Connecting Dentistry & Medicine by Robert Kulacz DDS and Thomas E Levy MD JD, Xlibris Corp. 2002
This book has been written jointly by Dr Thomas Levy, a US doctor, attorney and author and Dr Robert Kulacz, a dentist with a special interest in root canal treatments and the treatment of cavitations. This book addresses the many problems posed by current routine dental treatment which the authors firmly believe may account for the explosive increase in the numbers of people suffering from chronic, serious and degenerative diseases that appear to be peculiar to the developed world.
The dental profession is either oblivious to or in denial about the harm it is inflicting, and for understandable reasons, they are not likely to conduct research implicating their procedures in the causation of ill-health. And the medical profession by-and-large does not consider the mouth to be a part of the body, so they are looking the other way too! This schism means that, in the words of the authors, “No one is minding the shop!” (ie: the health of the body).
As an aside, I notice time and time again that the possibility of a dental cause for a variety of illnesses is almost completely overlooked by researchers. I remember a study into the stratospheric rise in rates of asthma on a particular Pacific island where those involved had exhaustively analysed the environment and diet but had completely neglected to look at what dental treatment(s) and materials may have been introduced to the island in recent times.
Although the book addresses the topics of the toxicity of dental materials and particularly the use of mercury-containing amalgam, and the problems posed by jaw cavitations and some other topics, this review will concentrate upon the dangers posed by root canal treatments as these other topics have been covered in previous articles available on this site.
The authors argue that the hidden infections found in all root canal treated teeth may be one of the largest contributory factors to the causation of diseases such as cancer and heart disease and that many – if not most – medical conditions get their start in the dentist’s chair. They maintain that routine procedures that are performed every day either initiate or may worsen most medical conditions.
Whilst infected root filled teeth are not the only source of dental infections, which may also arise from periodontal or gum disease, cavitations (holes which may form in the jaw bone further to tooth extraction), abscesses and dental implants, they have been consistently linked with serious medical consequences. The link between gum disease and a variety of disorders including heart disease, strokes and preeclampsia in pregnant women is now well established, but this has only been relatively recently accepted. However, at present, the dangers posed by root canal treated teeth remain either unacknowledged or actively rejected by the majority of the dental profession.
The authors counsel us to appreciate the money trail when understanding why things work the way that they do. If dentists in general and endodontists (who are dentists that have specialised in root canal treatments) in particular acknowledged the problems posed by root canal treatments they would have to stop doing them. This would have massive repercussions and consequences upon their livelihoods and dental practice. It is also very difficult medico-legally not to offer what is widely accepted best practice and certainly takes a lot of one-to-one explaining of why you adopt a different approach. I wonder if the medieval barber surgeons who refused to bleed their patients had the same problem.
In the 1960s US dentists performed nearly 3 million root treatments per year, by 1990 that figure had risen to 40 million per year and in 2002 there were estimated to be more than 50 million per year. Other similar increases have occurred and continue to occur throughout the rest of the world with a slight time lag. This has coincided with chronic and degenerative diseases that used to be the province of old age appearing earlier and earlier in life and the advent of many illnesses which appear to be ‘mysterious’ in that they have no clear diagnosis or cause.
In order to understand the problems posed by root canal treatments you need first to understand a little about the structure of the tooth and what a root treatment is.
The structure of the tooth
The bulk of the tooth is composed of a tubular structure known as dentine. In the visible part of the tooth (the crown) this dentine is covered in a heavily mineralised layer of enamel. Below the gum, the dentine is covered in cementum which anchors the periodontal ligament fibres that suspend the tooth roots within the jaw bone. The dentine encases the pulp of the tooth which comprises the blood, lymphatic and nervous supply to the tooth as shown below.
The dentine is composed of millions of tiny tubules that radiate outward from the pulp to the enamel or cementum junction. In health, each of these dentinal tubules is occupied by an odontoblast which originally formed the tooth and some believe continues to maintain the tooth structure thereafter. The processes of the odontoblasts may extend through some or most of the thickness of the dentine.
In fact, dentists use the tubular nature of dentine to be able to bond plastic materials on to the tooth by chemically cleaning the surface and then applying a fluid resin which locks into the tubules when set with a light.
What is a root canal treatment?
Root canal treatments are usually performed in response to an irreversible inflammatory process that takes part within the pulp of the tooth. This is most often caused by the bacteria and toxins that cause dental decay, but may also be caused by trauma or by a cracked tooth.
A cracked tooth is a tooth that has a hairline crack (often in turn caused by a dental amalgam fillings swelling) but has not broken. They can be painful to bite on at certain angles but the pain can be relieved when the teeth are not in contact. In such circumstances, bacteria from the mouth along with other substances can leach into the pulp of the tooth and the crack itself can also cause mechanical trauma.
Alternatively, the patient may present with an abscess (an infection around the tip of the root of the tooth) or a chronic infection may become apparent on an x-ray (often a granuloma ie: an area of fibrous, infected and inflammatory tissue) and this may be asymptomatic.
Whatever the cause, the inflammatory process within the pulp of the tooth effectively strangles the blood supply creating a necrotic pulp which can then act as a breeding ground for the bacteria which may have caused the pulp to die in the first place. Within the pulp which now has no circulation, bacteria can multiply and leach toxins and microbes from the ends of the roots.
When a dentist performs a root canal treatment they clean out the decay and create access to the pulp through the top (in the case of a molar or bicuspid/premolar tooth) or back of the tooth (in the case of an incisor or canine tooth). They then use either hand instruments or various ultrasonic or rotary devices to mechanically clean out the necrotic tissue and they ream the canals to create a uniform canal that they can then fill.
They use irrigation to flush and clean the canal system and wash away debris created by filing the canals. They may place an antiseptic paste within the canal system in the hopes of sterilising the inside of the tooth and place a temporary filling and complete the treatment at a later appointment or complete it in one visit.
The canals are then filled with a rubber-like material called gutta percha which is usually used along with a sealing material. This can be achieved by means of manually condensing points into the canal with a long probe-like instrument, or by heating and injecting the gutta percha with the goal of having it flow within the root canal system.
Continued in Book Review: The Roots of Disease 2.