Did You Know That About 80% of Teeth That Have Had Root Canal Therapy Probably Did Not Need It?
So why did those dentists perform the root canals? To me the answer is simple…they just don’t know about Biomimetic Dentistry. If they knew about Biomimetic Dentistry, the most minimally invasive way of practicing dentistry that saves the tooth’s nerve, saves the tooth ’s structure and saves you time and money, then hopefully they would be trained in these techniques and not put you through these procedures that are often unnecessary or overly aggressive.
So, when is root canal therapy really indicated and how can you avoid it? Here is a story that may explain the thought process behind the decision to have or not have a root canal, and why too many root canals are performed unnecessarily.
One day, about 5 years ago, I received a call from one of my patients who was traveling out of state and said his large old gold inlay came out while eating something chewy. He went to see a dentist near him who took an X-ray, looked at what was left, and said he needs to see an Endodontist (root canal specialist) to do the root canal right away. He said after he does the root canal, he should go back to the dentist that referred him to place a post and prepare the remaining tooth structure for a crown.
So, instead of a more conservative, minimally invasive, and holistic approach, the patient was sent to the Endodontist, who agreed with the referring dentist that my patient should have a root canal. Thankfully my patient called me from the Endodontist’s office first to update me and ask for my opinion.
I asked my patient if he was experiencing any discomfort and he said everything feels comfortable, and that it was just annoying to his tongue because the inlay was missing, and the edges of the remaining tooth were sharp.
I requested to speak with the Endodontist so I can verify the need for this root canal.
I asked the 3 most important questions when verifying if the tooth needs root canal or not:
(1) Is the tooth’s nerve vital? If it is vital, we want to do everything possible to keep it that way, since a root canal would effectively kill that tooth. In Biomimetic Dentistry (the most conservative and natural form of dentistry available) the goal is to check and see if the tooth’s nerve is vital, and if so, do everything to preserve it.
(2) The next most important question to ask if there is any infection present? The dentist should first look clinically to check and see if there is any infection around the tooth in question, and then take an x-ray to see if there is any infection or pathology around that tooth.
(3) And lastly, we ask if the patient is experiencing any pain or discomfort either to hot, cold, or chewing.
So when the Endodontist picked up the phone, I asked those three very important questions. I said, “Is the tooth vital”, and he replied “yes”. I then inquired about any evidence of infection around the tooth, and the Endodontist said “no.” I asked if the patient seems to be experiencing any discomfort to the tooth, such as a lingering discomfort to cold, or adverse response to heat, or pain when chewing or any spontaneous discomfort… and the answer was still “no”. To this I replied, “Well then, why, if the tooth is vital, no infection present and no discomfort experienced, are you recommending root canal therapy?” His response was typical to how most dentists would answer “the old restoration and decay around it looks very close to the nerve, so it probably will need root canal sooner or later so we might as well do it now.”
This is the mindset that contributes to the acceleration of the tooth death cycle. If a patient has any lost or broken restoration such as a lost filling, lost onlay, lost inlay or lost crown with cavity beneath it and close to pulp, or even just broke or fractured a portion of their tooth, why rush to do the root canal procedure? Why kill the nerve prematurely and then stick a large post in the brittle canal of the tooth and then cut away most of the good remaining tooth structure to place a crown? This, unfortunately, is what we were all taught in dental school. I do not fault the other dental practitioners. They are doing the best they can with the knowledge they were given. However, once my mind was opened to how we can save most teeth from unnecessary root canals and invasive preparations by utilizing the techniques, materials, and protocols of Biomimetic Dentistry and Biological Dentistry, I can never go back. I am very proud to be one of the few certified Biomimetic Dentists and Certified Biomimetic Instructors not only in NYC but in the country.
Thankfully the patient never had that root canal, and to this date, does not need one. He never needed the post or crown either. We reconstructed what was lost with a direct biomimetic reconstruction utilizing the various materials we have to mimic the natural properties of the tooth we were restoring, and we did that in one visit of less than 2 hours saving time, cost, tooth’s nerve and structure.
Next article: Does every tooth with Root Canal need a crown? Believe it or not, most don’t!
Let us keep your oral health in check — schedule an appointment with Marc Lazare D.D.S., M.A.G.D. online or by phone today: (332) 334-8290.