\">This makes it impossible for the body to fight the bacteria present in and around the tooth.\u00a0 Without the protection provided by the immune system, the bacteria that originally infected the tooth remain &#8211; although at reduced levels &#8211; and can slowly re-infect the tooth.<\/span><\/p>\n<p>Here is an example of what can happen with root canal therapy.\u00a0 The image to the right is an Xray of an old root canal that has gotten infected.\u00a0 See the dark area at the end of the root?\u00a0 Bacteria draining from the small hole at the end of the root into the bone around the tooth.<\/p>\n<p><a href=\"https:\/\/myholisticdentist.com\/wp-content\/uploads\/2018\/05\/Black-Roots-from-Infected-Root-Canal.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-4536 alignleft\" src=\"https:\/\/myholisticdentist.com\/wp-content\/uploads\/2018\/05\/Black-Roots-from-Infected-Root-Canal-300x300.jpg\" alt=\"Black Roots from Root Canal Filling\" width=\"300\" height=\"300\" srcset=\"https:\/\/myholisticdentist.com\/wp-content\/uploads\/2018\/05\/Black-Roots-from-Infected-Root-Canal-300x300.jpg 300w, https:\/\/myholisticdentist.com\/wp-content\/uploads\/2018\/05\/Black-Roots-from-Infected-Root-Canal-150x150.jpg 150w, https:\/\/myholisticdentist.com\/wp-content\/uploads\/2018\/05\/Black-Roots-from-Infected-Root-Canal.jpg 550w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/a>The picture to the left shows the same tooth after the patient decided to extract the tooth and get rid of the infected root canal.\u00a0 As you can see the roots are stained black due to infection in and around the root canal filling.\u00a0 This results in toxic material and bacteria soaking into the body of the tooth itself.\u00a0 Eventually this toxicity and bacteria will leak into the bone around the tooth causing inflammation and tissue damage.\u00a0 More on this below.<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<br \/>\n[\/et_pb_text][et_pb_text _builder_version=&#8221;3.27.4&#8243; background_size=&#8221;initial&#8221; background_position=&#8221;top_left&#8221; background_repeat=&#8221;repeat&#8221;]<span style=\"color: #128212; font-size: 20px; font-weight: bold;\">Doc, how can a root canal fail so badly?<\/span><\/p>\n<p>The goal of doing the root canal treatment is to reduce the amounts of the bacteria to such a low level that the patients pain resolves and the area heals as evidenced on Xrays.<\/p>\n<p>The problem is that no matter how thorough the procedure is done and how skilled the practitioner, a root canal procedure even when done perfectly cannot reach all the bacteria present.\u00a0 That is because bacteria remain:<\/p>\n<ol>\n<li>In the tubules of the tooth<\/li>\n<li>In the bone and ligament around the tooth<\/li>\n<li>In voids within the canals themselves as these canals are are irregularly shaped<span style=\"font-size: 16px;\">One of the prime problems with root canals and why they fail later is that the practitioner cannot reach all the bacteria or is therefore ineffective in killing them.<\/span><\/li>\n<\/ol>\n<h2>What are Dentinal Tubules and why do they matter?<\/h2>\n<p><a href=\"https:\/\/myholisticdentist.com\/wp-content\/uploads\/2018\/05\/SEM-of-dentinal-tubules.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-4534 alignright\" src=\"https:\/\/myholisticdentist.com\/wp-content\/uploads\/2018\/05\/SEM-of-dentinal-tubules.jpg\" alt=\"\" width=\"195\" height=\"162\" \/><\/a>Dentinal Tubules are communication channels between the pulpal tissue, i.e. the blood and lymph vessels inside the canals of the tooth and the ligament and bone outside the tooth.\u00a0 These channels transmit not only feeling to the nerve of the tooth but nutrition and immune cells from the pulp tissue into the hard structures of the tooth (the dentin and enamel) to keep it healthy and strong.\u00a0 More and more research is coming out showing the importance of the tubules in keeping the tooth vital and healthy.<\/p>\n<h2>What happens to the tubules when a tooth gets infected?<\/h2>\n<p>When the tooth &#8216;dies&#8217;, the pulpal tissue necroses (undergoes tissue death) through bacterial invasion.\u00a0 The most common cause of this is from decay or a deep cavity,\u00a0 When the bacteria invades and overruns the soft tissue in the canals, the tooth becomes diseased and infected.\u00a0 It is now a sick tooth and needs treatment.<\/p>\n<p>Before the tooth became infected the tubules were filled with nutrients, minerals and even immune cells.\u00a0 After the infection the tubules become filled with bacteria, bacteria waste products called endotoxins, and other inflammatory materials and byproducts of anaerobic metabolism now prevalent in the tooth.<\/p>\n<p><a href=\"https:\/\/myholisticdentist.com\/wp-content\/uploads\/2018\/05\/Bacteria-in-Dentinal-Tubules-of-Tooth.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-4533 alignleft\" src=\"https:\/\/myholisticdentist.com\/wp-content\/uploads\/2018\/05\/Bacteria-in-Dentinal-Tubules-of-Tooth-300x185.jpg\" alt=\"\" width=\"300\" height=\"185\" srcset=\"https:\/\/myholisticdentist.com\/wp-content\/uploads\/2018\/05\/Bacteria-in-Dentinal-Tubules-of-Tooth-300x185.jpg 300w, https:\/\/myholisticdentist.com\/wp-content\/uploads\/2018\/05\/Bacteria-in-Dentinal-Tubules-of-Tooth-610x377.jpg 610w, https:\/\/myholisticdentist.com\/wp-content\/uploads\/2018\/05\/Bacteria-in-Dentinal-Tubules-of-Tooth.jpg 680w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/a>Here are images under an electron microscope showing the bacteria now populating the tubules of the roots of a tooth after it has become infected.<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p><a href=\"https:\/\/myholisticdentist.com\/wp-content\/uploads\/2018\/05\/confocal-image-showing-in\ufb01ltration-of-bacteria-deep-into-the-dentin-tubules.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-4527 alignleft\" src=\"https:\/\/myholisticdentist.com\/wp-content\/uploads\/2018\/05\/confocal-image-showing-in\ufb01ltration-of-bacteria-deep-into-the-dentin-tubules-300x216.jpg\" alt=\"\" width=\"300\" height=\"216\" srcset=\"https:\/\/myholisticdentist.com\/wp-content\/uploads\/2018\/05\/confocal-image-showing-in\ufb01ltration-of-bacteria-deep-into-the-dentin-tubules-300x216.jpg 300w, https:\/\/myholisticdentist.com\/wp-content\/uploads\/2018\/05\/confocal-image-showing-in\ufb01ltration-of-bacteria-deep-into-the-dentin-tubules.jpg 395w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/a>It has been estimated that there is over a mile of tubules in one tooth if those tubules are laid side by side.\u00a0 That is a lot of tubules and potential bacteria that can be left behind even if all the bacteria inside the canals is removed or killed which, by the way, is almost impossible to achieve.<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<br \/>\n[\/et_pb_text][et_pb_text _builder_version=&#8221;3.27.4&#8243; background_size=&#8221;initial&#8221; background_position=&#8221;top_left&#8221; background_repeat=&#8221;repeat&#8221;]<\/p>\n<h2>Are you saying that some bacteria can be sealed into the tooth<\/h2>\n<h2>even after the root canal is finished?<\/h2>\n<p><a href=\"https:\/\/myholisticdentist.com\/wp-content\/uploads\/2018\/05\/SEM-of-dentinal-tubules-containing-microorganisms.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-4531 alignright\" src=\"https:\/\/myholisticdentist.com\/wp-content\/uploads\/2018\/05\/SEM-of-dentinal-tubules-containing-microorganisms.jpg\" alt=\"\" width=\"193\" height=\"150\" \/><\/a>Yes.\u00a0 I&#8217;m sorry to have to tell you this.\u00a0 However, bacteria are very good at surviving.\u00a0 Bacteria will create an oily ooze called a &#8216;biofilm&#8217; that they can use to hide from most antibiotics, medicaments, and drugs.\u00a0 There is also what is called a smear layer which is debris that plugs up the tubules and further insulates the bacteria.\u00a0 Unless this biofilm and smear layer are penetrated and broken down, the bacteria will remain and persist.\u00a0 The way that dentists break down the smear layer is with EDTA.\u00a0 Then the dentist can use rinses like Bleach and Chlohexidine to kill the bacteria in the canals of the tooth and in the biofilm.<\/p>\n<h2>Wait a minute, did you say bleach is used during root canal therapy?<\/h2>\n<p><a href=\"https:\/\/myholisticdentist.com\/wp-content\/uploads\/2018\/05\/Chlorox-Bleach.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\" wp-image-4552 alignleft\" src=\"https:\/\/myholisticdentist.com\/wp-content\/uploads\/2018\/05\/Chlorox-Bleach-175x300.jpg\" alt=\"\" width=\"123\" height=\"210\" srcset=\"https:\/\/myholisticdentist.com\/wp-content\/uploads\/2018\/05\/Chlorox-Bleach-175x300.jpg 175w, https:\/\/myholisticdentist.com\/wp-content\/uploads\/2018\/05\/Chlorox-Bleach.jpg 295w\" sizes=\"(max-width: 123px) 100vw, 123px\" \/><\/a>Yes.\u00a0 Up till now, bleach has been shown to be the best solution available to kill bacteria and break down biofilm.\u00a0 Bleach is Sodium Hypochlorite (NaClO), and the bleach used in dentistry is common household Clorox.\u00a0 Most practitioners dilute this, however even when diluted, it can denature the tooth structure and weaken it.<\/p>\n<p>The other problem of course is that if any bleach leaks or is pushed into the bone around the tooth, it is very caustic and can cause tissue damage.\u00a0 Believe me when I say that bleach is not good for you or for the bone and tissues around your tooth and can create problems.\u00a0 More on this in another article.\u00a0 The good news is that there is a protocol and solution that&#8217;s been made available that does not use bleach to kill bacteria during root canal therapy.\u00a0 More on this exciting breakthrough below.<\/p>\n<h2>OK, back to the problem of residual bacteria?<\/h2>\n<p>The problem with residual bacteria around root canals is that they release endotoxins.\u00a0 Endotoxins are basically poison to the body and stimulate an immune response to remove them and heal the cell death resulting form them.\u00a0 The way the body cleans out damaging and toxic material is through the release of cytokines into the area, which are inflammatory proteins that bring healing cofactors, activate stem cells and increase blood and lymph flow into the area.\u00a0 It is how the body heals.<\/p>\n<p>Activation of the immune system is how the body mounts this healing response.\u00a0 Everyone has experienced the inflammation caused during the flu or a cold.\u00a0 It is not a pleasant experience, but it is only temporary and then the body recovers.\u00a0 So inflammation is necessary to heal any injury or infection.\u00a0 On a short term basis it is fine.<\/p>\n<p>However, if inflammation remains for an extended period of time it is not good or healthy.\u00a0 Inflammation has been called the &#8216;Silent Killer.&#8217;\u00a0 This is the kind of inflammation that is chronic and remains in your body long term.\u00a0 This could be an inflammatory condition like an autoimmune disease, long term stress, or an infection that is never fully resolved or healed.<\/p>\n<p>A root canal can be considered to be a source of such a long term inflammation, as the bacteria associated with it continue to release endotoxins into your body.\u00a0 This is the long term inflammation we are talking about that creates an immune response and cytokine release that is low grade but continual.<\/p>\n<h2>All this doesn&#8217;t sound good, doc.\u00a0 Do I want a root canal at all?<\/h2>\n<p>This is a good question.\u00a0 Root canals are a definite compromise and have some inherent problems.\u00a0 However, it is the only way of saving your tooth once it becomes infected.\u00a0 The other option of course is to extract the tooth, but this is not a good option either if the tooth is not replaced, as it creates bite collapse.<\/p>\n<p>What I find in my practice even after informing my patients of the risks and benefits of all their options is that patients are fairly split down the middle in terms of keeping the tooth or extracting it.\u00a0 Most people want to keep their teeth, but are torn as root canals leave bacteria behind.<\/p>\n<h2>Is there a solution that allows me to keep my tooth<\/h2>\n<h2>and leave it bacteria and infection free?<\/h2>\n<p><a href=\"https:\/\/myholisticdentist.com\/wp-content\/uploads\/2018\/05\/Fotona-Laser-black-background.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-4553 alignright\" src=\"https:\/\/myholisticdentist.com\/wp-content\/uploads\/2018\/05\/Fotona-Laser-black-background-199x300.jpg\" alt=\"\" width=\"199\" height=\"300\" srcset=\"https:\/\/myholisticdentist.com\/wp-content\/uploads\/2018\/05\/Fotona-Laser-black-background-199x300.jpg 199w, https:\/\/myholisticdentist.com\/wp-content\/uploads\/2018\/05\/Fotona-Laser-black-background.jpg 472w\" sizes=\"(max-width: 199px) 100vw, 199px\" \/><\/a>Up to now the only solution I had to make sure that all the bacteria was removed was to extract the tooth and supply healing factors and co-factors to help speed the healing process and produce healthy bone.\u00a0 Please see my articles on PRF or platelet rich plasma.\u00a0 This sets up its own problem as the tooth usually needs to be replaced with a fixed bridge, removable partial denture or implant.<\/p>\n<p>Now there is a laser technology that can directly address many of the problems inherent in root canal therapy.\u00a0 In the image to the left is a Nd:Yag and Erbium laser combination called the Lightwalker from Fotona.\u00a0 It is a breakthrough in laser technology because it combines the two most effective lasers in dentistry into one unit.\u00a0 I have had dentists tell me that they have had multiple lasers in the past and none of them do what this laser does.\u00a0 It is indeed a game changer and will allow us to do things in dentistry we haven&#8217;t been able to do in the past.<\/p>\n<h2>PIPS and SWEEPS; a paradigm shift in root canal therapy<\/h2>\n<p>PIPS stands for Photon Induced PhotoAccoustic Streaming.\u00a0 And as far as I know, the Fotona laser in the only laser available in the marketplace that offers it, as they bought the technology.\u00a0 What is PIPS you might ask and how does it work?\u00a0 Let me show you by allowing you to play a video demonstrating how it works:<\/p>\n<p><iframe loading=\"lazy\" width=\"1080\" height=\"608\" src=\"https:\/\/www.youtube.com\/embed\/_cjbmxAfJoU?feature=oembed\" frameborder=\"0\" allow=\"autoplay; encrypted-media\" allowfullscreen><\/iframe><\/p>\n<p>This video shows the effects of Photo-Accoustic Streaming in a slightly different mode or combination of pulses called SWEEPS on the lateral canals in the root canal system of a plastic molar tooth model.\u00a0 Do you see those horizontal channels\/canals between the two vertical canals?\u00a0 Watch and see what happens when the laser is activated and super excites the solution:\u00a0 SWEEPS is like PIPS on steroids.<\/p>\n<h2>How important is this in the treatment of Root Canals?<\/h2>\n<p>Do you remember the video at the beginning of the post?\u00a0 If you watch it again, you will see that the files that are used can only access and clean the main canals of the tooth, which are vertical.\u00a0 As you can see in the videos just above using PIPS with the Fotona laser, now we can get to and kill all the bacteria that is trapped and hiding in the tubules of the roots and in all the lateral and accessory canals and communications between the main canals that cannot be reached or instrumented by traditional means.\u00a0 This is a game changer in dentistry.<\/p>\n<h2>What happens to the bacteria in the tubules?<\/h2>\n<p><a href=\"https:\/\/myholisticdentist.com\/wp-content\/uploads\/2018\/05\/SEM-image-showing-the-absence-of-bacteria-in-tubules.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-4530 alignleft\" src=\"https:\/\/myholisticdentist.com\/wp-content\/uploads\/2018\/05\/SEM-image-showing-the-absence-of-bacteria-in-tubules-300x229.jpg\" alt=\"\" width=\"300\" height=\"229\" srcset=\"https:\/\/myholisticdentist.com\/wp-content\/uploads\/2018\/05\/SEM-image-showing-the-absence-of-bacteria-in-tubules-300x229.jpg 300w, https:\/\/myholisticdentist.com\/wp-content\/uploads\/2018\/05\/SEM-image-showing-the-absence-of-bacteria-in-tubules.jpg 392w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/a>PIPS also seems to work to great effect with bacteria in the tubules that were before now unreachable.\u00a0 In the picture to the left we see an electron microscope image of the tubules after root canal treatment using PIPS with just water.\u00a0 Just think how much more effective we can be with this technology in combination with an antibacterial rinse.\u00a0 Now we can even get to the bacteria in the tubules.<\/p>\n<h2><\/h2>\n<h2><\/h2>\n<h2>Is there a way to avoid bleach during root canals?<\/h2>\n<p>Actually, there is.\u00a0 Ozone is now being used to good effect during root canal therapy.\u00a0 This is really good news as ozone breaks down to oxygen in he body and can be used to great effect when treating root canals.\u00a0 The reason ozone holds such promise in treating root canals is that is has been shown to be more effective\u00a0at killing bacteria that even bleach, which is toxic to the body.\u00a0 I am hopeful that we will hear more about PIPS technology and the use of ozone as an alternative to the use of bleach in root canal therapy.<\/p>\n<h2>Where can I get my root canal treated with the Fotona Laser &amp; Ozone?<\/h2>\n<p>The Fotona laser is such an upgrade and paradigm shift in dentistry that I have recently purchased one for my practice and am introducing it to my patients for those that want to address the bacterial infections associated with root canals and gum disease.<\/p>\n<p>&nbsp;<\/p>\n<p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n","protected":false},"excerpt":{"rendered":"<p>A lot of patients come to me seeking help in trying to resolve root canal infections.\u00a0 The problem is that the basic protocol for treating root canals hasn&#8217;t changed in the last 30 years, ever since I got out of dental school.\u00a0 There have been improvements and tweaks, but we are still using the same basic approach, strategies and tools.<\/p>\n<h2>What&#8217;s the problem in doing root canals?<\/h2>\n","protected":false},"author":2,"featured_media":4593,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_et_pb_use_builder":"on","_et_pb_old_content":"A lot of patients come to me seeking help in trying to resolve root canal infections.\u00a0 The problem is that the basic protocol for treating root canals hasn't changed in the last 30 years, ever since I got out of dental school.\u00a0 There have been improvements and tweaks, but we are still using the same basic approach, strategies and tools.\r\n\r\n<h2>What is a root canal and how is it done?<\/h2>\r\n\r\nHere is a video explaining what is done during root canal therapy:\r\n\r\nhttps:\/\/www.youtube.com\/watch?v=zZKvHXDDZ9E\r\n\r\n\u00a0\r\n\r\n<h2>What's the problem in doing root canals?<\/h2>\r\n\r\nSome problems that may arise in any root canal procedure are as follows:\r\n\r\n<ol>\r\n    <li>You remove the nerve and blood supply of the tooth, thereby removing the natural healing capability of your tooth.<\/li>\r\n    <li>Too much tooth structure might be removed through over-instrumenting and using posts (See above video).<\/li>\r\n    <li>Using the wrong rinses during the root canal procedure can cause denaturing, alteration and weakening of the remaining tooth structure.<\/li>\r\n    <li>The sealers used to fill the canals and plug up the tooth are sometimes inflammatory to the bone surrounding the tooth.<\/li>\r\n    <li>Bacteria is usually left behind that can eventually reinfect the tooth and bone around the tooth.<\/li>\r\n<\/ol>\r\n\r\nKeep in mind that dentists are trying to save your tooth when they recommend a root canal to you, and it takes a lot of skill and training to do a root canal.\u00a0 A whole specialty called endodontics is dedicated to doing root canals using the best materials and procedures known, as evidenced by research.\r\n\r\nHowever, there are problems when you weaken the structure of the tooth and remove its nerve and blood supply.\u00a0 It's not the practitioners' fault, as they are doing the best they can under very compromising circumstances.\u00a0 However, these problems still exist, as they are problems inherent in the procedure itself.\u00a0 This results in a lot of these teeth failing over time.\r\n\r\n<h2>Wait a minute, I thought root canal treatment lasted forever.\u00a0 Are you telling me it's going to fail?<\/h2>\r\n\r\nIn my practice I see many failing root canals due to infection.\u00a0 After root canal therapy, the tooth no longer has a blood or lymph supply to bring immune cells into the tooth or carry waste out of the tooth.\u00a0 This makes it impossible for the body to fight the bacteria present in and around the tooth.\u00a0 Without the protection provided by the immune system, the bacteria that originally infected the tooth remain - although at reduced levels - and can slowly re-infect the tooth.\r\n\r\n<a href=\"https:\/\/myholisticdentist.com\/wp-content\/uploads\/2018\/05\/Infection-draining-from-old-root-canal-tooth.jpg\"><img class=\"size-medium wp-image-4540 alignright\" src=\"https:\/\/myholisticdentist.com\/wp-content\/uploads\/2018\/05\/Infection-draining-from-old-root-canal-tooth-300x300.jpg\" alt=\"Root Canal Infection\" width=\"300\" height=\"300\" \/><\/a>Here is an example of what can happen with root canal therapy.\u00a0 The image to the right is an Xray of an old root canal that has gotten infected.\u00a0 See the dark area at the end of the root?\u00a0 That is bacteria draining from the small hole at the end of the root into the bone around the tooth.\r\n\r\n\u00a0\r\n\r\n\u00a0\r\n\r\n\u00a0\r\n\r\n<a href=\"https:\/\/myholisticdentist.com\/wp-content\/uploads\/2018\/05\/Black-Roots-from-Infected-Root-Canal.jpg\"><img class=\"size-medium wp-image-4536 alignleft\" src=\"https:\/\/myholisticdentist.com\/wp-content\/uploads\/2018\/05\/Black-Roots-from-Infected-Root-Canal-300x300.jpg\" alt=\"Black Roots from Root Canal Filling\" width=\"300\" height=\"300\" \/><\/a>The picture to the left shows the same tooth after the patient decided to extract the tooth and get rid of the infected root canal.\u00a0 As you can see the roots are stained black due to infection in and around the root canal filling.\u00a0 This results in toxic material and bacteria soaking into the body of the tooth itself.\u00a0 Eventually this toxicity and bacteria will leak into the bone around the tooth causing inflammation and tissue damage.\u00a0 More on this below.\r\n\r\n\u00a0\r\n\r\n\u00a0\r\n\r\n<h2><\/h2>\r\n\r\n<h2>Doc, how can a root canal fail so badly?<\/h2>\r\n\r\nThe goal of doing the root canal treatment is to reduce the amounts of the bacteria to such a low level that the patients pain resolves and the area heals as evidenced by improvement on Xrays.\r\n\r\nThe problem is that no matter how thorough the procedure is done and how skilled the practitioner, a root canal procedure even when done perfectly cannot reach all the bacteria present.\u00a0 That is because bacteria remain:\r\n\r\n<ol>\r\n    <li>In the tubules of the tooth<\/li>\r\n    <li>In the bone and ligament around the tooth<\/li>\r\n    <li>In voids within the canals themselves as these canals are are irregularly shaped<\/li>\r\n<\/ol>\r\n\r\nOne of the prime problems with root canals and why they fail later is that the practitioner cannot reach all the bacteria or is therefore ineffective in killing them.\r\n\r\n<h2>What are Dentinal Tubules and why do they matter?<\/h2>\r\n\r\n<a href=\"https:\/\/myholisticdentist.com\/wp-content\/uploads\/2018\/05\/SEM-of-dentinal-tubules.jpg\"><img class=\"size-full wp-image-4534 alignright\" src=\"https:\/\/myholisticdentist.com\/wp-content\/uploads\/2018\/05\/SEM-of-dentinal-tubules.jpg\" alt=\"\" width=\"195\" height=\"162\" \/><\/a>Dentinal Tubules are communication channels between the pulpal tissue, i.e. the blood and lymph vessels inside the canals of the tooth and the ligament and bone outside the tooth.\u00a0 These channels transmit not only feeling to the nerve of the tooth but nutrition and immune cells from the pulp tissue into the hard structures of the tooth (the dentin and enamel) to keep it healthy and strong.\u00a0 More and more research is coming out showing the importance of the tubules in keeping the tooth vital and healthy.\r\n\r\n<h2>What happens to the tubules when a tooth gets infected?<\/h2>\r\n\r\nWhen the tooth 'dies', the pulpal tissue necroses (undergoes tissue death) through bacterial invasion.\u00a0 The most common cause of this is from decay or a deep cavity,\u00a0 When the bacteria invades and overruns the soft tissue in the canals, the tooth becomes diseased and infected.\u00a0 It is now a sick tooth and needs treatment.\r\n\r\nBefore the tooth became infected the tubules were filled with nutrients, minerals and even immune cells.\u00a0 After the infection the tubules become filled with bacteria, bacteria waste products called endotoxins, and other inflammatory materials and byproducts of anaerobic metabolism now prevalent in the tooth.\r\n\r\n<a href=\"https:\/\/myholisticdentist.com\/wp-content\/uploads\/2018\/05\/Bacteria-in-Dentinal-Tubules-of-Tooth.jpg\"><img class=\"size-medium wp-image-4533 alignleft\" src=\"https:\/\/myholisticdentist.com\/wp-content\/uploads\/2018\/05\/Bacteria-in-Dentinal-Tubules-of-Tooth-300x185.jpg\" alt=\"\" width=\"300\" height=\"185\" \/><\/a>Here are images under an electron microscope showing the bacteria now populating the tubules of the roots of a tooth after it has become infected.\r\n\r\n\u00a0\r\n\r\n\u00a0\r\n\r\n\u00a0\r\n\r\n\u00a0\r\n\r\n<a href=\"https:\/\/myholisticdentist.com\/wp-content\/uploads\/2018\/05\/confocal-image-showing-in\ufb01ltration-of-bacteria-deep-into-the-dentin-tubules.jpg\"><img class=\"size-medium wp-image-4527 alignleft\" src=\"https:\/\/myholisticdentist.com\/wp-content\/uploads\/2018\/05\/confocal-image-showing-in\ufb01ltration-of-bacteria-deep-into-the-dentin-tubules-300x216.jpg\" alt=\"\" width=\"300\" height=\"216\" \/><\/a>It has been estimated that there is over a mile of tubules in one tooth if those tubules are laid side by side.\u00a0 That is a lot of tubules and potential bacteria that can be left behind even if all the bacteria inside the canals is removed or killed which, by the way, is almost impossible to achieve.\r\n\r\n<h2><\/h2>\r\n\r\n<h2><\/h2>\r\n\r\n<h2><\/h2>\r\n\r\n<h2>Are you saying that some bacteria can be sealed into the tooth even after the root canal is finished?<\/h2>\r\n\r\n<a href=\"https:\/\/myholisticdentist.com\/wp-content\/uploads\/2018\/05\/SEM-of-dentinal-tubules-containing-microorganisms.jpg\"><img class=\"size-full wp-image-4531 alignright\" src=\"https:\/\/myholisticdentist.com\/wp-content\/uploads\/2018\/05\/SEM-of-dentinal-tubules-containing-microorganisms.jpg\" alt=\"\" width=\"193\" height=\"150\" \/><\/a>Yes.\u00a0 I'm sorry to have to tell you this.\u00a0 However, bacteria are very good at surviving.\u00a0 Bacteria will create an oily ooze called a 'biofilm' that they can use to hide from most antibiotics, medicaments, and drugs.\u00a0 There is also what is called a smear layer which is debris that plugs up the tubules and further insulates the bacteria.\u00a0 Unless this biofilm and smear layer are penetrated and broken down, the bacteria will remain and persist.\u00a0 The way that dentists break down the smear layer is with EDTA.\u00a0 Then the dentist can use rinses like Bleach and Chlohexidine to kill the bacteria in the canals of the tooth and in the biofilm.\r\n\r\n<h2>Wait a minute, did you say bleach is used during root canal therapy?<\/h2>\r\n\r\n<a href=\"https:\/\/myholisticdentist.com\/wp-content\/uploads\/2018\/05\/Chlorox-Bleach.jpg\"><img class=\" wp-image-4552 alignleft\" src=\"https:\/\/myholisticdentist.com\/wp-content\/uploads\/2018\/05\/Chlorox-Bleach-175x300.jpg\" alt=\"\" width=\"123\" height=\"210\" \/><\/a>Yes.\u00a0 Up till now, bleach has been shown to be the best solution available to kill bacteria and break down biofilm.\u00a0 Bleach is Sodium Hypochlorite (NaClO), and the bleach used in dentistry is common household Clorox.\u00a0 Most practitioners dilute this, however even when diluted, it can denature the tooth structure and weaken it.\r\n\r\nThe other problem of course is that if any bleach leaks or is pushed into the bone around the tooth, it is very caustic and can cause tissue damage.\u00a0 Believe me when I say that bleach is not good for you or for the bone and tissues around your tooth and can create problems.\u00a0 More on this in another article.\u00a0 The good news is that there is a protocol and solution that's been made available that does not use bleach to kill bacteria during root canal therapy.\u00a0 More on this exciting breakthrough below.\r\n\r\n<h2><\/h2>\r\n\r\n<h2>OK, back to the problem of residual bacteria?<\/h2>\r\n\r\nThe problem with residual bacteria around root canals is that they release endotoxins.\u00a0 Endotoxins are basically poison to the body and stimulate an immune response to remove them and heal the cell death resulting form them.\u00a0 The way the body cleans out damaging and toxic material is through the release of cytokines into the area, which are inflammatory proteins that bring healing cofactors, activate stem cells and increase blood and lymph flow into the area.\u00a0 It is how the body heals.\r\n\r\nActivation of the immune system is how the body mounts this healing response.\u00a0 Everyone has experienced the inflammation caused during the flu or a cold.\u00a0 It is not a pleasant experience, but it is only temporary and then the body recovers.\u00a0 So inflammation is necessary to heal any injury or infection.\u00a0 On a short term basis it is fine.\r\n\r\nHowever, if inflammation remains for an extended period of time it is not good or healthy.\u00a0 Inflammation has been called the 'Silent Killer.'\u00a0 This is the kind of inflammation that is chronic and remains in your body long term.\u00a0 This could be an inflammatory condition like an autoimmune disease, long term stress, or an infection that is never fully resolved or healed.\r\n\r\nA root canal can be considered to be a source of such a long term inflammation, as the bacteria associated with it continue to release endotoxins into your body.\u00a0 This is the long term inflammation we are talking about that creates an immune response and cytokine release that is low grade but continual.\r\n\r\n<h2>All this doesn't sound good, doc.\u00a0 Do I want a root canal at all?<\/h2>\r\n\r\nThis is a good question.\u00a0 Root canals are a definite compromise and have some inherent problems.\u00a0 However, it is the only way of saving your tooth once it becomes infected.\u00a0 The other option of course is to extract the tooth, but this is not a good option either if the tooth is not replaced, as it creates bite collapse.\r\n\r\nWhat I find in my practice even after informing my patients of the risks and benefits of all their options is that patients are fairly split down the middle in terms of keeping the tooth or extracting it.\u00a0 Most people want to keep their teeth, but are torn as root canals leave bacteria behind.\r\n\r\n<h2>Is there a solution that allows me to keep my tooth and leave it bacteria and infection free?<\/h2>\r\n\r\n<a href=\"https:\/\/myholisticdentist.com\/wp-content\/uploads\/2018\/05\/Fotona-Laser-black-background.jpg\"><img class=\"size-medium wp-image-4553 alignleft\" src=\"https:\/\/myholisticdentist.com\/wp-content\/uploads\/2018\/05\/Fotona-Laser-black-background-199x300.jpg\" alt=\"\" width=\"199\" height=\"300\" \/><\/a>Up to now the only solution I had to make sure that all the bacteria was removed was to extract the tooth and supply healing factors and co-factors to help speed the healing process and produce healthy bone.\u00a0 Please see my articles on PRF or platelet rich plasma.\u00a0 This sets up its own problem as the tooth usually needs to be replaced with a fixed bridge, removable partial denture or implant.\r\n\r\nNow there is a laser technology that can directly address many of the problems inherent in root canal therapy.\u00a0 In the image to the left is a Nd:Yag and Erbium laser combination called the Lightwalker from Fotona.\u00a0 It is a breakthrough in laser technology because it combines the two most effective lasers in dentistry into one unit.\u00a0 I have had dentists tell me that they have had multiple lasers in the past and none of them do what this laser does.\u00a0 It is indeed a game changer and will allow us to do things in dentistry we haven't been able to do in the past.\r\n\r\n<h2><\/h2>\r\n\r\n<h2>PIPS and SWEEPS; a paradigm shift in root canal therapy<\/h2>\r\n\r\nPIPS stands for Photon Induced PhotoAccoustic Streaming.\u00a0 And as far as I know, the Fotona laser in the only laser available in the marketplace that offers it, as they bought the technology.\u00a0 What is PIPS you might ask and how does it work?\u00a0 Let me show you by allowing you to play a video demonstrating how it works:\r\n\r\nhttps:\/\/www.youtube.com\/watch?v=_cjbmxAfJoU\r\n\r\nThis video shows the effects of Photo-Accoustic Streaming in a slightly different mode or combination of pulses called SWEEPS on the lateral canals in the root canal system of a plastic molar tooth model.\u00a0 Do you see those horizontal channels\/canals between the two vertical canals?\u00a0 Watch and see what happens when the laser is activated and super excites the solution:\u00a0 SWEEPS is like PIPS on steroids.\r\n\r\n<h2>How important is this in the treatment of Root Canals?<\/h2>\r\n\r\nDo you remember the video at the beginning of the post?\u00a0 If you watch it again, you will see that the files that are used can only access and clean the main canals of the tooth, which are vertical.\u00a0 As you can see in the videos just above using PIPS with the Fotona laser, now we can get to and kill all the bacteria that is trapped and hiding in the tubules of the roots and in all the lateral and accessory canals and communications between the main canals that cannot be reached or instrumented by traditional means.\u00a0 This is a game changer in dentistry.\r\n\r\n<h2>What happens to the bacteria in the tubules?<\/h2>\r\n\r\n<a href=\"https:\/\/myholisticdentist.com\/wp-content\/uploads\/2018\/05\/SEM-image-showing-the-absence-of-bacteria-in-tubules.jpg\"><img class=\"size-medium wp-image-4530 alignleft\" src=\"https:\/\/myholisticdentist.com\/wp-content\/uploads\/2018\/05\/SEM-image-showing-the-absence-of-bacteria-in-tubules-300x229.jpg\" alt=\"\" width=\"300\" height=\"229\" \/><\/a>PIPS also seems to work to great effect with bacteria in the tubules that were before now unreachable.\u00a0 In the picture to the left we see an electron microscope image of the tubules after root canal treatment using PIPS with just water.\u00a0 Just think how much more effective we can be with this technology in combination with an antibacterial rinse.\u00a0 Now we can even get to the bacteria in the tubules.\r\n\r\n<h2><\/h2>\r\n\r\n<h2><\/h2>\r\n\r\n<h2><\/h2>\r\n\r\n<h2>You mentioned bleach before. Is there a way to avoid bleach during root canals?<\/h2>\r\n\r\nActually, there is.\u00a0 Ozone is now being used to good effect during root canal therapy.\u00a0 This is really good news as ozone breaks down to oxygen in he body and can be used to great effect when treating root canals.\u00a0 The reason ozone holds such promise in treating root canals is that is has been shown to be more effective\u00a0at killing bacteria that even bleach, which is toxic to the body.\u00a0 I am hopeful that we will hear more about PIPS technology and the use of ozone as an alternative to the use of bleach in root canal therapy.\r\n\r\n<h2>Where can I get my root canal treated with the Fotona Laser and Ozone?<\/h2>\r\n\r\nThe Fotona laser is such an upgrade and paradigm shift in dentistry that I have recently purchased one for my practice and am introducing it to my patients for those that want to address the bacterial infections associated with root canals and gum disease.","_et_gb_content_width":"","om_disable_all_campaigns":false,"footnotes":""},"categories":[165,268],"tags":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v22.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>How to Resolve a Root Canal Infection - A Pardigm Shift - Integrative Dentistry, San Diego Holistic Dentist<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/myholisticdentist.com\/2018\/05\/23\/how-to-resolve-a-root-canal-infection-a-pardigm-shift\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"How to Resolve a Root Canal Infection - A Pardigm Shift - Integrative Dentistry, San Diego Holistic Dentist\" \/>\n<meta property=\"og:description\" content=\"A lot of patients come to me seeking help in trying to resolve root canal infections.\u00a0 The problem is that the basic protocol for treating root canals hasn&#039;t changed in the last 30 years, ever since I got out of dental school.\u00a0 There have been improvements and tweaks, but we are still using the same basic approach, strategies and tools. What&#039;s the problem in doing root canals?\" \/>\n<meta property=\"og:url\" content=\"https:\/\/myholisticdentist.com\/2018\/05\/23\/how-to-resolve-a-root-canal-infection-a-pardigm-shift\/\" \/>\n<meta property=\"og:site_name\" content=\"Integrative Dentistry, San Diego Holistic Dentist\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/holisticdds1\" \/>\n<meta property=\"article:author\" content=\"https:\/\/www.facebook.com\/holisticdds1\/\" \/>\n<meta property=\"article:published_time\" content=\"2018-05-23T15:33:36+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2020-04-18T17:35:35+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/myholisticdentist.com\/wp-content\/uploads\/2018\/05\/LaserActivated-2.png\" \/>\n\t<meta property=\"og:image:width\" content=\"693\" \/>\n\t<meta property=\"og:image:height\" content=\"419\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/png\" \/>\n<meta name=\"author\" content=\"Carey O\u2019Rielly, DDS\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:creator\" content=\"@https:\/\/twitter.com\/holisticdds\" \/>\n<meta name=\"twitter:site\" content=\"@holisticdds\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Carey O\u2019Rielly, DDS\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"13 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\/\/myholisticdentist.com\/2018\/05\/23\/how-to-resolve-a-root-canal-infection-a-pardigm-shift\/#article\",\"isPartOf\":{\"@id\":\"https:\/\/myholisticdentist.com\/2018\/05\/23\/how-to-resolve-a-root-canal-infection-a-pardigm-shift\/\"},\"author\":{\"name\":\"Carey O\u2019Rielly, DDS\",\"@id\":\"https:\/\/myholisticdentist.com\/#\/schema\/person\/c994e1e5c23b8ee43d407be421710ec6\"},\"headline\":\"How to Resolve a Root Canal Infection &#8211; A Pardigm Shift\",\"datePublished\":\"2018-05-23T15:33:36+00:00\",\"dateModified\":\"2020-04-18T17:35:35+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\/\/myholisticdentist.com\/2018\/05\/23\/how-to-resolve-a-root-canal-infection-a-pardigm-shift\/\"},\"wordCount\":2563,\"commentCount\":6,\"publisher\":{\"@id\":\"https:\/\/myholisticdentist.com\/#organization\"},\"image\":{\"@id\":\"https:\/\/myholisticdentist.com\/2018\/05\/23\/how-to-resolve-a-root-canal-infection-a-pardigm-shift\/#primaryimage\"},\"thumbnailUrl\":\"https:\/\/myholisticdentist.com\/wp-content\/uploads\/2018\/05\/LaserActivated-2.png\",\"articleSection\":[\"Blog\",\"Dental Implants\"],\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\/\/myholisticdentist.com\/2018\/05\/23\/how-to-resolve-a-root-canal-infection-a-pardigm-shift\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\/\/myholisticdentist.com\/2018\/05\/23\/how-to-resolve-a-root-canal-infection-a-pardigm-shift\/\",\"url\":\"https:\/\/myholisticdentist.com\/2018\/05\/23\/how-to-resolve-a-root-canal-infection-a-pardigm-shift\/\",\"name\":\"How to Resolve a Root Canal Infection - A Pardigm Shift - Integrative Dentistry, San Diego Holistic Dentist\",\"isPartOf\":{\"@id\":\"https:\/\/myholisticdentist.com\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\/\/myholisticdentist.com\/2018\/05\/23\/how-to-resolve-a-root-canal-infection-a-pardigm-shift\/#primaryimage\"},\"image\":{\"@id\":\"https:\/\/myholisticdentist.com\/2018\/05\/23\/how-to-resolve-a-root-canal-infection-a-pardigm-shift\/#primaryimage\"},\"thumbnailUrl\":\"https:\/\/myholisticdentist.com\/wp-content\/uploads\/2018\/05\/LaserActivated-2.png\",\"datePublished\":\"2018-05-23T15:33:36+00:00\",\"dateModified\":\"2020-04-18T17:35:35+00:00\",\"breadcrumb\":{\"@id\":\"https:\/\/myholisticdentist.com\/2018\/05\/23\/how-to-resolve-a-root-canal-infection-a-pardigm-shift\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/myholisticdentist.com\/2018\/05\/23\/how-to-resolve-a-root-canal-infection-a-pardigm-shift\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\/\/myholisticdentist.com\/2018\/05\/23\/how-to-resolve-a-root-canal-infection-a-pardigm-shift\/#primaryimage\",\"url\":\"https:\/\/myholisticdentist.com\/wp-content\/uploads\/2018\/05\/LaserActivated-2.png\",\"contentUrl\":\"https:\/\/myholisticdentist.com\/wp-content\/uploads\/2018\/05\/LaserActivated-2.png\",\"width\":693,\"height\":419},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/myholisticdentist.com\/2018\/05\/23\/how-to-resolve-a-root-canal-infection-a-pardigm-shift\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/myholisticdentist.com\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"How to Resolve a Root Canal Infection &#8211; A Pardigm Shift\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/myholisticdentist.com\/#website\",\"url\":\"https:\/\/myholisticdentist.com\/\",\"name\":\"Integrative Dentistry, San Diego Holistic Dentist\",\"description\":\"San Diego Holistic Dentistry | Carey O&#039;Rielly, DDS | Serving Encinitas and San Diego, CA\",\"publisher\":{\"@id\":\"https:\/\/myholisticdentist.com\/#organization\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/myholisticdentist.com\/?s={search_term_string}\"},\"query-input\":\"required name=search_term_string\"}],\"inLanguage\":\"en-US\"},{\"@type\":\"Organization\",\"@id\":\"https:\/\/myholisticdentist.com\/#organization\",\"name\":\"Integrative Dentistry\",\"url\":\"https:\/\/myholisticdentist.com\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\/\/myholisticdentist.com\/#\/schema\/logo\/image\/\",\"url\":\"https:\/\/myholisticdentist.com\/wp-content\/uploads\/2014\/01\/Logo-new-2014-dk-blue-1-e1391894886100.png\",\"contentUrl\":\"https:\/\/myholisticdentist.com\/wp-content\/uploads\/2014\/01\/Logo-new-2014-dk-blue-1-e1391894886100.png\",\"width\":250,\"height\":142,\"caption\":\"Integrative Dentistry\"},\"image\":{\"@id\":\"https:\/\/myholisticdentist.com\/#\/schema\/logo\/image\/\"},\"sameAs\":[\"https:\/\/www.facebook.com\/holisticdds1\",\"https:\/\/twitter.com\/holisticdds\",\"https:\/\/www.linkedin.com\/in\/holisticdds\",\"https:\/\/www.youtube.com\/user\/holisticdds\"]},{\"@type\":\"Person\",\"@id\":\"https:\/\/myholisticdentist.com\/#\/schema\/person\/c994e1e5c23b8ee43d407be421710ec6\",\"name\":\"Carey O\u2019Rielly, DDS\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\/\/myholisticdentist.com\/#\/schema\/person\/image\/\",\"url\":\"https:\/\/secure.gravatar.com\/avatar\/51b934a77a6aea7519f40aee1d4d9c61?s=96&d=blank&r=g\",\"contentUrl\":\"https:\/\/secure.gravatar.com\/avatar\/51b934a77a6aea7519f40aee1d4d9c61?s=96&d=blank&r=g\",\"caption\":\"Carey O\u2019Rielly, DDS\"},\"description\":\"Carey O\u2019Rielly DDS has been a practicing dentist for 35 years.\u00a0 He went to USC Dental School and Duke University for his undergraduate degree.\u00a0 He grew up in Laguna Beach and now lives in La Costa with his wife Victoria, who runs his office. He began his career by owning and operating a network of six offices in the San Francisco Bay Area.\u00a0 Presently he owns a private holistic practice in North County San Diego\u2019s Encinitas. Dr. O started looking for solutions to his health challenges that resulted from the stress and environmental toxicity that built up over a ten year period running his dental network. He has dedicated himself to learning about oral systemic problems and how dentistry can affect your health. He has applied what he has learned over the last twenty years to ensure he, his staff and his patients are protected from the chemicals and toxic materials found in most dental offices. He has produced an environmentally friendly office that is also peaceful and calm. He is an expert on dental materials having looked at hundreds of biocompatibility lab tests over the years.\u00a0 He has identified the most bio-friendly materials to use in his practice and which dental materials can be used to replace metal fillings and crowns, including BPA free and fluoride free \u2018white\u2019 fillings.\u00a0 He also uses metal-free Zirconia or ceramic implants and PRF (platelet-rich fibrin) grafting materials which come from the patient\u2019s own blood. Dr. O\u2019Rielly teaches C.E. courses on the systemic effects of gum disease.\u00a0 He is an expert in using phase contrast microscopy for analyzing dental infections, where he shows patients what kind of microbes, i.e. bacteria, amoeba, and yeasts like candida are populating the mouth and affecting the body as a whole. He has an educational blog and is writing a book on dental health called \u2018Hidden Dental Infections: Healing Root Canals and Infected Teeth with the Erbium Laser\u2019 where he discusses dental nutrition, toxic dental materials and the effects of old root canals on inflammation and overall health.\",\"sameAs\":[\"https:\/\/myholisticdentist.com\",\"https:\/\/www.facebook.com\/holisticdds1\/\",\"https:\/\/twitter.com\/https:\/\/twitter.com\/holisticdds\"]}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"How to Resolve a Root Canal Infection - A Pardigm Shift - Integrative Dentistry, San Diego Holistic Dentist","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/myholisticdentist.com\/2018\/05\/23\/how-to-resolve-a-root-canal-infection-a-pardigm-shift\/","og_locale":"en_US","og_type":"article","og_title":"How to Resolve a Root Canal Infection - A Pardigm Shift - Integrative Dentistry, San Diego Holistic Dentist","og_description":"A lot of patients come to me seeking help in trying to resolve root canal infections.\u00a0 The problem is that the basic protocol for treating root canals hasn't changed in the last 30 years, ever since I got out of dental school.\u00a0 There have been improvements and tweaks, but we are still using the same basic approach, strategies and tools. What's the problem in doing root canals?","og_url":"https:\/\/myholisticdentist.com\/2018\/05\/23\/how-to-resolve-a-root-canal-infection-a-pardigm-shift\/","og_site_name":"Integrative Dentistry, San Diego Holistic Dentist","article_publisher":"https:\/\/www.facebook.com\/holisticdds1","article_author":"https:\/\/www.facebook.com\/holisticdds1\/","article_published_time":"2018-05-23T15:33:36+00:00","article_modified_time":"2020-04-18T17:35:35+00:00","og_image":[{"width":693,"height":419,"url":"https:\/\/myholisticdentist.com\/wp-content\/uploads\/2018\/05\/LaserActivated-2.png","type":"image\/png"}],"author":"Carey O\u2019Rielly, DDS","twitter_card":"summary_large_image","twitter_creator":"@https:\/\/twitter.com\/holisticdds","twitter_site":"@holisticdds","twitter_misc":{"Written by":"Carey O\u2019Rielly, DDS","Est. reading time":"13 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/myholisticdentist.com\/2018\/05\/23\/how-to-resolve-a-root-canal-infection-a-pardigm-shift\/#article","isPartOf":{"@id":"https:\/\/myholisticdentist.com\/2018\/05\/23\/how-to-resolve-a-root-canal-infection-a-pardigm-shift\/"},"author":{"name":"Carey O\u2019Rielly, DDS","@id":"https:\/\/myholisticdentist.com\/#\/schema\/person\/c994e1e5c23b8ee43d407be421710ec6"},"headline":"How to Resolve a Root Canal Infection &#8211; A Pardigm Shift","datePublished":"2018-05-23T15:33:36+00:00","dateModified":"2020-04-18T17:35:35+00:00","mainEntityOfPage":{"@id":"https:\/\/myholisticdentist.com\/2018\/05\/23\/how-to-resolve-a-root-canal-infection-a-pardigm-shift\/"},"wordCount":2563,"commentCount":6,"publisher":{"@id":"https:\/\/myholisticdentist.com\/#organization"},"image":{"@id":"https:\/\/myholisticdentist.com\/2018\/05\/23\/how-to-resolve-a-root-canal-infection-a-pardigm-shift\/#primaryimage"},"thumbnailUrl":"https:\/\/myholisticdentist.com\/wp-content\/uploads\/2018\/05\/LaserActivated-2.png","articleSection":["Blog","Dental Implants"],"inLanguage":"en-US","potentialAction":[{"@type":"CommentAction","name":"Comment","target":["https:\/\/myholisticdentist.com\/2018\/05\/23\/how-to-resolve-a-root-canal-infection-a-pardigm-shift\/#respond"]}]},{"@type":"WebPage","@id":"https:\/\/myholisticdentist.com\/2018\/05\/23\/how-to-resolve-a-root-canal-infection-a-pardigm-shift\/","url":"https:\/\/myholisticdentist.com\/2018\/05\/23\/how-to-resolve-a-root-canal-infection-a-pardigm-shift\/","name":"How to Resolve a Root Canal Infection - A Pardigm Shift - Integrative Dentistry, San Diego Holistic Dentist","isPartOf":{"@id":"https:\/\/myholisticdentist.com\/#website"},"primaryImageOfPage":{"@id":"https:\/\/myholisticdentist.com\/2018\/05\/23\/how-to-resolve-a-root-canal-infection-a-pardigm-shift\/#primaryimage"},"image":{"@id":"https:\/\/myholisticdentist.com\/2018\/05\/23\/how-to-resolve-a-root-canal-infection-a-pardigm-shift\/#primaryimage"},"thumbnailUrl":"https:\/\/myholisticdentist.com\/wp-content\/uploads\/2018\/05\/LaserActivated-2.png","datePublished":"2018-05-23T15:33:36+00:00","dateModified":"2020-04-18T17:35:35+00:00","breadcrumb":{"@id":"https:\/\/myholisticdentist.com\/2018\/05\/23\/how-to-resolve-a-root-canal-infection-a-pardigm-shift\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/myholisticdentist.com\/2018\/05\/23\/how-to-resolve-a-root-canal-infection-a-pardigm-shift\/"]}]},{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/myholisticdentist.com\/2018\/05\/23\/how-to-resolve-a-root-canal-infection-a-pardigm-shift\/#primaryimage","url":"https:\/\/myholisticdentist.com\/wp-content\/uploads\/2018\/05\/LaserActivated-2.png","contentUrl":"https:\/\/myholisticdentist.com\/wp-content\/uploads\/2018\/05\/LaserActivated-2.png","width":693,"height":419},{"@type":"BreadcrumbList","@id":"https:\/\/myholisticdentist.com\/2018\/05\/23\/how-to-resolve-a-root-canal-infection-a-pardigm-shift\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/myholisticdentist.com\/"},{"@type":"ListItem","position":2,"name":"How to Resolve a Root Canal Infection &#8211; A Pardigm Shift"}]},{"@type":"WebSite","@id":"https:\/\/myholisticdentist.com\/#website","url":"https:\/\/myholisticdentist.com\/","name":"Integrative Dentistry, San Diego Holistic Dentist","description":"San Diego Holistic Dentistry | Carey O&#039;Rielly, DDS | Serving Encinitas and San Diego, CA","publisher":{"@id":"https:\/\/myholisticdentist.com\/#organization"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/myholisticdentist.com\/?s={search_term_string}"},"query-input":"required name=search_term_string"}],"inLanguage":"en-US"},{"@type":"Organization","@id":"https:\/\/myholisticdentist.com\/#organization","name":"Integrative Dentistry","url":"https:\/\/myholisticdentist.com\/","logo":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/myholisticdentist.com\/#\/schema\/logo\/image\/","url":"https:\/\/myholisticdentist.com\/wp-content\/uploads\/2014\/01\/Logo-new-2014-dk-blue-1-e1391894886100.png","contentUrl":"https:\/\/myholisticdentist.com\/wp-content\/uploads\/2014\/01\/Logo-new-2014-dk-blue-1-e1391894886100.png","width":250,"height":142,"caption":"Integrative Dentistry"},"image":{"@id":"https:\/\/myholisticdentist.com\/#\/schema\/logo\/image\/"},"sameAs":["https:\/\/www.facebook.com\/holisticdds1","https:\/\/twitter.com\/holisticdds","https:\/\/www.linkedin.com\/in\/holisticdds","https:\/\/www.youtube.com\/user\/holisticdds"]},{"@type":"Person","@id":"https:\/\/myholisticdentist.com\/#\/schema\/person\/c994e1e5c23b8ee43d407be421710ec6","name":"Carey O\u2019Rielly, DDS","image":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/myholisticdentist.com\/#\/schema\/person\/image\/","url":"https:\/\/secure.gravatar.com\/avatar\/51b934a77a6aea7519f40aee1d4d9c61?s=96&d=blank&r=g","contentUrl":"https:\/\/secure.gravatar.com\/avatar\/51b934a77a6aea7519f40aee1d4d9c61?s=96&d=blank&r=g","caption":"Carey O\u2019Rielly, DDS"},"description":"Carey O\u2019Rielly DDS has been a practicing dentist for 35 years.\u00a0 He went to USC Dental School and Duke University for his undergraduate degree.\u00a0 He grew up in Laguna Beach and now lives in La Costa with his wife Victoria, who runs his office. He began his career by owning and operating a network of six offices in the San Francisco Bay Area.\u00a0 Presently he owns a private holistic practice in North County San Diego\u2019s Encinitas. Dr. O started looking for solutions to his health challenges that resulted from the stress and environmental toxicity that built up over a ten year period running his dental network. He has dedicated himself to learning about oral systemic problems and how dentistry can affect your health. He has applied what he has learned over the last twenty years to ensure he, his staff and his patients are protected from the chemicals and toxic materials found in most dental offices. He has produced an environmentally friendly office that is also peaceful and calm. He is an expert on dental materials having looked at hundreds of biocompatibility lab tests over the years.\u00a0 He has identified the most bio-friendly materials to use in his practice and which dental materials can be used to replace metal fillings and crowns, including BPA free and fluoride free \u2018white\u2019 fillings.\u00a0 He also uses metal-free Zirconia or ceramic implants and PRF (platelet-rich fibrin) grafting materials which come from the patient\u2019s own blood. Dr. O\u2019Rielly teaches C.E. courses on the systemic effects of gum disease.\u00a0 He is an expert in using phase contrast microscopy for analyzing dental infections, where he shows patients what kind of microbes, i.e. bacteria, amoeba, and yeasts like candida are populating the mouth and affecting the body as a whole. He has an educational blog and is writing a book on dental health called \u2018Hidden Dental Infections: Healing Root Canals and Infected Teeth with the Erbium Laser\u2019 where he discusses dental nutrition, toxic dental materials and the effects of old root canals on inflammation and overall health.","sameAs":["https:\/\/myholisticdentist.com","https:\/\/www.facebook.com\/holisticdds1\/","https:\/\/twitter.com\/https:\/\/twitter.com\/holisticdds"]}]}},"_links":{"self":[{"href":"https:\/\/myholisticdentist.com\/wp-json\/wp\/v2\/posts\/4226"}],"collection":[{"href":"https:\/\/myholisticdentist.com\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/myholisticdentist.com\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/myholisticdentist.com\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/myholisticdentist.com\/wp-json\/wp\/v2\/comments?post=4226"}],"version-history":[{"count":69,"href":"https:\/\/myholisticdentist.com\/wp-json\/wp\/v2\/posts\/4226\/revisions"}],"predecessor-version":[{"id":7201,"href":"https:\/\/myholisticdentist.com\/wp-json\/wp\/v2\/posts\/4226\/revisions\/7201"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/myholisticdentist.com\/wp-json\/wp\/v2\/media\/4593"}],"wp:attachment":[{"href":"https:\/\/myholisticdentist.com\/wp-json\/wp\/v2\/media?parent=4226"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/myholisticdentist.com\/wp-json\/wp\/v2\/categories?post=4226"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/myholisticdentist.com\/wp-json\/wp\/v2\/tags?post=4226"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}