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Root Canal Misinformation in Pop Media

I was speaking with a patient recently about an article she’d seen online that claimed that root canal treatments were ineffective and dangerous.  We spoke briefly about the research and authors behind these claims, and she asked me to post more on the topic.  In this post, I hope to provide some clarity not only on the root canal issue, but also on the much larger (and more important) issues of sound scientific research and, ultimately, accountability.

The explosion of social media in the last 5-10 years has brought with it an unprecedented access to information…and misinformation. It’s also birthed an era where anyone with an internet connection can speak to the world, spreading truth or falsehood with relative impunity.  With everyone from Oprah to Oz spewing sound-bite snippets designed to catch your ear, the media consumer is awash in a sea of half-truth mixed with falsehood…without a compass or a lifeboat.

One of my roles as a health professional is to act as a resource to my patients, pointing them in the right direction and helping them understand the big picture as it pertains to their health, mixed messages from the media, and the treatment that is appropriate for their situation.

I’m your compass.

My training as a dentist was and is lengthy, immersive, and ongoing.  Notably, it contains a great deal of historical context. This means that I understand not only what we do today, but what we used to do as profession, and why we used to do it that way.

The key point is that Dentistry (and indeed all of medicine) is evolving and one really can’t understand or contextualize new research or new claims unless one understands similar claims or research from before.

Case in point:  The Root Canal. You don’t need to look far to find Facebook posts or web pages falsely labeling this treatment as dangerous, unhealthy, or even deadly.  It may surprise you to know that the ebb and flow of this reactionary discourse has been going on since the early 1900’s!  Recent web articles often cite opinions of a Dr. Mercola, which in fact are largely informed by George Meinig’s earlier book called “The root canal cover up”.  Backing up even further, the statements in Meinig’s book are based on the 1920’s research of a Dr. Weston Price.   His “studies” consisted of implanting extracted human teeth under the skin of rabbits, which often resulted in the rabbit’s death due to infection.  He also looked at dental infections related to “root canals”, as they were then performed.  Price’s seminal research in this area is profoundly flawed in that:

-Root canal treatments in the early 1900’s were vastly inadequate and incomplete due to a lack of understanding of root canal anatomy and biology.  This, combined with a lack of technology and sterilizing chemistry, led to very poor outcomes from early root canal treatments.  Almost all early root canal treatments failed, therefore, for want of proper cleaning and sterilization of the interior of the tooth.  This lead to widespread reports of tooth infection, pain, and general illness following root canal treatments.  As such, Price’s assertion that “Root Canals cause disease” is understandable considering the current realities of root canal treatment at the time he formed his opinion. However, to take his statements out of historical context leads the modern patient astray.

-Price’s definition of “root canal Treatment” includes teeth that have NOT had a root canal treatment, but rather have undergone cavity repair with incomplete removal of the nerve of the tooth during the procedure.  In the past, it was common practice to remove decay and the portion of the tooth nerve nearest the decay.  We now understand that this is profoundly inappropriate and leads to nerve death and infection.  Dr. Price included these “incomplete” teeth in his sweeping statements about the efficacy of root canal treatments and the supposed “reservoirs” of infection that “root canaled” teeth represented.

-Price concluded that dead rabbits who had “Root Canal”  teeth implanted under their skin prove that root canals are dangerous.  I would wager that any body part, severed and sewn under the skin, would generate a lethal infection in the carrier.

-Price jumps the boundaries of logic in claiming that some implanted rabbits developed arthritis as a result of the implanted teeth.  What he did not understand (and is also not pointed out by those quoting him to date) was that these rabbit’s arthritis was likely septic arthritis, which is a joint disease brought on by massive infection.

It’s clear to me that, were I to form my opinion about root canals from the treatment techniques and research of the 1920’s and 1930’s, I would have a very negative view of them.  Unfortunately, the public opinion on this treatment is being swayed by a vocal minority who are unwittingly leaning on and promoting this very old, very bad “science”.  As I noted above, these authors can make statements as needed to further their agenda, without any liability on their part for actions taken (or not taken) by people under their spell.  Whether or not you have your tooth treated or have it extracted is of no interest to modern opponents, nor are the outcomes of your choices that unfold over the long term.  This is quite different from the reality that I practice in.

As a dentist, I am directly accountable for the treatment that I provide for each of my patients.  I am required by Canadian and BC law to comply with standards of care established by my regulatory body, the College of Dental Surgeons of BC.  I am accountable to practice in such a way that I can give sound account and justification for each and every one of my actions, each and every one of my recommendations or treatments, and even each and every step I follow in any given treatment.  By following modern, widely accepted standards of care and by keeping abreast of modern developments in scientific literature, I can confidently provide my patients with the best possible treatment.

The truth, in fact, is that Modern Root Canal Treatments do work in about 95% of cases in which the treatment is performed correctly. There are no valid, peer-reviewed, published scientific studies that systematically link root canal treatment to any disease.  Millions upon millions of teeth have been saved and are still anchored today in healthy, infection-free bone due to this treatment…and teeth that are saved are teeth that contribute to the maintenance of a healthy, intact dental arch and a healthy diet and lifestyle.  For further reading, I highly recommend that you visit the American Association of Endodontists site, as well as those of the Canadian and American Dental Associations.