Occasionally a new patient comes in to see me with a toothache and they are presented with a choice that they do not want to make.  Either have the tooth extracted or a root canal.  For those who read Weston Price we know that he was not a fan of root canals.  Advocating the extraction of teeth that could have been saved is why he fell out of favor with organized dentistry. Techniques and materials have changed and with proper treatment root canals can be acceptable.

On the plus side of extractions, the tooth will never bother you again and a potential focus of infection is removed.  The down side, it is the most disfiguring thing a dentist can do to you and your teeth can shift.  What other body parts to do you have voluntarily removed?

This is a recent case that I did; it is a lower left second molar.  Notice the black “halo” around the back root of the last tooth?  This is an abscess.  It is a bacterial infection.  It causes your immune system to mount a response, causes an inflammatory response in your body.  If you think of your immune system as a fire department this is a call that they don’t have to make.  In other words it is a stress on your system.  In this case there was a 10-millimeter pocket on thistooth.  Remember normal is 0-3 millimeters.

Here is the completed root canal.  Notice the filling material going to the tip of each root.  There is also a build up to hermetically seal the biting surface of the tooth.  The goals of modern root canal therapy are to thoroughly clean and seal the tooth.  Done properly and your immune system can help your body achieve sterility of the tooth.  It is true that the centrifugal fluid flow cannot now occur but properly isolated from the immune system a success rate of over 95% is possible.  This root canal was done in November 2011.

Here is how it looks in April 2012.  Note how the bone has filled in and the halo is disappearing.  The 10-millimeter pocket is now 2 millimeters.  The best way to avoid having to make the choice of root canal or extraction is prevention.  I always recommend a sugar free and low carbohydrate approach to eating but when prevention fails or trauma causes a tooth to abscess it is a choice you may have to make. With proper care this tooth can now be maintained for a lifetime.