By Dr. Mercola
Root canal is a commonly performed procedure in most adults. But is it a wise one? Dr. Robert Kulacz, a dentist, has spent a significant portion of his professional career trying to answer this question.
What he discovered profoundly changed his life, and led him to write a book about his findings called, The Toxic Tooth: How a Root Canal Could Be Making You Sick, which I think is among the best available on this subject.
Dr. Kulacz began practicing dentistry in Brewster, New York. After six years as an associate, he opened his own practice in Somers, New York in 1992, where he performed all the conventional procedures of dentistry, from restorations to extractions and root canals.
"I did a lot of root canals for many years," he says. "Everything was going smoothly until one day, a patient of mine said to me, 'You know, I heard from my physician that root canals may be bad; that root canals may cause or contribute to other diseases in the body.'
And I said, 'You're crazy. Who is telling you this? That's impossible.' He said, 'You got to look at this information.' He gave me websites of organizations like the International Academy of Oral Medicine and Toxicology (IAOMT) to look at.
I went on to explore this topic so I could come back to him and say, 'Here is where you're wrong, here's where your physician is wrong, and here is where the American Dental Association (ADA) is right.'
Lo and behold, I found out they're right; I was wrong.
I looked at Weston Price's work, the work of Rosenow, and others. I decided to go to an IAOMT meeting... Dr. Boyd Haley's lecture on root canals and how toxic they are changed my life. I realized I was wrong... From that day on, I changed my practice."
The Importance of Informed Consent
Dr. Kulacz stopped performing root canals in 1995. He doesn't promote a ban on root canals across the board, but stresses the importance of informed consent.
The American Dental Association states that root canals are a safe procedure that cannot cause any systemic diseases, and according to Dr. Kulacz and others who have spent time investigating the matter, that's simply not true.
"If a patient is informed that these root canal teeth remain infected; that bacteria can indeed travel to other sites in the body, and that bacteria in root canal teeth and the surrounding bone release potent toxins, then the patient can decide to have a root canal or not," he says.
Many dentists believe they can sterilize a root canal tooth and that the act of instrumenting and irrigating the canal will eliminate all the bacteria, but that's not the case.
“I’ve done biopsies on every root canal tooth that I have extracted. Almost all of them have remnants of necrotic debris still in that canal meaning that they were not thoroughly cleaned. Microbiological cultures of the surrounding bone showed infection almost 100% of the time.” Dr. Kulacz says.
According to the ADA, any remaining bacteria will be "entombed" within that tooth, but that's not true either. The gutta-percha, the filling material used to seal the canal, is not getting into the tiny lateral canals that branch off the main canal, so leakage is almost always possible, especially since the tooth is porous.
And even a perfectly sealed root canal cannot prevent the small molecule exotoxins produced by the bacteria inside the root canal tooth from easily migrating out of the tooth and into the body.
The bulk of the tooth structure is composed of dentinal tubules, hollow structures that run from the main canal outward. If you were to put these tubules end to end from just a single rooted tooth, they would stretch for about three miles.
But they’re big enough to harbor bacteria three across, which you can never remove or sterilize. A tooth is more like a sponge than a solid structure.
“If you had a solid tooth structure that was like steel or a metal, you were able to clear out the main canal of that tooth, there were no tributaries, and you can perfectly seal it, and eliminate the residual infection in the surrounding jaw bone a root canal would be great. But we can’t do that,” he says.
"Now, it doesn't mean that all root canal teeth are going to cause disease. It depends upon the type of bacteria that are in there, what kind of toxins they produce, and the immune system health of the individual.
But with 25 to 30 million root canals done per year, multiply that by how many years a person is alive, there's a lot of root canals out there. And a lot of them are not good."
Bacteria from Root Canals May Worsen Other Diseases
Since root canal teeth are chronically infected, they may contribute to a number of different health problems, including heart disease. While the ADA insists bacteria from root canal teeth can never travel to distant sites in your body, Dr. Kulacz disagrees, explaining:
"Heart disease is caused by the damage to the inside lining of the blood vessel (the cholesterol is a secondary byproduct). The primary cause of heart disease is the damage of the intima lining of the blood vessel and migration of macrophages and cholesterol inside that artery.
Inflammation causes plaque to rupture into the lumen, into the space of the blood vessel, causing a blood clot and a heart attack. [A] study done in 2013... compared the bacterial DNA in blood clots and arterial plaque in heart attack patients to the DNA of the bacteria in the mouth.
The same bacteria found in the root canal teeth and in gum disease are found in the plaques in coronary arteries and in the blood clots that caused the heart attack.
These bacteria move from the mouth into other sites of the body like the arterial plaques. They've also found the same bacteria in the pericardial fluid or the fluid that surrounds the heart... In heart disease you don't want infection and inflammation in an arterial plaque.
The presence of oral bacteria from root canal teeth and gum disease in the arterial plaque and blood clots of heart attack patients points to direct causation, rather than correlation between oral infection and cardiovascular disease.”
All Root Canal Teeth Will Become More Infected Over Time
Because root canal teeth no longer have a blood supply, the bacteria remaining inside all root canal teeth are effectively “hidden” from the immune system. To make matters worse, the root canal tooth becomes more infected over time due to the influx of bacteria from the gum tissue surrounding the tooth.
Other research has shown pathogenic bacteria from infected root canals destroy or kill the white blood cells designed to eliminate them, which is why the surrounding jaw bone can harbor such chronic infection. The bacteria can also evade your immune system by:
- Bacterial mimicry; mimicking your body's own bacteria, which your white blood cells will not attack
- Disabling your antibodies and white blood cells
- Forming sticky biofilms
The video above was recorded about four years ago. In it, I discuss some of the health effects I suffered from an infected tooth, which were resolved after having the tooth extracted. It's important to recognize that the reason you get cavities and/or infected teeth in the first place is related to your diet—primarily eating too much sugar.
If your diet is inadequate, your immune function will be compromised, and if your immune system is weakened, the bacteria's ability to wreak havoc is magnified. So does this mean you have to extract all of your root canal teeth? No, Dr. Kulacz says.
"We can't become so closed-minded that we ignore mainstream dentistry or mainstream medicine just because we don't believe one part of it. Just saying that we're going to extract all root canal teeth and we're going to cure all disease is not valid. That's as bad as saying that root canal teeth can't cause any problems. We have to find the balance... we have to evaluate objectively and then come to a reasonable conclusion and protocol on what to do with these root canal teeth."
If you’re considering having a root canal done, evaluate the data and your personal situation, such as your health risks, before making your decision. I would also suggest considering ozone therapy prior to root canal or tooth extraction. Ozone therapy is typically administered through a syringe, right into or around to the base of the tooth. Multiple visits are usually needed to address the infection. Ozone is directly toxic to infectious material, and it also stimulates your immune system.
I was able to prevent a root canal by using ozone therapy not too long ago. However if the pulp tissue has completely died due to infection, nothing, including ozone, will bring the tooth back to life. It took about five treatments. It's safe, non-toxic, and relatively inexpensive, so it may be worth considering before taking more drastic measures.
If you decide to have the tooth extracted rather than doing a root canal, there are several options on how to restore that missing tooth. The first and least expensive option is with a removable appliance or partial denture. You need to take it out at night, put it back in in the morning, and keep it clean. It's the least invasive way to restore missing teeth.
The second and considerably more expensive alternative is to do a bridge. The teeth on either side of the missing tooth are prepared for caps or crowns, and the missing tooth is attached to those two abutment teeth. The bridge is permanently put in as one unit. The problem is you have to cut down a lot of the enamel on the adjacent teeth, which causes trauma to those teeth, potentially risking the need for another root canal over time.
What You Need to Know About Dental Implants
The third option is a dental implant, where a screw is inserted into your jawbone after a healing time of between three and six months to ensure a base of solid, healthy bone in the jaw. Then a tooth is built upon the top of the implant. The implant functions as your root would have and you have a permanent crown that functions like your real tooth. While that may sound ideal, there potential problems to consider.
First, if you use a titanium implant, you're placing metal into your jawbone, which can cause a galvanic or battery response with other metals in your mouth. There are reports in the literature of allergy and tissue toxicity to the metal used in dental implants that can also negatively impact health. At the very least, if you are considering a titanium dental implant, have an allergy test to all the metals present in that implant. This is especially true if you have a known sensitivity to metals.
Dr. Kulacz prefers zirconium implants, as they do not have metallic ions found in titanium implants. However, if an implant is placed into the bone where a previous root canal was done, and the bone was insufficiently cleaned out when the tooth was extracted, then your bone may still be infected. In such a case, you're placing an implant into a chronically infected bone, which is inadvisable.
"It's critical when you extract the root canal tooth that you remove the periodontal ligament (the little sling that holds the tooth to the jawbone), the lamina dura or socket bone (the only purpose of that socket bone is to support the tooth), and then a small amount of bone outside that space. That's done with a slow-speed, round dental bur with copious or lots of sterile sealing and irrigation to keep the bone healthy.
If you do that, you remove the infection, you induce good blood flow into the jawbone – without blood, there is no healing – and you have a non-infected, healthy, and healed bone to which you can then place your dental implant," he says. “Bacterial cultures and tissue biopsy of the surrounding bone after thorough socket cleaning can uncover any residual infection that may remain. This is why I do not favor immediate placement of a dental implant into the socket of a root canal tooth, preferring to wait for the results of the cultures and biopsy as well as adequate bone healing.”
Gum disease is also a common problem associated with implants. An infection or an inflammation in the gums is very similar to having an infection or inflammation in the bone or the root canal tooth. Natural teeth have a barrier against the migration of bacteria into the surrounding bone.
They are full of fibers that insert from the gum into the root of the tooth and the bone, which prevents the bacteria from getting in to the bone area. Dental implants don't have that. They rely on a sticky coating secreted by the gum around the cuff of the collar of the post that supports the crown.
That cuff of tissue has to be maintained with good oral hygiene to prevent inflammation that might otherwise loosen the tissue around the tooth. If you have gum disease and don't clean the implant post thoroughly, the gum disease around implants will progress much more rapidly than around a natural tooth. If you have a dental implant, it's imperative to follow strict oral hygiene, or you may quickly end up with gum problems.
A Root Canal Tooth Is Dead, and Necrotic Tissue Tends to Cause Problems
A root canal tooth is no longer alive. It's dead tissue, which should never be left in your body. If you have appendicitis, the surgeon just doesn't isolate it and leave it in there. He has to remove it. Yet when it comes to teeth, this rule is ignored.
According to Dr. Kulacz, many people who came to see him—often as a last resort—were able to resolve chronic health issues once their severely infected root canal teeth were extracted and/or the infection properly treated. Interestingly, Dr. Weston A. Price was even able to reproduce people's diseases in rabbits simply by implanting the person's root canal tooth beneath the rabbit's skin.1
"The ADA tries to refute Price's work, saying it lacks adequate controls and they used too much bacteria when they inoculated the bacteria into these rabbits. Well, that's not true. They took the actual root canal tooth and they implanted the same root canal tooth with no more bacteria than would have been found in the person from which it came.
That same tooth was implanted under the skin of rabbits. Lo and behold, they would find the same disease occur in the rabbits. The ADA says they repeated Price's work and found it to be invalid. Well, they never have. I've looked for it. I've emailed them. There is no repeat of Price's work. Further, current research supports Price’s assertions that bacteria from root canal teeth DO travel to distant sites in the body.”
To learn more about root canals, and/or to help educate your dentist, I strongly recommend picking up a copy of Dr. Kulacz' book, The Toxic Tooth: How a Root Canal Could Be Making You Sick. If your dentist is honest and sincere, he or she will likely come to the same rational conclusion as Dr. Kulacz. Granted, in many cases, you're likely to meet with resistance. This seems to be the norm before changes in thinking finally shift to the majority. In some cases the resistance can be severe.
Dr. Kulacz ended up losing his practice after the New York State dental board drummed up a series of charges against him, including "gross misconduct" for extracting root canal treated teeth. The dental board initially wanted to pull his dental license, but backed off when the prosecuting attorney admitted no dentist had actually reviewed the reams of data he'd sent in defense of his treatment—a case of misconduct on behalf of the dental board.
“I called the chancellor of the board of regents in New York State and said, 'Your dental board is corrupt. The prosecutor admitted to me that my case was not about justice. It was not about the truth. The dental board had an agenda. They already dismissed this patient’s file as a cause of action.'
Now, I’m not a conspiracy guy. I never thought that this kind of thing could happen. In fact, if somebody would have told me in the years prior that this could happen, I would’ve thought they were crazy. But it did happen to me,” Dr. Kulacz says. “The next day, the attorney from New York State called and said, 'The dental board is going to drop all charges if you will accept a records violation.' They had to have something, otherwise I could go after them for false prosecution.”
Considering it would have taken several years and a quarter of a million dollars to continue fighting, he accepted the records violation—not realizing this would effectively put him out of business... He kept his dental license, but he never realized accepting the violation would increase his malpractice premium ten-fold—from $8,000 a year to $80,000. After being shut down for a year because of the board's action, he made the painful decision not to reopen. Dr. Kulacz' story is yet another example of what can happen to a professional who bucks the trend.
It's not very different from the case of Ignaz Semmelweis, an ob-gyn and surgeon who, about 150 years ago, was vilified for his theory that microbes cause infection. Semmelweis was labeled "insane" by his colleagues for having the audacity to suggest they should wash their hands between deliveries, and they fired him.
He tried to continue his research but was ostracized by the medical community. His mental health eventually did deteriorate, leading to his death in an insane asylum.
Fortunately for us, Dr. Kulacz wrote a book instead of mulling on the pain and frustration of losing a two decades long career. It's a great resource, with the details necessary to convince most rational individuals that root canals are not in the best interest of your health. And, if you have a root canal tooth, to be cautious and consider having it extracted if indicated. You can also learn more on his website, coletrex.com, or contact him via email at: firstname.lastname@example.org.
Resources to Help You Find a Biological Dentist
The following organizations can help you to find a biological dentist specializing in mercury-free dentistry and other holistic approaches: