Root canal alternatives: Is root canal therapy the best option?
A root canal is a procedure where your dentist removes any decay, bacteria and nerves from the interior of a damaged tooth. A root canal can help eliminate pain caused by damaged nerves, save the natural tooth and prevent the need for a tooth extraction.
The only real alternative to a root canal is a tooth extraction where your dentist removes a tooth from its socket in the bone. You would then also need to get a tooth replacement (such as a bridge, crown, implant, or removable partial denture) to restore chewing function and prevent surrounding teeth from shifting and causing more issues for your oral health. This alternative is more expensive than a root canal and also requires more treatment time and additional procedures to the surrounding teeth and tissues.
Do You Need Root Canal Treatment?
Recognizing the signs that you may need a root canal can save you from unnecessary suffering. If one or more of these signs and symptoms sound familiar, it's time to schedule an appointment with your dentists. Root canal therapy ends your pain by replacing your pulp with a durable filling and protective crown. The procedure can help you avoid tooth loss and keep your smile full and healthy.
Aches and Pains
Tooth pain is a clear sign that something's not quite right with your tooth. Although it's impossible to tell if your pain is caused by tooth decay or something more serious, a visit to your dentists can help you determine why you have pain.
Pain often occurs if you have an infection or inflammation in your tooth pulp. The soft mass of nerves, blood vessels and tissues is located in the center of your tooth and protected by the harder dentin and enamel layers.
Initially, pain caused by an inflammation or infection may be mild and might not be constant. If you don't see your dentist when you first experience any ache in your tooth, the pain may increase, making it hard to ignore.
Your symptoms may worsen when you chew or press on your tooth. Temperature changes don't affect healthy teeth but may cause sensitivity in inflamed or infected teeth. If eating or drinking hot, cold or sugary foods and drinks intensify your pain, you may need a root canal.
Inflammations sometimes cause obvious changes in your tooth or gum. You may need root canal therapy if your tooth darkens or the gum around your painful tooth becomes red and puffy.
Bacterial Abscess Symptoms
A bacterial abscess can cause severe, throbbing pain in your tooth and jaw. Other signs to look for include fever, facial swelling around your jaw, swollen lymph nodes, and pus or a pimple on the gum surrounding your tooth. Abscesses are dental emergencies and require prompt treatment.
You may also need a root canal if you injure your tooth. Contact your dentist right away if your tooth is damaged, loosened or knocked out due to a fall, accident or blow to the face.
Root Canal Complications
There are however common complications in this process as it is simply impossible to remove all bacteria 100%. The root canal cavity housing the tooth’s nerve, lymphatic tissue and blood supply is not a straight tube. It is a very complicated anatomical structure inside of the tooth with many branches and auxiliary canals that make the root canal procedure not so straightforward. There are other complications that can make successful completion of a root canal treatment difficult such as curved roots, accessory or lateral canals, and calcifications inside canals. Thus even the successfully completed root canal treated tooth can become reinfected due to secondary infection from a leaky restoration or residual bacteria in the canal system. Bacteria then can become toxic and harmful to the surrounding bone and ligament space and lead to abscess. Complicating the situation is that many bacteria are resistant to antimicrobial treatment during root canal therapy and can persist in the canal system and outside the tooth for years. The tooth dentin surrounding the root canal structure is composed of dentinal tubules that are oriented outwards from the root canal. Bacteria can enter these spaces and hide there and are resistant to efforts to remove them.
What are the alternatives to root canal?
Holistic dentists estimate that about 75% of root canals are unnecessary and could be better addressed by alternate treatments:
When a tooth is damaged so severely that the root must be removed, the tooth is effectively dead. Rather than keep a dead tooth in their mouth, many people opt for extraction to get rid of the tooth completely. There are several possibilities for closing the remaining gap, including:
- Partial dentures, which are removable and can replace one or more teeth
- A bridge, which consists of a false tooth connected on both sides by crowns to keep it the false tooth in place
- A dental implant made of strong, biocompatible materials like zirconia, affixed to the jawbone. Well-cared-for implants can cost less over a lifetime than a root canal, since there is not a need for further treatment.
Liquid Root Canal Therapy
The recently introduced GentleWave® System uses fluid dynamics and broad spectrum acoustic energy to clean the complex anatomies of the root canal system, which means fewer files are used than during standard root canal treatment.
During the GentleWave Procedure, much of the instrumentation used to clean and disinfect during standard root canal treatment is replaced with procedure fluids. The decreased use of files throughout the procedure helps make the GentleWave alternative more comfortable4 than standard root canal treatment—a statement that many patients can attest to!
The GentleWave System removes infected tissue and disinfects the root canal system using fluid dynamics and broad spectrum acoustic energy. This alternative method of cleaning enables cleaning in the deepest and most complex portions of the root canal system.
The GentleWave Procedure is an alternative that often results in fewer treatment visits than standard RCT. The procedure can be completed in just one session, and because the GentleWave Procedure removes the bacteria throughout the root canal system, there is a reduced chance of experiencing root canal failure.
Treatments to Buy Time
Not sure what you should do? There are a couple of minimally invasive treatment options that will buy you time so you can make a decision.
A dentist can inject ozone gas near the end of the tooth’s root to reduce bacteria in the area. This procedure won’t eliminate all the bacteria, and it may have to be repeated often, but the procedure may help reduce inflammation for some period of time.
If the tooth is already dead, the root canal area can be filled with calcium hydroxide as a temporary filling material, which will also keep the bacteria at bay for a period of time. Neither ozone nor calcium hydroxide treatment is permanent, but either one can buy you some time to make a decision about extraction versus a root canal.
What should I do if I’ve already had a root canal treatment?
Everybody’s situation is different, so make sure to consult with your biological dentist on the best next steps for your body. your decision may be different depending on the state of your teeth. No matter what you decide, there are some guidelines you should follow to avoid any future issues:
Follow an anti-inflammatory diet
A whole-foods diet with a variety of plants is a great way to lower inflammation. Remove processed foods and reduce sugar intake from your diet as much as possible. For those who are particularly sensitive, you may also want to remove gluten, dairy, and nightshades like tomatoes, peppers, goji berries, potatoes, paprika, and eggplant for a period of time to see if symptoms of inflammation subside.
Eat antimicrobial foods
While it may not be possible to fully eliminate all the bacteria in the root canal, it doesn’t hurt to incorporate more foods in your diet that have antimicrobial and antibacterial properties, such as clove, garlic, orange, coconut oil, and basil.
Oil pull with coconut oil
Since coconut oil is antimicrobial, it helps attract and pull bacteria out of the mouth (more on how oil pulling works here). Swish up to 1 tablespoon of the oil in your mouth and through your teeth for at least five minutes each morning (and spit in the trash, as coconut oil becomes solid at room temperature and can clog your sink pipes with re-solidified oil).
Keep stress levels low
Chronically high cortisol levels can cause a number of health issues, namely chronic inflammation. Ensure you get restful sleep each night, enjoy movement throughout the day, and practice self-care like meditation and other calming activities to help keep stress levels down.
Manage gut health
An amazing 70% of the immune system is located in the gut. This means that poor gut health can negatively affect immune response (among many other body systems). Incorporate gut-friendly probiotic foods into your daily diet (such as sauerkraut, kimchi, kefir, and kombucha) and get adequate hydration for proper production of stomach acid, which helps digestion.