Dr. Nammy talks about root canals, including what they are, how they are caused, and why a root canal should be a last resort, not a first option.
John Maher: Hi, I’m John Maher, and I’m here today with Dr. Nammy Patel, founder of Green Dentistry in San Francisco, California, helping patients recognize the vital connection between dental health and whole body health, and author of the best-selling book, Age With Style, guide to a youthful smile and healthy living. Today our topic is root canals. Welcome, Dr. Nammy.
Dr. Nammy Patel: Hi John, thank you for having me.
What Is a Root Canal?
John: Sure. So it’s almost a joke now when somebody might say, “Oh, I had this terrible day.” Or, “My life is falling apart.” And then somebody will say, “Well, at least you didn’t have a root canal.” Right? A root canal is this almost a synonym for the worst thing that you could have. The worst thing that could happen to you. Why is that? What is a root canal?
Dr. Nammy: Oh gosh, John. So a root canal is a dead tooth, so I can see why patients feel like that, or someone may say it’s the most horrific experience in the world. And to be honest, who wants drills, fills, and a big bill at the end of the day, right? Which is synonymous with a root canal.
Dr. Nammy: Because they tend to be very costly, they tend to be painful, and they need a lot of numbness, sometimes some antibiotics. It used to be multiple procedures. So it used to be you had to go in two or three times to get this done. So it definitely was a gruesome, awful experience for patients.
What Causes a Root Canal?
John: And so what causes the problem that then results in having to have a root canal done?
Dr. Nammy: So what a root canal is a cavity that has gone too big and it’s infected the nerve. So it is the last resort to save a tooth. And actually it can happen from … Can break a tooth, can have a big cavity in the tooth, you can also have trauma to the tooth, and in that require a root canal, but it is our last measure to save a tooth.
And what a root canal really is, is that a dentist, a specialized dentist called an endodontist who is somebody I prefer to have do the procedure, they go in, and they go in with really fine instruments, and they remove all the infection that is infected the root of the tooth. They have to use these special instruments that are curvy and really fine to make sure that they get all the microscopic areas, and make sure all the bacteria is removed. Once the bacteria is removed, what they do is they plug it with a rubber-like material called gutta-percha, and that is necessary in order to make sure that the root doesn’t get infected again. And again, it is the last measure to save a tooth so you don’t have to pull it.
Why Is a Root Canal a Last Resort?
John: On your website, you say that a root canal should be a last resort and not a first choice. Why is it that the root canal is the last resort?
Dr. Nammy: So John, I’m a big fan of you keeping your teeth, and your natural teeth, and your teeth that are alive and well, that is my goal. And when you have a root canal tooth or a dead tooth, it functions normally, and it looks normal, the only thing is that it becomes brittle. And when they’re brittle, they tend to break. And if they break, you have to pull the tooth out, and then you have to get it replaced with an implant. The other thing is if the root canal is not done properly, remember earlier, I said I prefer the root canals to be done by a specialist called a endodontist, and they’re done underneath a microscope, and … You can really see the infection so you remove all of it.
If all of the infection is not removed, and if the rubber-like material is not placed correctly, what happens is that it can get reinfected. And if it can get reinfected, it causes a lot of other issues. The bacteria can go up to your brain and cause damage. The other thing is there’s a sealer material that is used to place or complete the root canal with the rubber-like material to feel it in place, and if a lot of sealer is used, and it actually goes out into the body, it can be linked to a lot of other concerns like breast cancer, and cancer of a lot of other things. Alzheimer’s, things like that.
So, I am in the business of helping people keep their natural teeth, and I like teeth that are alive and well. And if I had to get a root canal done, I would make sure that it would be done with a specialist who uses lasers, and who uses really good techniques to make sure that the minimal amount of sealer is used. Because now there are techniques that are available with technology, they can actually melt the rubber-like material and put it into the tooth, so none of that toxic sealer is necessary, which makes me feel more confident and more comfortable if I need to get a root canal done that it is done properly.
John: Do you have people sometimes come in to see you, thinking that they’re likely going to need to have a root canal done? And then when you look at it, you’re able to save that tooth somehow? What is it that you do to avoid having to do the root canal, if you can?
Dr. Nammy: Absolutely, I have patients all the time. A lot of times they think they need a root canal and they don’t, which is awesome. I have lasers in my process that I can use, and materials in my process to induce something we call reparative dentin. So, when there’s a root canal the tooth is irritated, and the nerve is irritated, so I have chemicals and natural products and also lasers, what we do is we purposely irritate the nerves so it creates a barrier. Then that’s called reparative dentin. That is kind of like a callus. So we create this reparative callus-like material that is more protective to the nerve, and helps heal the nerve naturally, and gives you a longer-lasting tooth, which is wonderful to be able to have.
When Is a Root Canal Absolutely Necessary?
John: And then when is the root canal absolutely necessary? When do you know that?
Dr. Nammy: The root canal is absolutely necessary if there’s throbbing pain, if I can see that their infection has spread all the way down to the apex of the tooth, which is the tip of the tooth, or the roots. And sometimes if we have something called, we call it internal resorption. So internal resorption means that the tooth starts eating itself away from the inside, and we don’t know why. A lot of time it’s from trauma, like for example, if you’re 12 years old, you fell and the tooth was hit, but you didn’t really see anything then. Then all of a sudden you’re in your forties, and your tooth starts hurting, or your tooth starts eating itself away, and the only way to get rid of that would be to do a root canal.
How is a Patient’s Tooth Shape and Function Restored?
John: Okay, and then what happens after a root canal is done, and how do you restore a patient’s tooth shape and function?
Dr. Nammy: And so, when we have somebody do a root canal, we actually work with endodontists that makes really small access holes, so a lot of times we can just kind put a filling on it, which is great, because then you could keep your natural tooth. Sometimes the decay is really large, and we have to put a crown on it. So a crown is a [inaudible] material, and we use biocompatible materials in order to make it look like a natural tooth, and it covers the top of the tooth so that you can chew comfortably, and it looks like a natural tooth, it looks like a natural tooth, it feels like a natural, which is great. And it’s done in about two hours, which is really easy and comfortable for patients.
John: You’re able to get the crowns done that same day?
Dr. Nammy: Yes, we are.
John: All right, that’s really great information, Dr. Nammy. Thanks again for speaking with me today.
Dr. Nammy: You’re welcome. Have a fabulous day, John.
John: Thank you. And for more information about Green Dentistry, visit the website at sfgreendentist.com, or call 415, 433, 0119.