Endodontic FAQ

What is endodontics?

Endodontics is a branch of dentistry recognized by the American Dental Association involving treatment of the pulp (root canal) and surrounding tissues of the tooth. When you look at your tooth in the mirror, what you see is the crown. The rest of the tooth, the portion hidden beneath the gum line, is called the root. Though the outer portion of the root is a hard tissue called dentin, the inside channel or “root canal” contains a pulp of soft tissue, blood vessels and nerves. Bacteria that are introduced into the pulp as a result of tooth decay, periodontal disease, tooth fracture or other problems, can severely damage the pulp. When that happens, an endodontic specialist, such as Dr. Katz or Dr. Bonar, removes the diseased pulp to save the tooth and prevent further infection and inflammation. After successful endodontic treatment, the tooth continues to perform normally.

I’m worried about x-rays. Should I be?

No. While x-rays will be necessary during your endodontic treatment, we use an advanced non-film computerized system, called digital radiography, that produces radiation levels up to 90 percent lower than those of already low dose conventional dental x-ray machinery. These digital images can be optimized, archived, printed and sent to cotherapists via e-mail or CD-ROM. For more information contact Sirona Dental Systems, Inc.

What about infection?

Again, there’s no need for concern. We adhere to the most rigorous standards of infection control advocated by OSHA, the Centers for Disease Control and the American Dental Association. We utilize autoclave sterilization and barrier techniques to eliminate any risk of infection.

What happens after root canal treatment?

When your root canal therapy has been completed, a record of your treatment will be sent to your restorative dentist. You should contact his office for a follow-up restoration within a few weeks of completion at our office. Your restorative dentist will decide on what type of restoration is necessary to protect your tooth. It is rare for endodontic patients to experience complications after routine endodontic treatment or microsurgery. If a problem does occur, however, we are available at all times to respond.

What new technologies are being used?

Operating Microscopes:

In addition to digital radiography, we utilize special operating microscopes. Magnification and fiber optic illumination are helpful in aiding the doctor to see tiny details inside your tooth. Also, a tiny video camera on the operating microscope can record images of your tooth to further document the doctor’s findings.

i’ve heard about the netflix documentary “root cause.” is there any merit to their claims?

There is a difference between endodontic disease and endodontic treatment. Root canal treatment, well done, is the cure for the disease. 

The two main premises of Root Cause are that root canal treatment causes systemic disease and that we are leaving behind infected, dead teeth.

1. Regarding systemic disease, a number of studies have looked at the connection between root canal treatment, cancer and chronic disease. To date, there is no study that has shown a connection, let alone causation, contrary to what the “experts” in the video say. For example, the question is not whether 97% of the people with brain cancer have had root canal treatment. 100% of them breathe air and drink water, but no one is suggesting those things caused the cancer. The real question is how many people who get root canal treatment develop brain cancer? The answer is, about the same percentage as in the general population. There is even one study that showed people with root canal treatment had 45% fewer cancers. None of the causation claims made in the video are supported by real research published in peer-reviewed journals.

2. Regarding the dead, infected tooth, it is true that every microorganism is not eliminated during root canal treatment, but the way we judge the outcome of treatment is whether the tooth is comfortable and functions normally, and whether the “bone grows back” after treatment. After successful root canal treatment the tooth is not “dead.” It is still supplied by blood vessels and nerves from the surrounding tissues, and is the same as any other tooth, other than it can’t feel hot or cold. The presence of bacteria does not necessarily mean infection. Our bodies are full of microorganisms, some good and some bad, but most are just there, neither good nor bad. A recent study showed evidence of bacteria in vital teeth that have not had root canal treatment. In fact, 90% of the DNA in our bodies is bacterial.

3. There are issues and consequences of removing a tooth, including what is likely to happen if it is not replaced, as well as the treatment options and consequences if it is replaced. According to one study, bridge abutments have about a 1/3 chance of developing endodontic problems in the future. Implants have their own set of issues and costs. It is beneficial to retain a tooth if it has a good chance of long-term survival. Likewise, we as endodontists will advise our patients if the long-term prognosis is poor.

4. If you google the “experts” in the video, you will find some interesting facts. Some have been censured, at least two have lost their licenses to practice, one for writing prescriptions for cash to patients he had never seen. Another questioned whether HIV causes AIDS, suggests that many cancers can be cured with baking soda and that animals are psychic. Another got in trouble for selling a powerful chelating agent without FDA approval to children for treatment of autism. One of the MDs had several cancer patients die after his alternative treatment approaches failed, and served time in prison for manslaughter. Many participate in the anti-amalgam, anti-fluoride, and anti-vaccine campaigns. Many are anti-everything, conspiracy theorists. If you look at their websites, you can see that many of the “experts” benefit financially. Several have become quite wealthy from alternative medicine. They are not impartial or the “only honest practitioners” out there, as they portray themselves. A good example of the false logic and misinformation from the “experts” is their stance on implants. They don’t like titanium, or any metal that blocks the flow of energy through the patients’ meridians. They recommend zirconia. However, zirconia is a white metal, not a ceramic. One doctor in the video made a diagnosis based with a Ouija pole.