560 Jackson St, North Ste 250, St. Petersburg, FL 33705
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Downtown Endodontics

Downtown Endodotnics in St. Petersburg, FL

Root Canal Safety

The connection between our teeth, mouth, and overall health is well-established. Endodontics is essential for maintaining good oral health by removing infection and discomfort while keeping our natural teeth.

root canal safety guidelines st pete fl endodontist

Every dentist has an important duty to reassure patients who have concerns about endodontic treatment safety that their overall health comes first. The American Association of Endodontists website (www.aae.org) provides anxious patients with thorough information about the safety and effectiveness of endodontics and root canal treatment.

Although reliable information is readily available online from the AAE and other trusted sources, patients occasionally come to the dental office with incorrect information. This has happened with the outdated “focal infection theory” in endodontics, which was introduced in the early 1900s. In the 1920s, Dr. Weston A. Price published research claiming that bacteria trapped in tooth tubules during root canal treatment could “escape” and cause nearly any type of chronic systemic disease (such as arthritis; kidney, heart, nervous, gastrointestinal, endocrine and other system diseases). This was before medicine understood what actually caused these diseases.

Dr. Price promoted tooth extraction—the most invasive dental procedure—instead of endodontic treatment. This theory led to a disturbing period of tooth extractions both for treating systemic disease and preventing future illness. Dr. Price’s research methods were questioned when they were first published, and by the early 1930s, several well-designed studies using more advanced research methods had disproven his conclusions.

Many years of research have contradicted Dr. Price’s findings. In 1951, the Journal of the American Dental Association published a special issue examining the scientific literature and changed the standard of care back to endodontic treatment for teeth with dead pulp when the tooth could be preserved. The JADA examined Dr. Price’s research methods from the 1920s and found that they lacked many elements of modern scientific research, including proper control groups and the use of appropriate bacterial doses.

Current research continues to confirm the safety of dental treatment regarding overall systemic health. In 2007, the American Heart Association revised its guidelines on preventing infective endocarditis, significantly reducing the requirements for premedication before dental procedures and removing endodontic treatment from procedures needing premedication. In April 2012, the AHA found no scientific evidence connecting periodontal disease and heart disease, determining that heart disease and periodontal disease often occur together in the same person due to shared risk factors like smoking, age, and diabetes.

Years of research contradict the claims of “focal infection” supporters; there is no credible, scientific evidence connecting endodontically treated teeth and systemic disease. However, some patients still encounter this outdated theory.

Root Canal Safety Guidelines

Dentists are asked to use the following guidelines to address patients who inquire about a connection between root canal treatment and illness:

  • Acknowledge the patient’s concerns; stress that optimum health is the goal for every dental patient.
  • Provide the patient with written information about endodontic treatment, and discuss it. The AAE has a variety of patient education brochures available for purchase (AAE Online Store).
  • Provide the patient with information from the AAE website about common root canal myths:
  • www.aae.org/patients/root-canal-treatment/myths-root-canals/#2.
  • Indicate that the patient is in control of his/her own decision to move forward with any dental procedure, and reiterate a commitment to the highest quality dental care.

Endodontic References

  1. Easlick K: An Evaluation of the Effect of Dental Foci of Infection on Health. JADA 42:615-686, 694-697, June1951.
  2. Grossman L: Root Canal Therapy. 4th edition, Lea & Febiger, Philadelphia, 15-40, 1955.
  3. Grossman L: Focal Infection: Are Oral Foci of Infection Related to Systemic Disease? Dent ClinN Amer, 749-63,Nov. 1960.
  4. Bender TB, Seltzer S, Yermish M: The Incidence of Bacteremia in Endodontic Manipulation. Oral Surg 13(3):353-60, 1960.
  5. Goldman M, Pearson A: A Preliminary Investigation of the Hollow-Tube Theory in Endodontics: Studies withNeo-tetrazolium. J Oral Therapeutics and Pharm, 1(6):618-26, May 1965.
  6. Tomeck C: Reaction of Rat Connective Tissue to Polyethylene Tube Implants. Part. I. Oral Surg 21(3):379-87,March 1966.
  7. Torneck C: Reaction of Rat Connective Tissue to Polyethylene Tube Implants. Part. II. Oral Surg 24(5):674-83,Nov. 1967.
  8. Phillips J: Rat Connective Tissue Response to Hollow Polyethylene Tube Implants. J Canad Dent Assoc 33(2):59-64, Feb. 1967.
  9. Davis M, Joseph S, Bucher J: Periapical and Intracanal Healing Following Incomplete Root Canal Fillings in Dogs.Oral Surg 31(5):662-675, May 1971.
  10. Baumgarther J, Heggers J, Harrison J: The Incidence of Bacteremias Related to Endodontic Procedures. I. NonsurgicalEndodontics. J Endodon 2(5):135-40, May 1976.
  11. Ehrrnann E: Focal Infection: The Endodontic Point of View. Oral Surg 44:628-34, Oct. 1977.
  12. Wenger J, Tsaknis P, delRio C, Ayer W: The Effects of Partially Filled Polyethylene Tube Intraosseous Implants inRats. Oral Surg 46:88-100, July 1978.
  13. Delivanis P, Snowden R, Doyle R: Localization of Blood-borne Bacteria in Instrumented Unfilled Root Canals.Oral Surg 52(4):430-32, Oct. 1981.
  14. Grossman L: Puipless Teeth and Focal Infection. J Endodon 8:S18-S24, Jan. 1982.
  15. Torabinejad M, Theofilopoulos A, Ketering J, Bakiand L: Quantitation of Circulating Immune Complexes, ImmunoglobulinsG and M, and C3 Complement Component in Patients with Large Periapical Lesions. Oral Surg55(2):186-90, Feb. 1983.
  16. Delivanis P, Fan V: The Localization of Blood-borne Bacteria in Instrumented Unfilled and OverinstrumentedCanals. J Endodon 10(1 1):521-24, Nov. 1984.
  17. Benatti 0, Valdrighi L, Biral R, Pupo J: A Histological Study of the Effect of Diameter Enlargement of the ApicalPortion of the Root Canal. J Endodon 11(10):428-34, Oct. 1985.
  18. Wu M, Moorer W, Wesselink P: Capacity of Anaerobic Bacteria Enclosed in a Simulated Root Canal to InduceInflammation. Intemat Endodon J 22:269-77, Nov./Dec. 1989.
  19. Schonfeld SE: Oral Microbial Ecology. In: Slots J, Taubman M, eds. Contemporary Oral Microbiology andImmunology. St. Louis: Mosby Year Book, 1992:267-274.
  20. Wilson W, Taubert K, et al. Prevention of Infective Endocarditis: Guidelines From the American Heart Association,J Amer Heart Assoc 2007;116:1736-54.
  21. Lockhard P, Bolger A, et al. Periodontal Disease and Atherosclerotic Vascular Disease: Does the Evidence Supportan Independent Association? Circulation 2012;125:2520-2544.
  22. Tezal M, et al. Dental Caries and Head and Neck Cancers. JAMA Otolaryngol Head Neck Surg 139(10):1054-60,Oct. 2013.